Term
how often is there non-reassuring fetal status |
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Definition
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Term
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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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Definition
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