Fetal Physiology and Pathophysiology
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Questions and Answers

What type of deceleration is characterized by a rapid fall in heart rate with a rapid recovery to baseline?

  • Late deceleration
  • Early deceleration
  • Variable deceleration (correct)
  • Prolonged deceleration

    • Which deceleration pattern is a mirror image of uterine contractions and does not indicate hypoxemia?

  • Early deceleration (correct)
  • Variable deceleration
  • Late deceleration
  • Prolonged deceleration

    • What physiological process primarily contributes to chemoreceptor reflex decelerations?

  • Increased fetal systemic blood pressure
  • Accumulation of carbon dioxide and metabolic acids (correct)
  • Uterine contractions without blood loss
  • Decreased resistance in umbilical arteries

    • Which type of deceleration is likely to indicate fetal hypoxemia?

    <p>Late deceleration (D)</p> Signup and view all the answers

    What is the duration of a deceleration for it to be categorized as prolonged?

    <p>More than 3 minutes (A)</p> Signup and view all the answers

    What is the primary function of the placenta during fetal development?

    <p>To act as the lungs for gas exchange (B)</p> Signup and view all the answers

    What happens to the pH of blood returning to the fetus via the umbilical vein?

    <p>It decreases due to accumulation of CO2 (C)</p> Signup and view all the answers

    During normal labor, what effect do contractions have on maternal blood supply to the placenta?

    <p>They reduce blood supply to the placenta (C)</p> Signup and view all the answers

    What can occur if CO2 cannot pass freely to the mother during labor?

    <p>Respiratory acidemia in the fetus (D)</p> Signup and view all the answers

    What compensatory mechanism does the fetus utilize under conditions of low oxygen supply?

    <p>Increased affinity of fetal hemoglobin for oxygen (A)</p> Signup and view all the answers

    What is the consequence of a reduction in oxygen supply during labor?

    <p>Centralization of blood flow to vital organs (D)</p> Signup and view all the answers

    What role do catecholamines play during fetal distress?

    <p>Constrict peripheral blood vessels to prioritize vital organs (A)</p> Signup and view all the answers

    What is the effect of chronic impairment of placental circulation on the fetus?

    <p>Severe bradycardia (C)</p> Signup and view all the answers

    How does the fetus adapt to poor intrauterine nutrition?

    <p>By reducing oxygen consumption (B)</p> Signup and view all the answers

    What can be a result of anaerobic metabolism in the fetus?

    <p>Hypoglycemia in the neonatal period (A)</p> Signup and view all the answers

    What is one of the two possible consequences of CO2 accumulation in fetal circulation?

    <p>Reduced supply of O2 (A)</p> Signup and view all the answers

    What changes occur in the blood composition of the umbilical vein during hypoxia?

    <p>Lower pO2, higher pCO2, and lower pH (C)</p> Signup and view all the answers

    Which factor decreases the heart rate of the fetus?

    <p>Parasympathetic nerve (vagus) stimulation (B)</p> Signup and view all the answers

    Flashcards

    Fetal Heart Rate (FHR) Decelerations

    Changes in fetal heart rate patterns during labor, often indicative of fetal well-being or distress.

    Early Deceleration

    Shallow, short-lasting decelerations in FHR that mirror uterine contractions; not associated with fetal distress.

    Variable Deceleration

    Rapid drop in FHR, often V-shaped, reflecting umbilical cord compression. May not always mean distress.

    Late Deceleration

    Gradual slowing in FHR that starts after uterine contraction and returns slowly. Indicates potential fetal hypoxia.

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    Prolonged Deceleration

    Fetal heart rate deceleration lasting longer than 2 minutes. This could be from serious complications.

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    Fetal Circulation

    The flow of blood in a fetus. Deoxygenated blood is pumped to the placenta via umbilical arteries and returns to the fetus via the umbilical vein.

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    Placenta Function

    The placenta acts as the fetus's lungs, enabling gas exchange with the mother's blood.

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    pH

    A measure of acidity or alkalinity of a solution, specifically the concentration of free (unbuffered) hydrogen ions.

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    CO2 Transport

    Carbon dioxide travels to the placenta as H+ and HCO3- before being released to the mother's blood.

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    Respiratory Acidosis

    A condition where CO2 is produced faster than it's eliminated, leading to a drop in pH.

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    Fetal Hemoglobin (Hb)

    Fetal hemoglobin has a high affinity for oxygen, allowing effective oxygen extraction from the placenta.

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    Fetal Cardiac Output

    The volume of blood pumped by the fetal heart, which is significantly higher than that of an adult.

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    Fetal O2 Supply

    The fetus normally receives more oxygen than it needs, providing a reserve during labor.

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    Labor and Maternal Blood Supply

    During labor, contractions temporarily reduce the maternal blood supply to the placenta.

