Obgyn Ch 8 Intrapartum Fetal Surveillance

Front 1

Nonreassuring fetal status during labor occurs in approximately what percent of pregnancies?

Back 1

5 - 10%

Front 2

Which of the following is NOT a criterion suggestive of fetal asphyxia

Back 2

Heart rate acceleration NOT criterion for fetal asphyxia (criterion suggestive of fetal asphyxia: metabolic or mixed acidemia, persistent Apgar scores of 3 or below, and evidence of neonatal neurologic sequele)

Front 3

If a fetus experiences progressive and sustained hypoxia, the mixed metabolic and respiratory acidosis that may ensue typically results from

Back 3

anaerobic glycolysis

Front 4

The 1-minute Apgar for a newborn with a heart rate of less than 100, slow respiratory rate, flaccid muscle tone, a grimace, and blue color is

Back 4

3

Front 5

The 1-minute Apgar for a newborn with a heart rate of more than 100, good respiratory effort, active muscular activity, a good grimace, and pink color is

Back 5

9

Front 6

Intermittent fetal heart rate auscultation to monitor fetal well-being should be employed at least how often during the active phase of labor?

Back 6

Every 15 minutes

Front 7

Intermittent fetal heart rate auscultation to monitor fetal well-being should be employed at least how often in the second stage of labor?

Back 7

Every 5 minutes

Front 8

Baseline fetal tachycardia is defined as a heart rate greater than how many beats per minute?

Back 8

160

Front 9

The common cause of fetal tachycardia is

Back 9

maternal hyperthermia

Front 10

Baseline fetal bradycardia is defined as a heart rate of less than how many beats per minute?

Back 10

120

Front 11

A sinusoidal fetal heart rate pattern is frequently associated with

Back 11

Rh isoimmunization

Front 12

Fetal arrhythmias are seen in what percent of monitored labors?

Back 12

Less than 1%

Front 13

During fetal sleep, the fetal heart rate variability is

Back 13

decreased

Front 14

Which of the following was considered characteristic of the old term shortterm variability?

Back 14

all of the above (variation in amplitude seen on a beat-to-beat basis, amplitude of 3 to 8 bpm, normally encountered after approximately 28 weeks' gestation)

Front 15

The term "long-term fetal heart rate variability" was associated with an amplitude of

Back 15

5 to 16 bpm

Front 16

Accelerations of the fetal heart rate (FHR) are defined as an increase in the FHR above the baseline of at least how many bpm, usually of 15- to 20-second duration?

Back 16

15 bpm

Front 17

Accelerations of the FHR are associated with an intact fetal mechanism that is

Back 17

unstressed by hypoxia and acidemia

Front 18

If an observed FHR pattern is a mixture of two more patterns and variations of baseline values, it is usually prudent to manage the obstetric situation based on

Back 18

the most substantially nonreassuring pattern

Front 19

Fetal tachycardia is associated with all of the following EXCEPT

Back 19

maternal treatment with beta-blockers - not associated with fetal tachy (fetal tachycardia is associated with maternal fever and infection, fetal immaturity, and fetal hypoxia)

Front 20

Which of the following is a cause of fetal tachycardia?

Back 20

all of the above (maternal thyrotoxicosis, fetal anemia, and fetal infection)

Front 21

All of the following are associated with fetal bradycardia EXCEPT

Back 21

maternal treatment with atropine - not related to fetal brady (fetal bradycardia is associated with maternal tx with beta-blockers, fetal anoxia, and fetal congenital heart block)

Front 22

Early FHR decelerations are associated with

Back 22

pressure on the fetal head

Front 23

Variable FHR decelerations are associated with

Back 23

umbilical cord compressions

Front 24

Late FHR decelerations are associated with

Back 24

uteroplacental insufficiency

Front 25

The presence of persistent late decelerations and decreased beat-to-beat variability should lead to which of the following?

Back 25

Direct measurement of fetal acid-base status

Front 26

Which of the following best describes a late FHR deceleration?

Back 26

Deceleration starts after uterine contraction begins, reaches nadir after peak of uterine contraction, resolves to baseline after uterine contraction is over

Front 27

Repetitive late FHR decelerations are considered particularly ominous with respect to fetal well-being if associated with

Back 27

decreased FHR variability

Front 28

In the face of evidence of intrauterine fetal compromise, which drug may relax uterine tone and slow contraction rate?

Back 28

Terbutaline

Front 29

The single most reliable indicator of fetal status using electronic fetal monitoring is

Back 29

variability

Front 30

Uteroplacental insufficiency should be suspected in the presence of

Back 30

all of the above (maternal hypertension, diabetes mellitus, toxemia)

Front 31

A normal fetal scalp blood gas pH is in the range of

Back 31

7.25 to 7.40

Front 32

Fetal compromise is strongly expected with a scalp pH less than

Back 32

7.20

Front 33

Which of the following patterns of FHR is most ominous?

Back 33

late decelerations with loss of variability

Front 34

Transient loss of fetal sino-atrial node function is noted when the FHR falls below

Back 34

60

Front 35

Which of the following is likely to result from acute intrapartum blood flow disruption?

Back 35

Spastic quadriplegia

Front 36

What is the association between neonatal encephlopathy and permanet neonatal neurologic impairment?

Back 36

They are not always associated

Front 37

What is the incidence of neonatal encephalopathy caused by intrapartum hypoxia (absent other coincident preconceptual or antepartum abnormalities)?

Back 37

1.6/100,000

Front 38

A fetal scalp pH of 7.24 is

Back 38

reassuring

Front 39

Which of the following medications would be most useful in an attempted intrauterine resuscitation?

Back 39

terbutaline

Front 40

Which of the following maneuvers is potentially useful in an attempt to resuscitate the fetus in utero?

Back 40

change the maternal position to left lateral

Front 41

Moderate variability is best characterized by an amplitude range that is

Back 41

6 to 25 bpm

Front 42

Marked variability is best characterized by an amplitude range that is

Back 42

>25 bpm

Front 43

Minimal variability is best characterized by an amplitude range that is

Back 43

detectable but at 5 bpm or less

Front 44

Absent variability is best characterized by an amplitude range that is

Back 44

undetectable

Front 45

Accelerations are considered to be present at or after 32 weeks of gestation when an acceleration has an acme of

Back 45

15 bpm and a duration of >15 seconds but <2 minutes

Front 46

Accelerations are considered to be present before 32 weeks of gestation when an acceleration has an acme of

Back 46

10 bpm and a duration of >15 seconds but <2 minutes

Front 47

Fetal heart decelerations are defined as

Back 47

visually apparent and gradual

Front 48

Early FHR decelerations are considered

Back 48

physiologic and not a cause for concern