Week 9 pt 1 highlights Flashcards
(49 cards)
List 4 parts of fetal surveillance
1) Non-stress Test
2) Biophysical Profile
3) Oxytocin Challenge Test (Contraction Stress Test)
4) Kick counts
What is the goal amount of kick counts?
> 10 movements/2hrs
Kick counts:
1) By ______wks, movement should be felt (but varies)
2) If mom perceives _________________ fetal movement, further testing should occur.
1) 20wks
2) decreased
1) Fetal Heart Rate Auscultation should be done with a ___________ by the 8th week
2) After 16 weeks, use __________________.
3) Do a ________________ by the 18th week
1) doppler
2) external fetal monitor
3) fetoscope
Baseline fetal HR auscultation must be for a minimum of __________ mins in any 10min segment
2 mins
1) The most common means of assessing the health and viability of the fetus throughout labor is what?
2) What does it track?
3) What testing is it used to perform?
1) External Fetal Heart Rate (FHR) Monitor
2) Tracks the variability in the fetal heart rate
3) Used to perform Non-Stress and Contraction Stress testing
Why is Intrapartum Fetal Surveillance Important?
An indirect measurement of indicators (like FHR) of fetal status (oxygenation) during labor
What is the only way to accurately assess the beat-to-beat variability of the fetal heart?
Scalp electrode
ONLY way to accurately determine the strength of a contraction is what?
Internal Pressure Catheter
Give 2 examples of internal fetal monitoring
1) Scalp electrode
2) Internal Pressure Catheter
Intrapartum Fetal Surveillance:
1) When can you start intermittent surveillance if there is a diagnosed underlying fetal or maternal issue?
2) Is it intermittent appropriate if low-risk labor?
1) Can start around 32weeks for >20min twice weekly (outpt)
2) May be appropriate for low-risk labors (*if staffing adequate)
What type of intrapartum fetal surveillance is standard practice in the US?
Continuous fetal surveillance
Define intrapartum
the time spanning childbirth from onset of labor through the delivery of the placenta
Contraindications to Intermittent Fetal Monitoring include what categories?
1) Maternal medical illness
2) Obstetric complications
3) No prenatal care
4) Tobacco use and/or drug abuse
Intermittent Fetal Monitoring: During labor, listen from the beginning of one ____________ to the beginning of the next _____________ to assess fetal wellbeing
contraction; contraction
Should convert to continuous monitoring if any suspicion of complications, BUT in the US, ______________ monitoring is standard of care
continuous
Do NOT Interpret FHR in Isolation; what are some groups of factors?
1) Timing
2) Size + Hx of complications
3) Clinical factors
4) Misc factors
Non-Stress Test (NST): Evaluation of the __________________ while the fetus is not placed under any stress
fetal heart rate tracing
Non-Stress Test (NST): Measures what 3 things for at least 20min to see how the baby is tolerating the pregnancy?
fetal heart rate, patterns, and accelerations
Non-Stress Test (NST): What is reassuring? What is not?
Reactive = reassuring
Non-reactive = non-reassuring
Equivocal = concerning
Non-Stress Test (NST): Does it require an IV, oxytocin, or contractions?
No, not required
Biophysical Profile (BPP):
1) What is it?
2) When is it done?
1) NST + ultrasound
2) To evaluate health of the fetus if there are concerns or if pregnancy is high-risk (during late 2nd or 3rd trimester for 30 minutes)
Biophysical Profile (BPP): What 5 things does it measure?
1) Variability (from NST)
2) Tone
3) Movement
4) Breathing movements
5) Amniotic fluid volume (AFV)
BPP:
1) 2 points are assigned for each __________ variable
2) What score is normal and reassuring?
1) NORMAL
2) Score of 8-10 with normal AFV
