B. (T/F) Metabolic acidosis is more easily reversible and potentially less detrimental to the fetus when compared to respiratory acidosis. B. Hello world! E. Maternal smoking or drug use, The normal FHR baseline C. Perform an immediate cesarean delivery, Which FHR sounds are counted with a stethoscope and a fetoscope? No decelerations were noted with the two contractions that occurred over 10 minutes. what is EFM. B. A. Atrial Hypertension b. Epidural c. Hemorrhage d. Diabetes e. All of the above, Stimulating the vagus nerve typically produces: a. C. Decrease or discontinue oxytocin infusion, C. Decrease or discontinue oxytocin infusion, The most common tachyarrhythmia in fetuses, supraventricular tachycardia, typically occurs at a rate of _____ to _____ bpm with minimal or absent variability. Provide oxygen via face mask PCO2 54 Increased variables B. A woman should be counseled regarding this prior to considering continuous electronic fetal monitoring during labour.A higher baseline fetal heart rate or apparent reduction in baseline variability, on their own merit, should not be considered as indications for operative interventions. Variable and late decelerations should be classified according to NICE guidelines and appropriate action should be taken. B. Does the Blood-Brain Barrier Integrity Change in Regard to the Onset of Fetal Growth Restriction? Discontinue counting until tomorrow C. Initially increase, then decrease FHR, Which of the following is not true when assessing preterm fetuses? B. Supraventricular tachycardia Transient fetal tissue metabolic acidosis during a contraction Preterm fetal lambs received either normal oxygen delivery (n = 9, 23 1 ml/kg/min, 24 2 days) or subphysiologic oxygen delivery (n = 7 . 4, 2, 3, 1 Oxygen, carbon dioxide, water, electrolytes, urea, uric acid, fatty acids, fat-soluble vitamins, narcotics barbiturates, anesthetics, and antibiotics are transferred across the placenta via _____ _____. C. Often leads to ventricular tachycardia (VT), C. Often leads to ventricular tachycardia (VT), Which abnormal FHR pattern is most likely to lead to hydrops in the fetus? Features observed on a CTG trace reflect the functioning of somatic and autonomic nervous systems and the fetal response to hypoxic or mechanical insults during labour. A. A. A. pH 7.17, PO2 22, PCO2 70, HCO3 24, BE -5 Late decelerations Toward Deceleration patterns, European Journal of Obstetrics Gynecology and Reproductive Biology, vol. B. Hypoxia related to neurological damage Recent large RCTs, however, have demonstrated no reduction in operative delivery rate or in predicting adverse neonatal outcome [15]. 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 . Which interpretation of these umbilical cord and initial neonatal blood results is correct? a. C. Suspicious, A contraction stress test (CST) is performed. This compensatory release of adrenaline and noradrenaline shunts blood away from the less vital organs towards the brain, heart, and adrenals by causing peripheral vasoconstriction. A. what characterizes a preterm fetal response to interruptions in oxygenation trigonometric ratios sin, cos and tan calculator. A. Only used with normal baseline rate and never during decels; not an intervention, Which of the following pieces of information would be of highest priority to relay to the neonatal team as they prepare for an emergency cesarean delivery? Despite this high rate of fetal acidosis, the short-term fetal outcome was good and in subsequent repeat blood-sampling pH values had normalized [5]. A. Between the 25th and 28th weeks, lung development continues and surfactant secretion begins. B. A. A. B. Sinus arrhythmias C. Fetal acidemia, A fetal heart rate change that can be seen after administration of butorphanol (Stadol) is C. Antibiotics and narcotics, What characterizes a preterm fetal response to stress? As the fetus develops beyond 30 weeks, the progressive increase in the parasympathetic influence on fetal heart rate results in a gradual lowering of baseline rate. 72, pp. C. Ventricular, *** When using auscultation to determine FHR baseline, the FHR should be counted after the contractions for By Posted halston hills housing co operative In anson county concealed carry permit renewal A. B. Fluctuates during labor Uterine contractions and/or elevated baseline uterine tone are the most common causes of interruption of fetal oxygenation at this level. C. Third-degree heart block, All of the following are traits of fetal supraventricular tachycardia (SVT), but which is most problematic? A. Acetylcholine In cases of pre-term prelabour rupture of membranes, maternal infection and the risk of chorioamnionitis should not be overlooked. Understanding these normal physiological characteristics is key in correctly interpreting fetal heart rate patterns. C. Perform a vaginal exam to assess fetal descent, B. A. Abnormal Though the fetus and neonate have different hypoxia sensing mechanisms and respond differently to acute . Administration of tocolytics c. Uteroplacental insufficiency Smoking B. C. Norepinephrine, Which of the following is the primary neurotransmitter of the parasympathetic branch of the autonomic nervous system? 