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22 Cards in this Set
- Front
- Back
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Define abnormal fetal heart rate
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changes in the fetal heart rate pattern detected by either IA or EFM that suggest that there may be a physiologic response to the normal stresses of labour
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Define normal fetal heart rate
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baseline 110-160
variablity 6-25 bpm no late decels occasional uncomplicated variables or early decels spontaneous accelerations |
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Define Atypical fetal heart rate
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baseline 100-110 bpm or tachycardia short term
<5 bpm variability for 40-80 mins occasional late decels or single decel >2mins but <3 repetitive (>3) uncmplicated variable decels no accels |
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Define Abnormal fetal heart rate
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<100 bpm
tachycardia for long term erratic baseline minimal variability >80 mins |
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Associated Maternal Risk Factors (4)
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dehydration
intrauterine infection unterine rupture epidural |
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Associated fetal risk factors(4)
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congenital anomaly
significant anemia (isoimmunization) fetal hemorrhage (vasa previa) meconium |
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Risk factors associated with the umbilical cord (6)
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oligohydramnios
cord prolapse nuchal cord true knot short cord cord entanglement |
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Risk factors associated with the placenta
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gestatinal hypertention
placental abruption iugr chorioamnionitis |
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Indications for EFM
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meconium
maternal fever VBAC oxytocin IUGR gestational hypertension with proteinuria |
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Management of Abnormal Fetal Heart Rate
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Inform family of concern
change position maternal oxygen VE to assess change communicate coach tomodify breathing IV bolous stop oxytocin palpate contrations call for help monitor vitals draw blood document |
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management if birth is imminent
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facilitate birth
prep for nrp clamp and cut cord leaving several inches in order to facilitate umbilical catheter consider active management |
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define asphyxia
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pathological changes caused by lack of oxygen in respired air, resulting in a deficiency of oxygen in the blood (hypoxia) and an increase in carbon dioxide in the blood and tissues (hypercapnia)
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Rspiratory acidosis
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Respiratory acidosis is a condition in which a build-up of carbon dioxide in the blood produces a shift in the body's pH balance and causes the body's system to become more acidic.
uncommon to have secondary postnatal complications |
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Metabolic acidosis
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a pH imbalance in which the body has accumulated too much acid and does not have enough bicarbonate to effectively neutralize the effects of the acid
happens in 2% of deliveries long term sequelae more likely |
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Hypoxia
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reduction of oxygen supply to a tissue below physiological levels despite adequate perfusion of the tissue by blood
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hypoxic acidemia
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can occur anytime
includes various cerebral injuries mostly in the cerebral cortex at term |
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cerebral palsy
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chronic motor disorder of cerebral origin
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incidence of cerebral palsy
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2-3/1000
cord ph <7 & base deficit >12 early onset of severe encephalopathy CP of quadriplegia or dyskinetic type exclusion of other causes |
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what do cord gases do
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provide evidence of fetal oxygenation at birth
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Early decelerations
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a drop in FHR at the start of contraction and returns to baseline by the end
usually due to head compression |
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late decelerations
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drop in fhr that starts midway through contration and returns to baseline after the contraction has ended.
this is caused by reduced utero/placental blood flow and fetal hypoxia |
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variable deceleration
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non uniform in shape with sudden drops and accelerations anytime between/during contractions
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