Term
| how often is there non-reassuring fetal status |
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Definition
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Term
|
Definition
obselete term
less percise
neonata often shows no sign of intrauterine compormis as measured by APGAR score and blood gas studies |
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Term
| 3 causes of non reassuring fetal status |
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Definition
uteroplacental insufficiency
umbilical cord compression
fetal conditions/anomalies |
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Term
| 5 causes of uteroplacemtal insufficiency |
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Definition
placental edema: maternal DM, fetal hydrops
placental accidents: abruption placentae, placental previa
postdatism
intrauterine growth restriction
uterine hyerstimulation |
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Term
| 2 causes of umbilical cord compression |
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Definition
umbilical cord accidents: prolapse, enlargement, knot abnormal insertion, anomalous cord
oligohydramnios: less fluid pushes baby on cord causing compression |
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Term
| 5 causes of fetal conditions/anomalies |
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Definition
sepsis
fetal congenital anomalies
intrauterine growth restrictions
prematurity
postdatism |
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Term
| methods of intrapartum monitoring |
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Definition
intermittent ascultation
electronic fetal monitoring
fetal heart rate
fetal heart rate variability
fetal heart rate pattern |
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Term
| intermittent ascultation: how often |
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Definition
Q15-30 min post contraction 1st stage
Q5-15 min 2nd stage |
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Term
| what are the typs of electric fetal monitoring |
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Definition
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Term
| what does internal electronic fetal monitoring show |
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Definition
spiral electrode records fetal ECG
sagittal section showing attachment of fetal scalp and wires transversing cervix and agina |
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Term
| what is a normal, fast, slow, causes of fetal HR |
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Definition
normal 120-160 BPM (slightly high pre term)
tachy: >160 (usually chorioamnionitis)
brady: <120 (fetal anemia) |
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Term
| define fetal heart rate variability |
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Definition
fluctuations in FHR from beat to beat
single most reliable EFM indicator of fetal well being |
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Term
| what does variability reflext |
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Definition
| adequate fetal CNS oxygenation |
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Term
| what is decreased variability associated with |
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Definition
fetal hypoxia
acidemia
drugs
fetal CNS and cardiac anomalies
uterine hypertonus (not enough time between contractions for baby to rest)
prematurity: less CNS developed decreases variability
fetal sleep |
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Term
| what are the levels of variability, which is ideal |
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Definition
absent: no change from midline
minimal: <6 units change
moderate: 6-12 units change IDEAL
marked: >25 units change |
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Term
| what acceleration is good <32 wks |
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Definition
| 2 accelerations per strip that increase by 10 bpm and last 10 sec |
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Term
| what acceleration is good >32 wks |
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Definition
| 2 accelerations per strip that increase by 15 bpm and last for 15 sec |
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Term
| define sinusoidal fetal heart rate pattern |
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Definition
fetal anemia
Rh immunization
newborns with significant compormise GET BABY OUT |
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Term
| why does fetal heart rate vary |
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Definition
| uterine contractions slow and accelerate it |
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Term
| why are fetal accelerations good |
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Definition
| intact fetal mechanism is reassuring |
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Term
| how can you test for acceleration if you dont see it (2) |
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Definition
fetal scalp stimulation
external vibroacoustic stimulation |
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Term
| define decelerations of fetal heart rate changes |
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Definition
| visually apparent and gradual onset to nadir 30sec or more |
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Term
| cause of early decelerations |
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Definition
pressure on fetal head as baby moves into pelvis mediated by vagus nerve
this is normal |
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Term
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Definition
30 sec to peak
30sec to normal |
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Term
| cause of variable decelerations |
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Definition
anything compressing the cord causes
no relation to contraction |
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Term
| cause of late decelerations |
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Definition
uteroplacental insufficiency
after a contraction with prolonged recovery
BAD sign |
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Term
| what is the best evaluation of health of fetus |
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Definition
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Term
| what causes poor beat to beat variability |
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Definition
| narcotics, intolerance ot labor |
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Term
| what do you do if baby has poor beat to beat stimulation |
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Definition
scalp stimulation
acoustic stimulation
pH sampling (<7 is significant hypoxia) |
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Term
| what can compormise fetal variability |
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Definition
severe bradycardia
repetitive late decelerations
undulating baseline
non-reassuring pattern with poor beat to beat |
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Term
| when is a variable deceleration not reassuring |
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Definition
>45-60 sec
repetitive
rising fetal hR baseline
tend towards tachycardia
loss of variability
delay of return to baseline |
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|
Term
| late decelerations: marker for, when to be concerned |
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Definition
marker for fetal hypoxia and uteroplacental insufficiency
repetative lates are clear warning that fetus is in trouble |
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Term
| define prolonged deceleration |
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Definition
| decel 15 beats/min or more lasting 2min - 10 min |
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|
Term
| causes of prolonged deceleration |
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Definition
tetanic contractions
prolapse unbolical cord
vaginal exam
application of internal electrode
paracervical block
epidural bloick
supine hypotensive event
rapid descent of fetal head during delivery |
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Term
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Definition
70% of neonatal encephalopathy is caused by factors present befoe labor
1/1000 are classified as encephalopathy are associated with acute intrapartum event |
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Term
| parts of intrauterine recussitation |
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Definition
check maternal BP
increase IV fluids
DC ocytocin (consider iv tocolytic)
change moms position
administer O2
check cord prolapse
check cervix babys head may be ready to deliver
amnioinfusion |
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Term
| what position should mom be in when she delivers |
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Definition
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Term
| when do you do episiotomy, how, why |
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Definition
only when you need to get baby out fast
midline: could tear into rectum
mediolateral: more painful, heals slow |
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Term
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Definition
| finger in rectum used to adjust babys head |
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Term
| what do you do right after the baby's head is delivered |
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Definition
check for nucal cord
downward traction to assist in delivery of anterior shoulder |
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Term
| when should you suction the baby's airway |
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Definition
some say after head but before shoulder out
some say all the way out |
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Term
| what are the events and complications of the third stages of labor |
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Definition
collection of cord blood
delivery of placenta
inversion of uterus
manual removal of placenta in OR if it dosent remove in 30 min
inspection of cord
inspection of vagina |
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Term
| what do you inspect the vagina for after delivery |
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Definition
| tears, lacerations, extensions of episiotomy |
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Term
| what should the contents of the cord be, what is a common abnormality |
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Definition
2 arteries
1 vein
1A/1V associated with renal anomolit |
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Term
| cause of inversion of the uterus |
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Definition
| excessive traction force on placenta |
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Term
| signs of delivery of placenta |
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Definition
uterus rises in abdomen and becomes globular
gush of blood #1 sign
lengthening of umbilical cord |
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Term
| what are the degree of obstretic laceration and their descriptions |
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Definition
1: skid marks: vaginal mucosa and perineal skin but not underlying tissue
2: most common. involves underlying SC tissue but not rectal sphincter or rectal mucosa
3: extends through the rectal sphincter but not the rectal mucosa
4: extends into rectal mucosa |
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Term
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Definition
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Term
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Definition
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Term
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Definition
| prolonged fetal bradycardia |
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Term
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Definition
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Term
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Definition
| normal likes contractions |
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Term
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Definition
| normal labor with pushing |
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Term
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Definition
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Term
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Definition
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Term
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Definition
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