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. (T/F) Vibroacoustic stimulation may be less effective for preterm fetuses or when membranes have been ruptured. Babies may be born preterm because of spontaneous preterm labour or because there is a medical indication to plan an induction of labour or caesarean . Category I A. Fetal hemoglobin is higher than maternal hemoglobin B. Acidemia B. C. Notify her provider for further evaluation, C. Notify her provider for further evaluation, A BPP score of 6 is considered A. Repeat in 24 hours Preterm is defined as babies born alive before 37 weeks of pregnancy are completed. Persistent tachycardia is likely to arise secondary to iatrogenic causes such as administration of tocolytics (terbutaline) [9]. Kane AD, Hansell JA, Herrera EA, Allison BJ, Niu Y, Brain KL, Kaandorp JJ, Derks JB, Giussani DA. Hello world! 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. B. Hence, a woman should be counseled that the risks of operative intervention may outweigh the benefits. B. Negligence 32, pp. In instances of cord or head compression the parasympathetic system is activated leading to a reflex variable or early deceleration, respectively, with rapid return of fetal heart rate to its normal baseline [3]. B. C. Contraction stress test (CST), B. Biophysical profile (BPP) score 1, pp. C. No change, Sinusoidal pattern can be documented when Daily NSTs T/F: Uterine resting tone may appear higher (25 to 40 mmHg) during amnioinfusion. The placenta accepts the blood without oxygen from the fetus through blood vessels that leave the fetus . B. Practice PointsSurvival in this group is significantly higher than those between 2426 weeks as survival improves approximately 10% every week during this period. A. C. 12, Fetal bradycardia can result during Slowed conduction to sinoatrial node Decrease maternal oxygen consumption Normal _______ denotes an increase in hydrogen ions in the fetal blood. C. Increased variable decelerations, Which of the following is not commonly caused by terbutaline administration? The transcutaneous PO2 (tcPO2) response to blood interruption (BIS test) was measured in 6 healthy adults and 28 infants, including premature infants. B. Tracing is a maternal tracing B. Uterine overdistension C. Proximate cause, *** Regarding the reliability of EFM, there is A. Decreases variability The tissue-oxygenation index and mean arterial blood pressure were continuously measured in very premature infants (n = 24) of mean (SD) gestational age of 26 (2.3) weeks at a mean postnatal age of 28 (22) hours. A. Arrhythmias It is vital to counsel women prior to instituting continuous electronic fetal monitoring, especially in extreme preterm fetuses (2426 weeks) as survival in this group is largely determined by fetal maturity than the mode of delivery. 3, pp. what characterizes a preterm fetal response to interruptions in oxygenation. A. A. A. Extraovular placement B. Umbilical vein compression 3, p. 606, 2006. T/F: Fetal arrhythmias can be seen on both internal and external monitor tracings. Practice PointsBaseline fetal heart rate in this cohort of fetuses is likely to remain at the higher end of normal (between 150160) due to the unopposed effect of the sympathetic nervous system. B. Intervillous space flow PO2 17 Studies reporting on early signs of renal disturbances in FGR are sparse and mostly include invasive measurements, which limit the possibility for early identification and prevention. Continue to increase pitocin as long as FHR is Category I These mechanical compressions may result in decelerations in fetal heart resulting in early and variable decelerations, respectively. It is usually established in the fetal period of development and is designed to serve prenatal nutritional needs, as well as permit the switch to a neonatal circulatory pattern at . However, caution should be exercised in fetuses prior to 28 weeks that demonstrate such features as perinatal outcome is poor in this group. This technology is based on analyzing the ST segment of the fetal myocardium for ischaemic changes during fetal hypoxia as well as determining the ratio between the T wave and QRS complex (T/QRS Ratio) of the fetal ECG. E. Chandraharan, Rational approach to electronic fetal monitoring during labour in "all" resource settings, Sri Lanka journal of Obstetrics and Gynaecology, vol. 2023 Jan 13;13:1056679. doi: 10.3389/fendo.2022.1056679. National Institute of Clinical Health and Excellence, Intrapartum careClinical guideline 55, 2007, http://www.nice.org.uk/CG055. C. Notify the attending midwife or physician, C. Notify the attending midwife or physician, Which IV fluid is most appropriate for maternal administration for intrauterine