OGCO-C3.4 Intrapartum monitoring

Question 1

What is the FHR monitoring rate during labor if no machine?

Answer 1

Every patient in labour should have a chart recording the fetal heart rate at least half-hourly except when the fetal heart is monitored continuously by machine.
During 2nd stage of labor, FHR auscultated every 5 mins unless it is monitored by machine.

Question 2

What are the indications for continuous fetal heart monitoring (CFHM) during labor)?

Answer 2

Question 3

How to classify normal, suspicious or pathological CTG?

Answer 3

Question 4

Define early, late and variable decelerations

Answer 4

• Early decelerations: repetitive and periodic slowing of the fetal heart rate with onset early in the contraction and return to baseline at the end of the contractions
• Late decelerations: repetitive and periodic slowing of the fetal heart rate with onset at mid to end of the contraction and the lowest point more than 20 seconds after the peak of contraction and ending after the contraction
• Variable decelerations: intermittent and periodic slowing of the fetal heart rate with a variable time in relation to the contraction

Question 5

How to manage if normal, suspicious, pathological or urgent intervention needed based on CTG?

Answer 5

Question 6

When would fetal blood sampling be done?

Answer 6

• If abnormal FHR detected by CFHM and delivery is not imminent
• However, in case of persistently abnormal or pathological FHR pattern, repeated fetal blood sampling may result in delay of appropriate intervention i.e. prompt delivery.

Question 7

What is the contraindications to fetal blood sampling?

Answer 7

• Maternal infections which predispose to the risk of maternal to fetal transmission, suspected fetal bleedifng disorders, or prematurity (gestation <34 weeks)

Question 8

Procedure of PBS?

Answer 8

Question 9

Dx and Mx of fetal blood sampling>

Answer 9