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    Increased O2 Extraction

    Fetus extracts more oxygen using its higher hemoglobin levels and better extraction mechanisms at placenta.

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    Centralization of Blood Flow

    Blood flow prioritizes vital organs like the brain and heart during stress, reducing supply to less crucial organs.

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    Anaerobic Metabolism

    Energy production without oxygen, leading to a fall in pH due to free H+ ions.

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    Catecholamines

    Hormones like adrenaline and noradrenaline released by adrenal glands. Increase heart rate, constrict peripheral blood vessels.

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    Poor Intrauterine Nutr.

    Reduction in fetal growth/movement or increased Hb in response to reduced O2 consumption & supply.

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    Anaerobic Metabolism (consequence)

    Depleted glycogen stores resulting in fetal/neonatal hypoglycemia.

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    Study Notes

    Physiology and Pathophysiology

    • This presentation covers fetal physiology and pathophysiology, including fetal circulation, fetal adaptations, baseline heart rate, variability, decelerations, and uterine contractions.
    • The fetus has a higher concentration of hemoglobin and a higher affinity for oxygen than an adult, enabling it to extract more oxygen from the placenta.
    • Fetal cardiac output is significantly higher than adult cardiac output.
    • Fetal physiology is designed to be oversupplied with oxygen.
    • The fetus is capable of accommodating significant reductions in oxygen supply through several adaptations.
    • Factors influencing fetal heart rate (FHR) include the nervous system, blood pressure, blood gas levels, cord compression, hypoxia, and cerebral activity.

    Fetal Circulation

    • The placenta acts as a fetal lung, facilitating gas exchange between the mother and fetus.
    • Deoxygenated blood flows to the placenta via umbilical arteries.
    • The placenta facilitates gas exchange.
    • Oxygenated blood returns to the fetus via the umbilical vein.
    • Free gas exchange depends on normal maternal blood flow through the placental bed and normal blood flow through the placenta.

    Fetal Adaptations

    • The fetus can adjust its circulation to prioritize critical organs (brain, heart, and adrenal glands) when faced with decreased oxygen supply.
    • The fetus can compensate for reduced oxygen supply by increasing oxygen extraction and centralizing blood flow.
    • Oxygen is crucial in aerobic metabolism of glucose to produce energy.
    • Damage to the heart or brain occurs with profound hypoxia, severe oxygen restriction.
    • Reduced maternal blood supply during labour is compensated for by fetal heart adaptation.

    Baseline Heart Rate

    • Baseline heart rate is a proxy measure of cardiac output, reflecting the work of the heart.
    • Baseline heart rate is influenced by circulatory function for oxygen delivery and carbon dioxide removal.
    • Increased baseline rate indicates increased circulation.

    Variability

    • Variability refers to short-term fluctuations in baseline heart rate.
    • Normal heart rate variability indicates good neurological function and fetal wellbeing.
    • Reduced variability may be a sign of fetal distress, such as from hypoxaemia or inadequate oxygen supply.
    • Reduced variability can result from hypoxaemia and chronic hypoxaemia.

    Decelerations

    • Decelerations are transient falls in fetal heart rate.
    • They can be caused by various factors, such as head compression, cord compression, and reduced oxygen supply.
    • Decelerations are crucial for evaluating fetal physiological state, often associated with reduced oxygen delivery.
    • Early decelerations, variable decelerations, and late decelerations are different types of decelerations.
    • Decelerations are 'lost heart beats'.

    Uterine Contractions

    • Uterine contractions are essential for labour progression.
    • They temporarily interrupt blood flow across the placenta, reducing oxygen supply to the fetus.
    • Carbon dioxide elimination from the fetus is also temporarily reduced.
    • Fetal recovery of oxygen and carbon dioxide exchange is essential between contractions, particularly during strong contractions.

    Sinusoidal Patterns

    • A sinusoidal pattern in fetal heart rate implies severe fetal compromise, possibly from chronic hypoxaemia and/or hypoxia.
    • This pattern indicates significant, ongoing oxygen deprivation.
    • The inability of the fetus’ central nervous system to maintain adequate heart rate implies poor fetal well-being.

    Summary

    • The presented material highlights fetal physiology, adapting to labour.
    • Normal physiology, adaptation, baseline rate, variability, decelerations, and abnormal patterns are critical points.

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    Related Documents

    Pathophysiology of Fetal Heart Rate PDF

    Description

    This quiz covers key concepts in fetal physiology and pathophysiology, focusing on fetal circulation, adaptations, and factors affecting fetal heart rate. Understanding these principles is crucial for comprehending how the fetus interacts with its environment, especially regarding oxygen supply and cardiac function. Test your knowledge on these critical aspects of fetal development and health.

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