8/26 Lecture

Question 1

What does the acronym of NR FHR mean?

Answer 1

Non reassuring Fetal Heart Rate

Question 2

What provides oxygen and nutrients to the fetus?

Answer 2

Umbilical vein

Question 3

What receives CO2 and waste from the fetus?

Answer 3

Umbilical artery

Question 4

If fetal hypoxia continues what can happen?

Answer 4

Metabolic acidosis
Damage to vital organs
Accumulation of lactic acid can lead to birth asphyxia
Permanent brain damage may result

Question 5

If the baby has respiratory difficulties, lack of tone, subnormal consciousness, seizures, what do you suspect?

Answer 5

Neonatal encephalopathy

Question 6

What type of cerebral palsy is associated with AP or IP asphyxia (ACOG say majority IP)

Answer 6

Spastic CP

Question 7

What type of cerebral palsy is more related to genetics?

Answer 7

Dyskinetic or ataxic CP

Question 8

What is a FSE?

Answer 8

Fetal scalp electrode

Used to monitor baby pulse rate

Question 9

What is normal baseline rate for baby?

Answer 9

120-160

Question 10

What is fetal bardycardia?

Answer 10

80-100 (if persists this is an ominous sign)

Question 11

What is fetal tachycardia?

Answer 11

Above 160

Question 12

What is a common reason for fetal tachycardia?

Answer 12

Chorioamnionitis

Question 13

Chorion faces who?

Answer 13

Mom

Question 14

Amnion faces who?

Answer 14

Baby

Question 15

What are 2 common side effects of epidurals?

Answer 15

Fevers can lead to tachy in the baby

maternal hypotension

Question 16

What is gentamycin toxic to?

Answer 16

The kidneys

Question 17

Why is heart rate variability important?

Answer 17

shows that there is both parasympathetic and sympathetic control

Question 18

Moderate variability (adequate oxygenation) is variability of how many bpms?

Answer 18

6-25 bpms

Question 19

What is marked variability?

Answer 19

> 25 bpm

Question 20

What is nonreassuring FHR variability?

Answer 20

Absent

Question 21

What is minimal feta heart rate variability (concerning, or baby could be asleep)

Answer 21

<6 bpm

Question 22

What is early decelerations?

Answer 22

Occurs early with UCs. can be due to head compressions, physiologic

Question 23

If late declarations are persistent, what do you want to think?

Answer 23

Uteroplacental insufficiency (which can lead to fetal hypoxia)

Question 24

What do variable deceleration indicate usually?

Answer 24

Umbilical cord compression

Question 25

How many babies are born with a cord around their neck?

Answer 25

1/3 of babies

Question 26

If there are persistent and deep FHR changes what can be done?

Answer 26

Amniofusion may relieve cord compression

Question 27

What category is reassuring for FHR?

Answer 27

Category I

Question 28

What category is worrisome with absent variability, recurrent late or variable decels, bradycardia.

Answer 28

Category III

Question 29

What category for FHR is concerning?

Answer 29

Category II

Question 30

What is the most used test where you rub the babies' head and the fetal heart rate increases.

Answer 30

Fetal scalp stimulation. Indicates that pH is about 7.2

Question 31

What does a tocolytic agent do?

Answer 31

Stop contractions for a moment, allows baby to get more oxygen

Question 32

What is the most common thing used to check fetal well being?

Answer 32

Non-stress test (NST)

Question 33

What do you want to happen in the non-stress test?

Answer 33

Baby to move twice within 15 minutes and both times the HR increases 15 above baseline

Question 34

What is thick, black, tarry substance in the fetal GI tract? Mixture of lanugo, vernix, bile, skin cells.

Answer 34

Meconium

Question 35

What is a sign of fetal stress in terms of amniotic fluid?

Answer 35

MSAF- Meconium-stained amniotic fluid (looks like pea soup)

Question 36

What is included in meconium aspiration syndrome (MAS)?

Answer 36

Pneumonitis Pneumothorax Pulmonary HTN

Question 37

How is meconium managed at birth?

Answer 37

Don't suction Observation if baby is vigorous look down airway with laryngoscope

Question 38

What should be done with a vigorous baby after it is born?

Answer 38

Dried off and placed on the mother's abdomen skin to skin

Question 39

Why is putting the baby on the mom's skin better?

Answer 39

Allows baby to stabilize- respirations, heart rate, glucose levels

Question 40

What is the minimal amount of time that baby should be left skin to skin?

Answer 40

1-2 hours

Question 41

what is a point system to score neuromuscular and physical maturity. Helps determine gestational age.

Answer 41

Ballard score

Question 42

Should alcohol or ointments be used when the cord is cut?

Answer 42

No, inhibits drying and falling off

Question 43

What is an opthalmic ointment used to treat gonorrhea in the birth canal?

Answer 43

Erythromycin

Question 44

When should the baby void and have a bowel movement within?

Answer 44

24 hours

Question 45

What type babies is hyperbilirubinemia more common in?

Answer 45

Near term (35-37 weeks)

Question 46

What is a drug that can be given for severe respiratory depression?

Answer 46

Narcan

Question 47

What cord gas will always look better?

Answer 47

Venous

Question 48

an UA pH less than what is the beginning of acidemia?

Answer 48

<7.20

Question 49

What can acidemia turn into

Answer 49

Acidosis then asphyxia

Question 50

What is responsible for neonatal mortality?

Answer 50

Preterm birth (Less than 37 weeks gestation)

Question 51

What is early pre-term labor?

Answer 51

23-26 weeks

Question 52

What cause the whole prostaglandin synthesis to be released leading to pre-term labor?

Answer 52

inflammatory cytokines

Question 53

What is induction of labor before 39 weeks?

Answer 53

Iatrogenic (not allowed electively anymore)

Question 54

what is the metabolic, active part of the uterus?

Answer 54

Decidual

Question 55

The signs and symptoms must be ____, predicts per-term labor.

Answer 55

Rhythmic

Question 56

Where does fetal fibronectin collect?

Answer 56

Posterior fornix of the women's cervix.

Question 57

What does the TVUS allow you to see?

Answer 57

Funneling. (amniotic sac pushing in on cervix)

Question 58

What other condition is associated w/ pre-term labor?

Answer 58

Bacterial vaginosis (BV)

Question 59

what is given for women who are at risk of pre-term labor

Answer 59

17- alpha-hydroxyprogesterone

Question 60

What weeks gestation should you give corticosteroids to enhance fetal lung maturity preventing RDS?

Answer 60

24-34 weeks

Question 61

What are some tocolytics?

Answer 61

Magnesium sulfate, nifedipine (earlier) | Indomethacin, terbutaline

Question 62

What length of the baby with give you an estimate of the gestational age?

Answer 62

Crown- rump length

Question 63

What is a main reasons for post dates?

Answer 63

Inaccurate estimation of gestational age

Question 64

What is a syndrome with growth restriction, dehydration, hypoglycemia, RDS? Babie's skin was peeling, look like old people

Answer 64

Dysmaturity Syndrome

Question 65

What is where AFI less than 5 cm, can lead to cord compression, placental insufficiency?

Answer 65

Oligohydramnios