Fetal Monitoring & Assessment Flashcards

(36 cards)

1
Q

Normal HR variability in the fetus is a reflection of what?

A

intact neurological modulation

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2
Q

The loss of HR variability in the fetus is the single most reliable sign of what?

A

fetal compromise

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3
Q

What medication is most associated with a decrease in fetal HR variability?

A

narcotics

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4
Q

What is normal fetal HR acceleration at 32 weeks or more?

A

15 beats for 15 seconds

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5
Q

How is fetal bradycardia defined?

A

fetal HR < 110 bpm for a 10 minute period

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6
Q

fetal bradycardia is associated with mother’s who have this systemic disease.

A

Lupus

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7
Q

How is fetal tachycardia defined?

A
  • mild = 161-180

- severe = >180

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8
Q

When does an early deceleration begin and end?

A

begins with the onset of contraction and ends with its completion

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9
Q

What is the cause of variable decelerations?

A

cord compression

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10
Q

What is the most common periodic change in the fetal HR in labor?

A

variable deceleration

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11
Q

When does a late deceleration begin?

A

begins 20-30 seconds after the contraction

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12
Q

What is the cause of late deceleration?

A

uterine-placental insufficiency

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13
Q

What is the cause of early deceleration?

A

head compression causes a vagal stimulation

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14
Q

These 2 criteria must be met for internal fetal HR monitoring to be done.

A
  • fetal membranes must be ruptured

- cervix must be partially dilated

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15
Q

A patient is doing well and has no significant findings. She can proceed with labor as tolerated. What category is she under for classifications of fetal tracings?

A

Category 1

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16
Q

This category is associated with abnormal tracings and abnormal fetal acid-base.

17
Q

This category is indeterminate. It requires further evaluation and continued surveillance.

18
Q

What is a normal finding on a scalp stimulation test?

A
  • stimulation of the fetal scalp with constant pressure results in an increase in FHR by 10 bpm
19
Q

What is the goal of antepartum fetal surveillance?

A

identification of suspected fetal compromise before progressive metabolic acidosis leads to fetal death

20
Q

What is a normal finding on a non stress test?

A

2 accelerations of the FHR > 15 bpm above the baseline lasting at least 15 seconds within 20 minutes

21
Q

What is a positive test on a contraction stress test?

A
  • repetitive late decelerations following 50% or more of the contractions
22
Q

What is a contraction stress test done for?

A

assess if a vaginal delivery attempt can be undertaken

23
Q

A biophysical profile looks at these 4 factors.

A
  • fetal breathing
  • fetal movement
  • fetal tone
  • amniotic fluid volume
24
Q

What is a biophysical profile?

A
  • ultrasound evaluation for fetal well being
25
What biophysical profile score is considered normal? What biophysical profile score is considered abnormal?
- normal = 8/8 | - abnormal = 4/8
26
Potter's syndrome aka renal agenesis is associated with what amniotic fluid abnormality?
- oligohydramnios
27
How is oligohydramnios defined?
an amniotic fluid index <5 cm or a max vertical pocket <2 cm
28
How is polyhydramnios defined?
- amniotic fluid index >24cm | - max vertical pocket >8cm
29
What is the most common cause of MILD polyhydramnios?
idiopathic
30
What are the 5 causes of polydramnios?
- fetal malformation (most GI) - twin-twin transfusion - hydrops fetalis - DM - idiopathic
31
A normal umbilical cord consists of how many arteries and veins?
2 arteries and 1 vein
32
When is a single umbilical artery diagnosed?
at the time of second trimester ultrasound
33
Doppler studies are used to assess what?
placental function
34
What should you do if the fetal tracings are a category III?
prompt delivery!
35
What should you do if the fetal tracings are a category II and the fetus responds to scalp stimulation?
continue surveillance
36
What should you do if the fetal tracings are a category II and the fetus does not respond to scalp stimulation?
consider delivery