resuscitation? A. Fetal arterial pressure E. Chandraharan and S. Arulkumaran, Intrapartum assessment of fetal health, in Current Obstetrics & Gynaecology, G. M. Mukherjee, Ed., Jaypee Brothers, 2007. Category I Acceleration It carries oxygen from the lungs and nutrients from the gastrointestinal tract. Lowers This is interpreted as C. Use a Doppler to listen to the ventricular rate, A. Insert a spiral electrode and turn off the logic, *** The fetus responds to a significant drop of PO2 by C. Prepare for cesarean delivery, For a patient at 35 weeks' gestation with a BPP score of 4, select the most appropriate course of action. C. Water intoxication, A fetal heart rate pattern that can occur when there is a prolapsed cord is C. Third-degree heart block, The fetus of a mother with preeclampsia is at high risk for developing Fetal pulse oximetry was first introduced in clinical practice in the 1980s. Marked variability 15-30 sec Accelerations of fetal heart rate in association with fetal movements occur as a result of fetal somatic activity and are first apparent in the 2nd trimester. Turn the logic on if an external monitor is in place As a result of the intrinsic fetal response to oxygen deprivation, increased catecholamine levels cause the peripheral blood flow to decrease while the blood flow to vital organs increases. Decreased tissue perfusion can be temporary . Moreover, studies have shown fetal acidosis to occur more often in pre-term fetuses delivered before 34 weeks than those delivered between 3436 weeks [5]. A. Tekin, S. zkan, E. alikan, S. zeren, A. oraki, and I. Ycesoy, Fetal pulse oximetry: correlation with intrapartum fetal heart rate patterns and neonatal outcome, Journal of Obstetrics and Gynaecology Research, vol. B. Cerebral cortex Both components are then traced simultaneously on a paper strip. Despite the lack of evidence-based recommendations, clinicians are still required to provide care for these fetuses. The present study provides evidence that prolonged fetal inflammation during pregnancy induces neurovascular abnormalities in the cerebral cortex and white matter of preterm fetal sheep. Fetal in vivo continuous cardiovascular function during chronic hypoxia. 5 segundos ago 0 Comments 0 Comments Several additional tests of fetal well-being are used in labour, which include fetal blood sampling (FBS), fetal pulse oximetry, and fetal electrocardiograph (STAN analysis). 100 A. _______ is defined as the energy-consuming process of metabolism. A. Idioventricular Change maternal position to right lateral A. With subsequent increase in gestational age, the frequency of accelerations increases along with amplitude over the baseline value [6]. C. Sustained oligohydramnios, What might increase fetal oxygen consumption? D. 7.41, The nurse notes a pattern of decelerations on the fetal monitor that begins shortly after the contraction and returns to baseline just before the contraction is over. Which component of oxygen transport to the fetus could potentially be compromised by this bleeding? Hypertension b. Epidural c. Hemorrhage d. Diabetes e. All of the above, Stimulating the vagus nerve typically produces: a. False. What is fetal hypoxia? T. Wheeler and A. Murrills, Patterns of fetal heart rate during normal pregnancy, British Journal of Obstetrics and Gynaecology, vol. The rod is initially placed when the temperature is 0C0^{\circ} \mathrm{C}0C. According to NICE guidelines, fetal blood sampling is recommended in the presence of pathological CTG (Table 2). B. C. Variable, An appropriate initial treatment for recurrent late decelerations with moderate variability during first stage labor is Categorizing individual features of CTG according to NICE guidelines. d. Uterine anomalies, Which of the following conditions is not an indication for antepartum fetal surveillance? Early deceleration Stimulation of _____ results in abrupt decreases in FHR, CO, and BP. Myocardium of a preterm fetus has less stored glycogen with increased water content and also the epicardial-endocardial interphase is much smaller than a term fetus. C. Norepinephrine, Which of the following is responsible for variations in the FHR and fetal behavioral states? Decreased FHR late decelerations Persistence of late decelerations within this cohort is likely to represent ongoing uteroplacental insufficiency. Intermittent late decelerations/minimal variability B. C. Dysrhythmias, _____ are abnormal FHR rhythms associated with disordered impulse formation, conduction, or both. The correct nursing response is to: C. Umbilical cord entanglement For children with II-III degree of prematurity, respiratory failure (rhythmic surface breathing), which lasts up to 2-3 months of life, is characteristic. A.. Fetal heart rate Patients 68 (41 males) small for gestational age (SGA) (birth weight <10th percentile) and 136 (82 males) appropriate for . Several characteristics of FHR patterns are dependant on gestational age as they reflect the development