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19 Cards in this Set
- Front
- Back
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Purpose of electronic fetal monitoring |
Asses fetal oxygenation and well being Cardiotocography - monitors have two major components - FRH and Uterine contractions |
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External vs Internal |
External = Doppler US transducer Internal - Fetal scalp electrode - uses cardiotachometer. |
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FHR is controlled by |
ANS. Preterm HR will be higher. |
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Fetal Asphyxia |
Low o2 states with baby=
1. maternal o2 decrease 2.inadequate UBF 3.Cord BF 4. Fetal pathology |
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Low O2 states causes |
1st compensatory mechanisms 2. decrease RR 3. anaerobic metabolism 4.prolonged end organ death |
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FHR interpretation ph relation |
Reassuring pattern pH> 7.25 Nonreassuring - HR up/down, variable decelerations w/ non reassuring pattern or late decelerations w/ preserved beat to beat variability PH 7.2 - 7.25 Ominous - Late decelerations with loss of beatot beat variability, prolonged sever bradycardia, sinusoidal pattern - ph<7.2 delivery recommended |
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pH interpretation |
Reassuring > 7.25 Nonreassuring 7.2 -7.25 Delivery now less than 7.2 |
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What to do with non reassuring pattern interventions |
O2 for mom Change position Fluids Vag exam and fetal scalp stimulation Determine need for urgent/STAT delivery (forceps/cesarean) |
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Normal Fetal HR |
110-150 |
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Tachycardia |
greater 150 -160 for ten minutes or a 30 bpm or more increase in the normal baseline rate for 10 minutes Causes: hypoxia, prematurity, parasympatholytic (atropine), sympathomimetics (terbutaline/ritodrine), Maternal fever, chorioamnionitis, mild fetal acidosis, and fetal infection. |
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Bradycardia |
Less than 110 for 10 minutes or a 30 bpm or more decrease in normal rate for 10 min or more. Causes: mild or non-asphyxia related - heart block, drugs like b-blockers, hypothermia, post-date, posterior presentation. can be academia related |
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Baseline Variability |
Normal is 3-25 bpm short r-r long term - over 1 minute Absent 0-2, Decreased or minimal 3-5, increased or moderate 6-25, marked 25+ |
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Variability |
Maternal meds, fetal sleep, preterm, hypoglycemia, fetal anemia, tachycardia, hypoxia. |
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VEAL CHOP |
V= Variable decelerations C= Cord compression E =early decelerations H= head compression A= Accelerations O= Okay L= Late decelerations P = Problem( uterine flow problem) |
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Accelerations |
transient increase in FHR - due to fetal movement usually. okay and good |
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Decelerations Variable |
Cord Compression - all over the place
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Early Decelerations |
Occuring at the same time as the contractions
Head compression, mirror contractions, benign. |
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Late Decelerations |
Uterine blood flow decreased Decelerations persisting after the contraction has finished tx improve uterine blood flow = left uterine displacement, oxygen, hydration, and decrease oxytocin |
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Sinusoidal |
ominous- associated w/ high rates of fetal M&M. regular smooth and undulating form with a frequency of two to five cycles per minute and amplitude range of five to 15 bpm. SEVERE FETAL ANEMIA> |
