Intrapartum Management Flashcards Preview

Third year shit > Intrapartum Management > Flashcards

Flashcards in Intrapartum Management Deck (14):

What kind of things do you monitor?

- Fetal movement (min 10 movements over 2 hr time). Decreased movement suggests baby is under stress

- Monitoring HR and fetal activity = Non Stress test. (Nonreactive = normal)
- Contraction stress test (older) - see how baby responds to induced contraction. If no stress with 3 contractions in 10 min.

- Biophysical profile: combined US with monitoring fetal HR tracing. Measure fetal HR, fluid, fetal movement, fetal tone, fetal breathing motion. Rated on a 1- pt scale, 2 pts per measurement. Good = 8-10/10

- S/D ratio

** False positives


What does fetal monitoring measure and name the 2 types

Assesses baseline, variability, accelerations, decelerations

External: Indirect, doppler ultrasound
Internal: directly applied scalp electrode; need to be dilated enough


ways to monitor contraction

External: Indirectly monitor via abdominal pressure electrode

Internal: Direct (IUPC)
- hollow tube next to baby's head in space around baby's body; measures intrauterine pressure. Membranes have to be ruptured and need to be dilated enough to fit tube in.
- assess how often and how intesnse
- increased risk of infection


How to assess fetal heart rate

Rate, variability, accelerations , deceleration


Normal baseline HR

- Determined based on 10 min window


What is considered normal, moderate variability in HR?

6-25 variability


Do you want variability in HR

you want moderate variability. Don't really like No/minimal variability. Absent pretty bad.


What do variable decelerations look like

- like "V"---abrupt decrease in HR
- usually near contraction
- can be due to cord compression/interruption in blood flow
- healthy baby can tolerate this.
- see more often if low fluids


What is an amnioinfusion

hook up NS infusions into pressure catheter; may help with oligohydramnios and keep cord floating/not compressed
- too much will cause uterine rupture
- only indicated to help with variable decelerations


What are Early decelerations

gradual deceleration where lowest point of deceleration correlated with peak of contraction.


What are late decelerations

- gradual deceleration after contraction
- lowest HR after peak of contraction.
- fetal response to hypoxemia during contraction.
- Decreased maternal perfusion during contraction of intervillous space, so less blood to capillaries
- BP goes up due to vasoconstriction from hypoxemia, so HR goes down in resopnse


What can you do for fetal Supraventricular tachy

give beta blockers, they cross placenta


What does a sinusoidal pattern indicate on fetal HR tracings



What does terbutaline do

Stops contractions