B. Several theories have been proposed as a potential explanation for this fetal heart rate pattern, notably decreased amount of amniotic fluid, reduced the Wharton jelly component in the cord of the preterm fetus and lack of development of the fetal myocardium and, therefore, the resultant reduced force of contraction. C. No change, What affect does magnesium sulfate have on the fetal heart rate? 20 min Respiratory acidosis A. A. C. Lungs, Baroreceptor-mediated decelerations are T/F: Fetal arrhythmias can be seen on both internal and external monitor tracings. Increasing variability C. Late deceleration Uterine activity modifies the response of the fetal autonomic nervous system at preterm active labor. B. Background and Objectives: Prematurity is currently a serious public health issue worldwide, because of its high associated morbidity and mortality. 2016 Mar 1;594(5):1247-64. doi: 10.1113/JP271091. 5 Fetal physiology relies on the placenta as the organ of gas exchange, nutrition, metabolism, and excretion. A. A. Preeclampsia Study with Quizlet and memorize flashcards containing terms like Which of the following factors can have a negative effect on uterine blood flow? absent - amplitude range is undetectable. There are various reasons why oxygen deprivation happens. C. Homeostatic dilation of the umbilical artery, A. Increased FHR baseline C. No change, Sinusoidal pattern can be documented when Therefore, understanding of oxygen transport across the human placenta and the effect of maternal ventilation on fetal oxygenation is tentative, and currently based on a model that is derived from evidence in another species. B. Categories . C. Respiratory acidosis, As a contraction beings, partial umbilical cord compression causes occlusion of the low-pressure vein and decreased return of blood to the fetal heart, resulting in decreased CO, hypotension, and a compensatory FHR _____. C. Maternal and fetal hemoglobin are the same, A. Fetal hemoglobin is higher than maternal hemoglobin, A 36 week gestation patient is brought to triage by squad after an MVA on her back. T/F: All fetal monitors contain a logic system designed to reject artifact. Stimulating the vagus nerve typically produces: The vagus nerve begins maturation 26 to 28 weeks. B. Recent ephedrine administration By the 24th week, the fetus weighs approximately 1.3 pounds (600 g). Epub 2013 Nov 18. This illustrates development of the fetal myocardium and increase in glycogen-storage levels as the fetus matures. a. Gestational hypertension D. 400, What would be a suspected pH in a fetus whose FHTs included recurrent late decelerations during labor? HCO3 24 The aim of intrapartum continuous electronic fetal monitoring using a cardiotocograph (CTG) is to identify a fetus exposed to intrapartum hypoxic insults so that timely and appropriate action could be instituted to improve perinatal outcome. Term newborns should begin at 21% oxygen (room air oxygen concentration), whereas preterm babies should be started at a higher oxygen concentration, such as 30% (Kattwinkel et al., 2010). B. PCO2 The latter is determined by the interaction between nitric oxide and reactive oxygen species. C. Dysrhythmias, _____ are abnormal FHR rhythms associated with disordered impulse formation, conduction, or both. Continue to increase pitocin as long as FHR is Category I A. Metabolic acidosis A. (T/F) An internal scalp electrode will detect the actual fetal ECG. A. Lactated Ringer's solution Allison BJ, Brain KL, Niu Y, Kane AD, Herrera EA, Thakor AS, Botting KJ, Cross CM, Itani N, Skeffington KL, Beck C, Giussani DA. A. A. Metabolic acidosis C. Turn the patient on her side and initiate an IV fluid bolus, C. Turn the patient on her side and initiate an IV fluid bolus, A woman at 38 weeks gestation is in labor. T/F: A Doppler device used for intermittent auscultation of the fetal heart rate may be used to identify rhythm irregularities, such as supraventricular tachycardia. The basic physiology and adaptive responses that regulate the fetal heart rate and physiological fetal adaptations to stress as reflected in the FHTs are described. A. Repeat in one week A. T/F: In the context of moderate variability, late decelerations are considered neurogenic in origin and are typically amenable to intrauterine resuscitation techniques directed towards maximizing uterine blood flow. The rod is initially placed when the temperature is 0C0^{\circ} \mathrm{C}0C. The Effect of External Cephalic Version on Fetal Circulation: A Prospective Cohort Study. B. 5. B. 2009; 94:F87-F91. C. Increases during labor, Bradycardia in the second stage of labor following a previously normal tracing may be caused by fetal Turn patient on side C. Early decelerations Preterm birth, also known as premature birth, is the birth of a baby at fewer than 37 weeks gestational age, as opposed to full-term delivery at approximately 40 weeks. B. Deposition This intervention may be required earlier compared to term fetuses as a consequence of these low fetal reserves. C. Terbutaline, The initial response in treating a primigravida being induced for preeclampsia who has a seizure is Lower, The fetus has a _______ cardiac output and heart rate than the adult, resulting in rapid circulation. d. Gestational age. Practice PointsBaseline fetal heart rate and variability should be comparable to the term fetus and accelerations with an amplitude of greater than 15 beats from the baseline should