Antenatal Monitoring

Question 1

Guidance for kick counts?

Answer 1

10 in 2 hours

Question 2

When do kick counts peak?

Answer 2

9pm-1am

Question 3

What is a decrease in fetal movement a sign of?

Answer 3

Hypoxemia

Question 4

What is normal fetal heart rate?
Tachy?
Brady?

Answer 4

120-160
>160
<110

Question 5

How long is a baseline

Answer 5

Over 10 minutes

Question 6

How was the baseline named?

Answer 6

In increments of five

Question 7

What is absent variability?

Answer 7

Zero bpm and a straight line

Question 8

What is minimal variability

Answer 8

1 to 5 bpm In the baseline

Question 9

What is moderate variability

Answer 9

5 to 25 bpm in the baseline

Question 10

What is marked variability

Answer 10

Greater than 25 bpm in the baseline

Question 11

What is an acceleration at greater than 32 weeks gestational age

Answer 11

15 bpm above baseline for 15 seconds in duration

Question 12

What is an a celebration at lesson 32 weeks gestational age

Answer 12

10 bpm for a 10 second duration

Question 13

What is a prolonged acceleration

Answer 13

Greater than two minutes but less than 10 minutes

Question 14

What is a baseline change

Answer 14

Greater than 10 minutes

Question 15

What is an early deceleration

Answer 15

It mirrors the contraction and starts and ends with a contraction

Question 16

What is an early deceleration a sign of

Answer 16

Had compression and a vagal response

Question 17

What is a variable deceleration

Answer 17

V or W shaped
that may or may not be associated with a contraction
Less than 30 seconds to nadir

Question 18

What does a variable deceleration show

Answer 18

Partial cord occlusion leads to a decrease in venous return which causes
baroreceptor mediated acceleration in HR → Hypertension and decreased arterial
oxygen tension

Cord compression

Question 19

What is a late deceleration

Answer 19

Starts after a contraction and ends after a contraction

Question 20

What does a late deceleration mean

Answer 20

Fetus vasoconstricts → baroreceptor response → decrease in HR

Utero-placental insufficiency

Hypertonus and hypotension

Question 21

What are the interventions for recurrent variable decelerations

Answer 21

Side to side positioning 
knee to chest position 
IVF bolus
turn off the oxytocin 
02 by facemask 
tocolytics 
amnioinfusion

Question 22

Describe the contraction pattern in minutes

Answer 22

q3 to 5 minutes
Quiet or none
Irritable

Question 23

What does tocometry measure

Answer 23

The timing of contractions

Question 24

What do you need to have a place to measure contraction strength

Answer 24

IUPC

Question 25

How many Montevideo units is an adequate contraction

Answer 25

Greater than 200

Question 26

What is tachysystole

Answer 26

More than five contractions in 10 minutes

Question 27

How do you treat tachysystole

Answer 27

Terbutaline

Question 28

What is a reactive NST

Answer 28

<32 Weeks - 2 accels of 10 beats/minute above baseline for 10 seconds duration >32 weeks - 2 accels 15 beats/minute above baseline for 15 seconds duration Do this for 20 minutes

Question 29

What is the most common cause of a non-reactive NST

Answer 29

Fetal inactivity or feet of sleep

Question 30

Next step if NST is non-reactive after 40 minutes

Answer 30

BPP

Question 31

What is a contraction stress test and how is it done

Answer 31

Place mother in semi Fowler’s position and stimulate contractions 3 contractions in a 10 minute period lasting 40-60 seconds are stimulated

Question 32

What is a negative contractions stress test What is a positive contraction stress test What is an unsatisfactory contraction stress test

Answer 32

No late or variable decelerations Late decelerations with at least half of the contractions Lesson three contractions in 10 minutes

Question 33

When should you avoid a contraction stress test

Answer 33

Placenta previa or a previous classical cesarian

Question 34

What does a biophysical profile show And how long does it last

Answer 34

Fetal acid-base status and intact CNS Can last up to 30 minutes

Question 35

How is the BPP scored

Answer 35

Two points for each category max of 10

Question 36

Name all of the categories in the BPP

Answer 36

Gross body movements: Three body movements in 30 minutes Fetal Tone: One episode of extension with return to flexion Amniotic fluid volume: A pocket that is 2 x 2 Fetal breathing: One episode of more than 30 seconds A reactive NST

Question 37

How to manage a score of eight or 10

Answer 37

Repeat at weekly or biweekly intervals

Question 38

What to do with a score of six

Answer 38

It greater than 36 weeks repeat in 4 to 6 hours. Deliver if oligohydramnios

Question 39

What to do with the score of four

Answer 39

If >36 weeks, deliver. If <32 weeks, repeat score.

Question 40

What to do with a score of 0 to 2

Answer 40

Extend to 120 minutes deliver if persistent

Question 41

What is a modified BPP

Answer 41

It is a reactive NST and then AFV with a 2x2 pocket