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Questions and Answers
How frequently should uterine contractions be observed during the active phase according to standard protocol?
What indicates that the fetal head is engaged above the pelvic brim during labor?
How is the duration of uterine contractions recorded in the Partograph?
Who should assess the fetal heart rate during labor using cardiotocography?
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What does the shading of a square represent in the Partograph when documenting contractions greater than 40 seconds?
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What is the recommended frequency for recording maternal pulse during labor?
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In the assessment of maternal condition, how often should blood pressure be recorded?
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What is the purpose of placing a sensor on a fetus during cardiotocography?
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What is the primary advantage of indirect external fetal monitoring?
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Which maternal condition does NOT typically indicate the need for electronic fetal monitoring?
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What is a disadvantage of using indirect external fetal monitoring?
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Which of the following accurately describes the method of internal fetal monitoring?
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What does fetal heart rate deceleration indicate when interpreting cardiotocography?
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In what situation might a clinician choose to use electronic fetal monitoring continuously during labor?
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Which of the following parameters would indicate an acceleration in fetal heart rate during monitoring?
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What is a likely consequence of uterine hypertonicity during labor as indicated by electronic fetal monitoring?
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What is the function of the Intrauterine Pressure Catheter (IUPC)?
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Which of the following is a disadvantage of using internal fetal monitoring methods?
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What does 'frequency' refer to in the context of uterine activity?
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What constitutes normal uterine activity during labor?
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Why might the insertion of a fetal scalp electrode be challenging?
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Which factor is measured by the 'resting tone' in assessing uterine activity?
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What must occur before the Intrauterine Pressure Catheter (IUPC) can be inserted?
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How does internal fetal monitoring compare to external monitoring?
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Study Notes
Electronic Fetal Monitoring (EFM)
- EFM is a method used to monitor fetal heart rate (FHR) and uterine contractions during pregnancy and labor.
- External monitoring uses a device placed on the mother's abdomen.
- Internal monitoring requires insertion of a device into the uterus, which allows for more accurate measurements.
Indications for EFM
Maternal Indications
- High blood pressure (hypertension)
- Diabetes
- Labor induction or augmentation
- Previous cesarean birth
- Prolonged rupture of membranes
- Antepartum hemorrhage
- Post-term pregnancy (over 42 weeks)
- Premature labor
Fetal Indications
- Fetal growth restriction
- Prematurity (under 37 weeks)
- Abnormal fetal heart rate
- Low amniotic fluid (oligohydramnios)
- Congenital malformations
- Multiple pregnancies
- Breech presentation
Methods of Fetal Heart Rate and Uterine Contraction Monitoring
Indirect (External Monitoring)
- Uses external transducers placed on the mother's abdomen.
- One transducer measures FHR using ultrasound.
- The other transducer measures uterine contractions using a toco transducer.
Advantages
- Easy to apply
- Non-invasive
- Safe for mother and fetus
Disadvantages
- Difficult to use with obese women
- Restricts maternal mobility
- Difficult to accurately assess contraction intensity
Direct (Internal Monitoring)
- Uses internal devices placed within the uterus.
- An Intrauterine Pressure Catheter (IUPC) monitors uterine contractions.
- A Fetal Scalp Electrode (FSE) monitors fetal heart rate.
Advantages
- Most accurate method for assessment
Disadvantages
- Requires cervical dilation
- Requires skilled practitioner to apply
- Can be uncomfortable for the mother
- Requires sterile equipment
- May be impossible to insert if the fetus is at a low station
- Difficult to attach FSE in the presence of thick fetal hair
Interpretation
1- Uterine Activity
- Frequency: The amount of time between the start of one contraction to the start of the next contraction.
- Duration: The length of time from the start of a contraction to the end of the same contraction.
- Resting Tone: How relaxed the uterus is between contractions.
- Interval: The period of time between the end of one contraction to the beginning of the next contraction.
- Normal: Less than or equal to 5 contractions in 10 minutes.
- Abnormal: More than 5 contractions in 10 minutes.
Fetal Heart Rate Parameters
- Baseline Fetal Heart Rate: The average FHR between contractions.
- Accelerations: Transient increases in FHR above baseline, usually associated with fetal movement.
- Decelerations: Transient decreases in FHR below baseline, which can be classified into early, late, or variable types.
Partograph
- A graphical tool used to monitor the progress of labor.
- Tracks various parameters over time, including cervical dilation, fetal heart rate, uterine contractions, and maternal vital signs.
- Helps identify potential complications and guide clinical decisions.
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Description
Explore the essential aspects of Electronic Fetal Monitoring (EFM), including its methods, indications, and applications during pregnancy and labor. This quiz delves into both maternal and fetal indications for monitoring, as well as the differences between external and internal monitoring techniques.