be present as an indicator of fetal well-being. baseline FHR. Engel O, Arnon S, Shechter Maor G, Schreiber H, Piura E, Markovitch O. Onset of-labour in gestational ages between 2426 week represents a high-risk group in which greater than two thirds of cases are driven by an underlying infective process. B. The response was similar in both infants and adults with a time lag at the beginning of blood interruption, a subsequent linear decrease, a time lag at the end of blood interruption, and an . Category II (indeterminate) March 17, 2020. Angiotensin II and cardiovascular chemoreflex responses to acute hypoxia in late gestation fetal sheep. Presence of late decelerations in the fetal heart rate One of the hallmarks of fetal wellbeing is considered to be cycling of the fetal heart rate [3]. Category I A. Hypoxemia Would you like email updates of new search results? D. 3, 2, 4, 1, FHTs with accelerations, no decelerations, and minimal variability would be categorized as Pulmonary arterial pressure is the same as systemic arterial pressure. High glucose levels lead to increased oxidative stress and activate caspase with consequent reactive oxygen species (ROS) production, which are in turn known to be involved in the pathogenesis of BPD. Uterine contractions produce transient decreases in blood flow to the placenta, which can lead . C. Nifedipine, A. Digoxin A. FHR baseline may be in upper range of normal (150-160 bpm) B. A. Persistent supraventricular tachycardia A. Late-term gestation B. Spikes and variability what characterizes a preterm fetal response to interruptions in oxygenation. She is not bleeding and denies pain. Late Characteristics of antepartum and intrapartum fetal heart rate tracings differ in the preterm fetus as compared to a term fetus. Kane AD, Hansell JA, Herrera EA, Allison BJ, Niu Y, Brain KL, Kaandorp JJ, Derks JB, Giussani DA. C. Release of maternal prostaglandins, A. Maturation of the parasympathetic nervous system, Which of the following is not a type of supraventricular dysrhythmia? In the presence of a non-reassuring CTG trace, further testing in the form of fetal scalp blood sampling may aid in assessing fetal well-being. During labour, uterine contractions gradually build up and increase in intensity and frequency and may cause compression of the umbilical cord and/or the fetal head. 1, pp. Notably, fetal baseline heart rate is higher, averaging at 155 between 2024 weeks (compared to a term fetus where average baseline fetal heart rate is 140). A. T/F: Umbilical cord influences that can alter blood flow include true knots, hematomas, and number of umbilical vessels. B. PO2 17 What information would you give her friend over the phone? B. Gestational diabetes Category II-(Indeterminate) FHR patterns may indicate problems in the oxygenation pathway but no clue as to severity/effect on the fetus. Prepare for cesarean delivery B. Tracing is a maternal tracing Fetal heart rate is regulated by the autonomic nervous system consisting of 2 branches; the parasympathetic and sympathetic branch which exerts opposing influences on the FHR. A. Asphyxia related to umbilical and placental abnormalities Continuing Education Activity. 160-200 C. Supraventricular tachycardia (SVT), B. Persistent tachycardia is likely to arise secondary to iatrogenic causes such as administration of tocolytics (terbutaline) [9]. A. Digoxin Background Fetal growth restriction (FGR) is associated with an increased risk for kidney disease in later life. Fetal adaptive response to progressive hypoxe-mia and acidosis are detectable and produce recogniz-able patterns in the fetal heart rate. A. These types of decelerations are termed late decelerations and due to the accumulation of carbon dioxide and hydrogen ions are more suggestive of metabolic acidosis [3]. C. 12, Fetal bradycardia can result during By increasing fetal oxygen affinity B. Langer, B. Carbonne, F. Goffinet, F. Le Gouff, N. Berkane, and M. Laville, Fetal pulse oximetry and fetal heart rate monitoring during stage II of labour, European Journal of Obstetrics Gynecology and Reproductive Biology, vol. Late decelerations are caused by uteroplacental insufficiency, which is a decrease in the blood flow to the placenta that reduces the amount of oxygen and nutrients transferred to the fetus. Transient fetal hypoxemia during a contraction C. E. East, S. P. Brennecke, J. F. King, F. Y. Chan, and P. B. Colditz, The effect of intrapartum fetal pulse oximetry, in the presence of a nonreassuring fetal heart rate pattern, on operative delivery rates: a multicenter, randomized, controlled trial (the FOREMOST trial), American Journal of Obstetrics and Gynecology, vol. eCollection 2022. This is considered what kind of movement? B. Catecholamine Premature ventricular contraction (PVC) C. Sinus tachycardia, A. Lowers Daily NSTs Decreased blood perfusion from the fetus to the placenta 99106, 1982. Based on current scientific evidence, a CTG is not recommended in the UK as a method of routine fetal assessment of the preterm fetus (<37 weeks gestation) and currently no clinical practice guidelines on intrapartum monitoring of the preterm fetus exist in the UK The International Federation of Gynaecologists and Obstetricians (FIGO) guidelines for interpretation of intrapartum cardiotocogram distinguish 2 levels of abnormalities, suspicious and pathological, however, the gestation to which such criteria can be applied has not been specified.