week 7 Flashcards
Interpretation CTG
Registration of contractions, foetal heart rythm; decelerations, accelerations, variability, baseline heartrate (most important).
What are the signs of hypoxia?
Complicated variable decelerations with a average of > 60 sec. Also no accelerations and missing variability.
What four factors are important in the fysiology of the fetal heart rythm?
Baroreceptors, chemoreceptors, SA node and autonomic nervous system
Why do decelerations exsist?
Are a protection mechanism of the heart, by putting down the HF -> less oxygen needed. If the heart muscle relaxes, the coronary arteries will open up > more oxygen heart.
What are the 3 stages of oxygen shortage?
- Hypoxemia: days-weeks. The growth decreases, even as the movement.
- Hypoxia: hours. Less oxygen to perifere. Central organs get enough oxygen.
- Asphyxia: Also less oxygen to the central organs. Takes 18 minutes.
What are the 3 central organs?
Brain, adrenal glands and heart.
What is MOTHERS? and what is the most important factor?
Causes for less oxygen. Meconium stained fluid Oxytocin! most important Temperature mother Hyperstimulation Epidural Rate of progress in labour Scar
What are the 3 steps you take when the spiral arteries remain closed?
- Stop oxytocin
- Give tocolyse: stops contractions
- Call OK
What is the ABCDE of hypoxia?
Starts with decelerations. A. accelerations will disappear B. Baseline increases C. Compensated stress D. Decompensation E. End stage (myocard failure)
What are the three types of hypoxia?
- Gradually evolving: takes hours
- Subacute: More decelerations. No baseline. Takes 30-60 minutes. pH decreses 0.01 every 3-6 minutes.
- Acute: sudden decrease of fetal heart rate> 3 minutes. pH decreases every minute.
What are causes of acute asphyxia?
Schoulder dystocia, uterine rupture, cord prolaps, placental abruption.
What is perinatal asphyxia?
Failure of gas exchange and blood supply, leading to hypoxia. 80% survives, of the 80%, 25% has severe impairment.
What are the phases of asfyxia?
- Primary energy failure: Important organs don’t get blood > neural damage
- Latent phase: 6 hours, body tries to function again; also brings slechte stoffen.
- secondary energy failure: reperfussion, inflammation, accumulation of harmfull neurotransmitters, oxidative injury, apoptosis, edema.
What does cooling do in asphyxia?
You want to start whithin 6 hours. If you bring down the temperature > less free radicals, inflammatory cascade, reduction of NO synthesis, inhibition of apoptosis. You cool core temperature > whole body
What are the side effects of cooling?
Sinus bradycardia, thrombocytopenia, more use iontropic drugs, persistent pulmonary hypertension, risk of sepsis, subcutaneous necrosis, slower metabolism.
