Causes of uteroplacental perfusion decrease: - CORRECT ANSWER • HTN
• Pregnancy
• DM
• Hypotension
• Excessive uterine contractions
... [Show More] (hypertonus)
• Decreased surface area, edema, degenerative calcifications, infarcts, infection
FHR reflects fetal oxygenation from which extrinsic factors: - CORRECT ANSWER •
Maternal oxygenation
• Uterine blood flow
• Placental change
• Umbilical blood flow
FHR reflects oxygenation from which intrinsic factors: - CORRECT ANSWER • Fetal
circulation
• Oxygenation of tissues
• FHR regulation
Fetal shunts: - CORRECT ANSWER • Ductus venosus- liver
• PFO- Right to left atria
• Ductus arteriosis- pulmonary a. to aorta
Oxygen depletion cascade: - CORRECT ANSWER • Aerobic metabolism
• Hypoxemia
• Tissue hypoxia
• Anaerobic metabolism
• Lactic acid build up
• Metabolic acidosis
Sympathetic innervation: - CORRECT ANSWER • Releases Eip/norepi
• Increases FHR
Parasympathetic/Vagal innervation: - CORRECT ANSWER • Releases ach
• Decreases FHR and transmits variability
Early decel: - CORRECT ANSWER • Fetal head compression
• ->vasovagal response
Variable decel: - CORRECT ANSWER • Cord compression
• ->increase BP/HTN
• ->activation of baroreceptor
• ->decrease FHR, BP, and CO
Late decel: - CORRECT ANSWER • Inadequate uteroplacental blood flow->decreased
maternal fetal O2 transfer
• ->activation of chemoreceptors to respond due to increased PCO2, decreased PO2,
and decreased pH
• ->Fetal bradycardia and hypertension
Category I: - CORRECT ANSWER • Normal fetal acid base status
• All the following are required:
• Moderate variability
• Baseline rate 110-160
• Late or variable decels are absent
• Early decels present or absent
• Accels present or absent
Category II: - CORRECT ANSWER • Indeterminate compensatory response
• Not category I or II
Category III: - CORRECT ANSWER • Abnormal fetal acid-base status
• Either required
• Absent variability with:
o Recurrent late decels, or
o Recurrent variable decels, or
o Bradycardia
• Sinusoidal pattern
In-Utero resuscitation: - CORRECT ANSWER • Change maternal position
• Decrease uterine activity
• IV fluid bolus
• Correct maternal hypotension
• Oxygen administration
• Amnioinfusion
• Alteration in 2nd stage maternal pushing efforts
• If prolapsed cord, then elevate fetal presenting part while moving toward operative
birth
Baseline FHR: - CORRECT ANSWER • Approximate mean FHR excluding
accelerations and decelerations or periods of marked variability (>25 bpm)
• Minimum of 2 minutes of identifiable BL segments in any 10 min window
• May need to refer to previous 10 min window
Baseline variability: - CORRECT ANSWER • Irregular fluctuation in baseline FHR in
both amplitude and frequency
• Absent- Undetectable
• Minimal- 0-5 [Show Less]