Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
24 Cards in this Set
- Front
- Back
|
27. What conditions may cause fetal bradycardia?
|
1. Maternal hypothermia
2. Certain medications given to the mother 3. Congenital heart block 4. May be a sign of fetal stress. |
|
|
28. Short-term (or beat-to-beat) variability?
|
a. The change in fetal heart rate from one beat to the next
b. It can only be accurately determined when an internal scalp electrode is placed c. Normal short-term variability: 6-25 beats/min. |
|
|
29. Long-term variability?
|
a. Is the waviness of the baseline heart rate over 1 min., with normal oscillations occurring at a rate of 3 to 5 cycles per minute.
b. As variability is largely a manifestation of the autonomic nervous system anything that affects the nervous system functioning can affect it. |
|
|
30. Common causes of decreased variability?
|
a. Fetal sleep cycles
b. CNS depressant drugs (such as narcotic analgesics) c. Congenital neurologic abnormalities d. Prematurity e. Fetal acidemia 2° to hypoxemia can impair CNS function and reduce variability. |
|
|
31. What is the presence of normal variability may come unlikely?
|
a. Fetal acidemia
|
|
|
32. What are periodic heart rate changes (accelerations and decelerations) from the baseline often related to?
|
a. Uterine contractions
|
|
|
33. Acceleration?
|
a. An increase in the fetal heart rate of 15 bpm or more for 15 seconds or longer.
b. It is a reassuring finding |
|
|
34. What does an early deceleration coincides with?
|
a. In early deceleration coincides with the contraction in onset of the fetal heart rate decline and return to baseline.
|
|
|
35. Significance of early decels?
|
a. Early decels are thought to be the result of increased vagal tone caused by compression of the fetal head and are not associated with fetal hypoxia or acidemia
|
|
|
36. Late decelerations?
|
a. Late deceleration is a gradual reduction fetal heart rate that starts at or after the peak of the contraction and has a gradual return to the baseline.
|
|
|
37. Significance of late decelerations?
|
a. Late decelerations are manifestation of uteroplacental insufficiency and can be caused by numerous circumstances such as:
1. Maternal hypotension (as is often seen with epidural anesthesia in uterine hyperstimulation caused by oxytocin administration). |
|
|
b. Conditions that impair placental circulation such as:
|
i. Maternal hypertension
ii. Diabetes iii. Prolonged pregnancy iv. Placental abruption |
|
|
38. Variable deceleration?
|
a. A variable deceleration is an abrupt ↓ in fetal heart rate, usually followed by an abrupt return to baseline that occurs variably in its timing, relative to a contraction.
b. They are the most common type of decelerations. |
|
|
39. Significance of variable decelerations?
|
a. Variable decelerations are due to umbilical cord compression during contractions.
b. Variable decelerations, particularly when there is also presence of normal variability and acceleration, are usually not associated with fetal hypoxemia. |
|
|
40. How may contractions that are inadequate in frequency or power be augmented?
|
a. With an oxytocic agent.
b. IV oxytocin is the drug of choice, as is effective, inexpensive, and those practitioners are familiar with its usage |
|
|
41. Half-life of oxytocin?
|
a. Oxytocin has a short half-life, which allows it to be given by continuous infusion and allows for the rapid cessation of its activity when it is discontinued.
|
|
|
42. Uterine hyperstimulation?
|
a. Presence of 6 or more contractions in a 10 min period that causes nonreassuring fetal heart rate abnormalities (such as late decelerations).
b. Uterine hyperstimulation can be a side effect of oxytocin. |
|
|
43. Management of uterine hyperstimulation?
|
a. Reduction in dose or discontinuation of the oxytocin
b. Repositioning of the patient c. Providing oxygen via facemask to the mother |
|
|
44. 4 Cardinal movements of labour?
|
1. Flexion: (During initial descent)-bringing the fetal chin to the chest.
2. Internal rotation- causing the fetal occiput to move anteriorly toward the maternal symphysis pubis. 3. Extension-occurs in the head approaches the Vulva. 4. External rotation-further extension leads to delivery of the head, which then restitutes via External Rotation to face either the maternal right or left side. |
|
|
45. Shoulder dystocia?
|
a. Occurs when the anterior shoulder will not pass readily below the pubic symphysis.
b. Is obstetrical emergency, requirements for new effort by the entire medical team reduce the dystocia. |
|
|
46. Treatment of shoulder dystocia (maneuvers)?
|
a. Hyperflexion of the hips (McRoberts maneuver)
b. Suprapubic pressure c. Cutting episiotomy d. Rotation of the fetal body in the vaginal canal |
|
|
47. What are the most common indications for a C-section?
|
a. Prior cesarean delivery
b. Arrest of labour or descent c. Fetal distress necessitating immediate delivery d. Reach presentation |
|
|
48. Pearl note: the presence of accelerations only fetal heart rate tracing is very reassuring and consistent with fetal pH of 7.2 or more.
|
48. Pearl note: the presence of accelerations only fetal heart rate tracing is very reassuring and consistent with fetal pH of 7.2 or more.
|
|
|
49. Complete.
|
49. Complete.
|
