Questions and Answers
What is the normal fetal heart rate range?
What could it mean if FHR is high?
infection, low O2, young
What could it mean if FHR is low?
post date pregnancy
What is the number one way to know a baby's age?
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What do you do if there's low amniotic fluid and variable decelerations?
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If the baby is stressed, which organ won't get good blood flow?
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What category tracing is absent variability without decelerations?
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What category tracing is absent variability with decelerations?
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What term describes influences on fetal heart patterns that are outside the fetus?
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Where does all transfer take place during pregnancy?
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What is marked variability related to during labor?
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Bradycardia is a baseline of < _____ bpm for > _____ minutes.
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Tachycardia is a baseline of >____ bpm for >____ minutes.
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What happens when the blood flow gets shunted to the brain, heart, and adrenals during stress?
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Should you perform scalp stimulation during a deceleration?
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What is the first thing you should do with recurrent late decelerations?
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What category is absent variability with recurrent decelerations?
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What is the baseline pH that should be maintained for a well-oxygenated baby?
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Study Notes
Fetal Heart Rate (FHR) Parameters
- Normal fetal heart rate range is 110-160 bpm.
- High FHR may indicate infection, low oxygen levels, or being in a younger gestational stage.
- Low FHR can suggest post-date pregnancy.
Monitoring Techniques
- Sonograms are the primary method for determining a baby's age.
- Amnioinfusion is performed when there is low amniotic fluid or variable decelerations in FHR.
Physiological Responses
- When the fetus experiences stress, blood is rerouted from kidneys, leading to low urine output and amniotic fluid levels.
- Moderate variability in FHR indicates the absence of metabolic acidosis.
- Sympathetic responses (increased FHR) can be triggered by infection, fetal movement, noise, or maternal repositioning.
- A parasympathetic response (slower FHR) can be caused by variable decelerations, head compression, or post-dates.
Categories of FHR Tracing
- Category 1 tracing indicates normal conditions: baseline 110-160 bpm, moderate variability, and absence of late/variable decels.
- Category 2 tracing includes indicators like bradycardia without absent variability, tachycardia, and minimal baseline variability.
- Category 3 tracing presents severe abnormalities and requires immediate evaluation and action.
FHR Variability and Patterns
- Absent variability is undetectable and can indicate serious issues.
- Bradycardia is defined as a baseline FHR of <110 bpm for >10 minutes, while tachycardia exceeds 160 bpm for >10 minutes.
- Sinusoidal FHR patterns, lasting >20 minutes, are linked with fetal anemia and can result from bleeding.
Indicators of Fetal Well-being
- Normal indicators encompass adequate baseline variability, normal baseline FHR, and absence of decelerations.
- Late or variable decels suggest uteroplacental insufficiency and potential distress.
- FHR patterns can be classified as periodic (associated with contractions) or episodic (not associated with contractions).
Deceleration Definitions
- Early decels show gradual decrease correlated with contraction peak.
- Late decels display a drop after contraction peaks, indicating potential distress.
- Variable decels arise abruptly and can be linked to umbilical cord compression.
Acidosis and Electrolyte Levels
- CO2 levels above 60 indicate respiratory acidosis.
- Base excess greater than 12 suggests metabolic acidosis, impacting fetal oxygenation.
- Fetal reserve refers to the amount of hypoxemia a fetus can endure before tissue hypoxia occurs.
Interventions and Management
- First intervention for recurrent late decels is to change the maternal position.
- Increased IV fluids correlate with shorter labor durations and lower rates of prolonged labor.
- Administer 10 liters per minute of supplemental oxygen using a nonrebreather mask for stabilization.
Technology and Monitoring Devices
- Intermittent auscultation utilizes fetoscope or handheld Doppler for heart sound detection.
- Intrauterine pressure catheters provide quantitative measurements of contractions but require palpation for accuracy.
- Fetal spiral electrodes can provide direct ECG monitoring when continuous detection of FHR is necessary.
Contraction Characteristics
- Frequency is measured from the beginning of one contraction to the beginning of another.
- Duration refers to how long a contraction lasts.
- Intensity can be assessed via palpation, classified as mild, moderate, or strong.
Hormonal Influence and Management
- Oxytocin has a half-life of 10-12 minutes, requiring multiple half-lives to reach steady concentrations in the bloodstream.
- Starting oxytocin dose ranges from 0.5 to 2 mU/min, with gradual increase as needed.
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Description
Test your knowledge of fetal monitoring terminology with these flashcards. Learn about normal fetal heart rate ranges, the implications of abnormal rates, and key diagnostic methods. Perfect for students and professionals in maternal and fetal health care.
