Questions and Answers
What is the baseline of the FHT in Card 58?
145
Describe the variability in Card 58.
Absent
Are there accelerations present in Card 58?
False
Are there decelerations present in Card 58?
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Are contractions present in Card 58?
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Is this FHT reassuring in Card 58?
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What is the baseline of the FHT in Card 59?
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Describe the variability in Card 59.
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Are there accelerations present in Card 59?
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Are there decelerations present in Card 59?
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Are contractions present in Card 59?
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Is this FHT reassuring in Card 59?
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What is absent variability?
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What is minimal variability?
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What is moderate variability?
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What is marked variability?
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What are the possible causes of absent variability?
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What are the possible causes of minimal variability?
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What is sinusoidal FHR pattern?
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What is fetal tachycardia?
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What is fetal bradycardia?
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What are accelerations of FHR?
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What are early decelerations?
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What are late decelerations?
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What are variable decelerations?
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What are prolonged decelerations?
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What is the baseline of FHT?
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What is the significance of variability in FHT?
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What does it mean if FHT is reassuring?
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What is the clinical significance of minimal variability?
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Study Notes
Fetal Monitoring Variability
- Absent Variability: Amplitude range undetectable. Associated with fetal hypoxemia, metabolic acidemia, congenital anomalies, or preexisting neurologic injury.
- Minimal Variability: Amplitude range detectable ≤5 bpm. Causes include fetal hypoxemia, CNS depressant medications, and can occur during sleep states.
- Moderate Variability: Amplitude range 6-25 bpm. Indicates normal fetal acid-base balance and normal FHR regulation unaffected by sleep cycles or conditions.
- Marked Variability: Amplitude range ≥25 bpm. May signify fetal distress and should be monitored closely.
Fetal Heart Rate Patterns
- Sinusoidal Pattern: Smooth, wavelike undulating pattern lasting 3-5 minutes, persisting for at least 20 minutes; may indicate chorioamnionitis or fetal sepsis.
- Fetal Tachycardia: FHR >160 bpm for more than 10 minutes. Causes include hypoxemia, maternal fever, infections, and certain medications; clinical significance varies based on associated conditions and interventions needed.
- Fetal Bradycardia: FHR <110 bpm for >10 minutes. Possible causes include heart block, structural defects, and maternal conditions. Significance depends on underlying cause and accompanying patterns.
Accelerations and Decelerations
- Accelerations: Apparent increases in FHR above baseline; sign of fetal well-being. Caused by movements, examinations, or contractions.
- Early Decelerations: Gradual decrease in FHR coinciding with contractions. Generally normal, caused by head compression.
- Late Decelerations: Decrease in FHR occurring after contractions. Indicative of possible fetal hypoxemia or uteroplacental insufficiency; requires immediate intervention.
- Variable Decelerations: Abrupt FHR decrease due to umbilical cord compression; generally transient and correctable through maternal position changes.
- Prolonged Decelerations: Decrease lasting >2 minutes but <10 minutes; indicates prolonged interruption in fetal oxygen supply.
Clinical Significance and Interventions
- For Late Decelerations involving uteroplacental insufficiency, interventions may include changing maternal position, increasing IV fluid rates, or administering oxygen.
- Variable Decelerations may require maternal repositioning or potential amnioinfusion if indicated.
- Bradycardia and Tachycardia interventions depend on the cause, e.g., treating maternal hypotension for bradycardia or antipyretic administration for tachycardia.
Baseline Heart Rates and Reassuring Patterns
- Normal baseline FHR ranges from 110-160 bpm. The presence of moderate variability and accelerations is generally reassuring.
- Any tracing with absent variability or concerning decelerations (late or prolonged) necessitates further evaluation and intervention.
Summary of FHT Findings
- Details such as baseline, variability, presence of accelerations, decelerations, and contractions are critical for assessing the fetal heart tracing.
- Regular monitoring and prompt intervention for nonreassuring patterns are essential for maternal-fetal health.
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Description
This quiz explores the concepts of fetal monitoring variability and heart rate patterns. Participants will learn about different types of variability, their clinical significance, and the implications of various heart rate patterns. Understanding these patterns is crucial for ensuring fetal health during pregnancy.