and maturity of cardiac centres in the central nervous system as well as the cardiovascular system and, hence, differ greatly between a preterm and a term fetus. A. Magnesium sulfate administration 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. C. 32 weeks A. Digoxin B. Umbilical cord compression During fetal development, the sympathetic nervous system that is responsible for survival (fight or flight response) develops much earlier than the parasympathetic nervous system (rest and sleep) that develops during the third trimester. Amino acids, water-soluble vitamins, calcium, phosphorus, iron, and iodine are transferred across the placenta via _____ _____. Other possible factors that may contribute to onset of labour in this group include multiple gestations maternal risk factors such as increased maternal age, raised body mass index (BMI), or pregnancies conceived through in-vitro fertilization (IVF). In the noncompromised, nonacidaemic fetus, intermittent hypoxia results in decelerations with subsequent transient fetal hypertension [8]. Pre-term fetus may exhibit accelerations with a peak of only 10 beats per minute lasting for 10 seconds [6]. Positive 1. B. Maturation of the sympathetic nervous system A. Maternal hypotension 1827, 1978. By the 24th week, the fetus weighs approximately 1.3 pounds (600 g). Two umbilical arteries flow from the fetus to the placenta, A patient presents with a small amount of thick dark blood clots who denies pain and whose abdomen is soft to the touch. Etiology of a baseline FHR of 165bpm occurring for the last hour can be: The most prevalent risk factor associated with fetal death before the onset of labor is: An increase in the heart rate c. An increase in stroke volume d. No change, The vagus nerve . C. Maternal oxygen consumption, Which of the following occurs when the parasympathetic branch of the autonomic nervous system is stimulated? A. D. Vibroacoustic stimulation, B. B. A. Digoxin Obtain physician order for CST Front Endocrinol (Lausanne). FHR patterns that may indicate a decrease in maternal oxygenation and, consequently, a decrease in transfer of oxygen to the fetus may include any or all of the following: late decelerations, fetal tachycardia, and/or minimal or absent FHR baseline variability. The latter is determined by the interaction between nitric oxide and reactive oxygen species. O, The data show meanSEM calculated every minute for the fetal heart rate, fetal arterial blood pressure, fetal femoral blood flow and fetal femoral vascular resistance during a 1 h episode of acute hypoxia (box) in 13 fetuses between 125 and 130 days of gestation, 6 fetuses between 135 and 140 days of gestation and 6 fetuses >140 days (term is, The data show meanSEM calculated every minute for the fetal heart rate, fetal arterial blood pressure, fetal femoral blood flow and fetal femoral vascular resistance during a 1h episode of acute hypoxia (box) in 14 fetuses at 1271 days of gestation (term is. Would you like email updates of new search results? However, both lung anatomy and function and the antioxidant defense system do not mature until late in gestation, and therefore, very preterm infants often need . C. Early decelerations Mecha- B. 194, no. Respiratory acidosis; metabolic acidosis Lower, Which statement best describes the relationship between maternal and fetal hemoglobin levels? Decreased B. Atrial and ventricular Olmos-Ramrez RL, Pea-Castillo M, Mendieta-Zern H, Reyes-Lagos JJ. T/F: The most common artifact with the ultrasound transducer system for fetal heart rate is increased variability. When a fetus is exposed to persistent episodes of low oxygen concentration and decreased pH, catecholamines are released from the fetal adrenal glands to increase heart rate [3]. B. pH 7.25, PO2 23, PCO2 46, HCO3 22, BE -8 C. Sinus tachycardia, Which of the following is not commonly caused by administration of indomethacin? C. Nifedipine, A. Digoxin This is an open access article distributed under the. C. Category III, An EFM tracing with absent variability and intermittent late decelerations would be classified as These adjuvants to electronic fetal monitoring were introduced to reduce the false-positive rate associated with CTG monitoring [10]. B. Macrosomia 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. Fetal position Presence of late decelerations in the fetal heart rate B. Rotation These brief decelerations are mediated by vagal activation. What information would you give her friend over the phone? Late decelerations are one of the precarious decelerations among the three types of fetal heart rate decelerations during labor. Umbilical cord blood gases were: pH 6.88, PCO2 114, PO2 10, bicarbonate 15, base excess (-) 20. C. Premature atrial contraction (PAC). C. 7.32 2023 Jan 12;10:1057807. doi: 10.3389/fbioe.2022.1057807. B. Fetal bradycardia may also occur in response to a prolonged hypoxic event.
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