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Flashcards in Electronic Fetal Monitoring Deck (6)
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1
Q

What are examples of electronic fetal monitoring (EFM)

A

Continuous Fetal heart rate = indirect measure of fetal oxygenation of almost all births

  • also determines fetal hypoxia/acidosis during labor
  • reduces hypoxic-ischemic encephalopathy, CP and fetal death rates
  • *must compare it to the uterine contractions**
  • dark vertical lines =1 min apart
  • light vertical lines = 10 seconds apart
2
Q

Uterine activity in EFM

A

Contractions

  • frequency (time from one contraction to the next (should be equal to or less than 5 contractions in 10 minutes)
  • Duration of contractions (length of time of one contraction to the next in seconds)
  • Intensity (mild, moderate or strong rating based on what you feeling during palpation)
  • resting tone between contractions (rated soft or hard based on what is felt on palpation)
3
Q

Baseline heart rate for FHR on EFM

A

Appreciate mean FHR rounded to increments of 5 bpm during a 10 minute window
- exclude accelerations or decelerations

Normal = 110-160 bpm

Bradycardia = <110
- anemia, dehydration, cardiac anomalies, hypoxia

Tachycardia = > 160
- hypotension, hyperthermia, hypoglycemia, cord compression, hypoxia

4
Q

Special examples of baseline HR in FHR measurements with EFM

A

Absent = amplitude range is undetectable

  • metabolic acidosis
  • EMERGENT DELIVERY needed

Minimal amplitude
- causes = corticosteroid use, general anesthesia, hypoxia, magnesium sulfate use, prematurity

Marked amplitude (amplitude range > 25 bpm) 
- hypoxia and excessive stress 

Sinusoidal amplitude (looks like constant sine waves for HR)

  • severe fetal anemia/hypoxia (often is placental abruption)
  • EMERGENT DELIVERY
5
Q

Accelerations of EFM

A

Indicates adequate central fetal oxygenation, fetal movement, predict absence of fetal hypoxia and acidemia

> 32 weeks = at least 15 bpm above baseline is normal
(15 x15)

< 32 weeks = 10 bpm for 10 seconds is normal
(10 x 10)

6
Q

Common interventions to abnormal EFM

A

Change maternal position to maximize uterine blood flow

Give oxygen 10 LPL in hypoxic

Give fluid bolus of 500 mL

always call for an OB team and NICU team to prepare for emergent delivery if needed

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