fetal heart monitoring and CTG

Question 1

Variability

Answer 1

fluctuations in the fetal heart rate above base line

Question 2

Absent variability
* Minimal :
* Moderate
* Marked

Answer 2

Absent variability : Amplitude range undetectable
* Minimal : = < 5 BPM
* Moderate = 6 to 25 BPM (normal ) * Marked > 25 BPM

Question 3

Accelerations in >32 weeks

Answer 3

abrupt increase in FHR above baseline , >15 BPM above
baseline for > 15 seconds twice in 20 minutes

Question 4

Decelerations:

Answer 4

is an abrupt decrease in FHR below baseline , >15 BPM below
baseline for > 15 seconds

Question 5

early deceleration relation to contraction

Answer 5

*symmetric to contraction
*nadir of deceleration corresponds to peak of contraction
*gradual(>30 sec from onset to nadir )

Question 6

early deceleration etiology

Answer 6

*fetal head compression
*can be normal

Question 7

variable deceleration relation to contraction

Answer 7

*not necessarily related with contractions
*abrupt (<30 sec from onset to nadir )
*

Question 8

variable deceleration etiology

Answer 8

*cord compression
*oligohydramnios
*cord prolapse

Question 9

late deceleration relation to contraction

Answer 9

*delayed compared to contraction
*nadir occurs after peak of contraction
*gradual > 30 sec from onset to nadir

Question 10

late deceleration etiology

Answer 10

uteroplacental insufficiency

Question 11

fetal heart rate tracing patterns
of category 1 (normal) and its management ?

Answer 11

all of the followings are required:
*baseline 110-160
*moderate variability (6-25)
*no late/ variable decelerations
* +/- early deceleration
*+/- acceleration

**its normal nothing to manage

Question 12

fetal heart rate tracing patterns
of category 2 and its management ?

Answer 12

not category 1 or 3 (interminate)
*we manage it by observation

Question 13

fetal heart rate tracing patterns
of category 3 and its management ?

Answer 13

1 or more of the following:
* absent variability + recurrent late deceleration
*absent variability + recurrent variable deceleration
*absent variability +bradycardia
+sinusoidal pattern (fetal anemia)

*** management :
its an emergency
but first we try to stabilize patient by: stopp oxytocin , fluids ,left cubits position then sent her to emergency