Fetal Monitoring
Head compression is probable cause, resulting in a vagal response
What is early decelerations?
FHR 110-160
FHR Baseline
Emergency that occurs when umbilical cord precedes or comes out adjacent to the presenting part; first sign may be variable decelerations or severe, prolonged fetal bradycardia
What is prolapsed cord?
Medications given for Postpartum Hemorrhage
Pitocin, Cytotec, Hemabate, Methergine, TXA
Occurs when the uterine fundus collapses into the endometrial cavity, turning the uterus partially or completely inside
What is uterine inversion?
Uteroplacental insufficiency or diminished placental function
The nadir of the deceleration occurs after the peak of the contraction
What are late decelerations?
Greater than 5 contractions in 10 minutes averaged over 30 minutes
What is tachysystole?
Broad term for abnormal placentation most often diagnosed in late 2nd and 3rd trimester with US
What is placenta accreta spectrum (PAS)?
Inflammation of a vein after formation of a thrombus; pregnant patients are at increased risk
What is thrombophlebitis?
Abnormal accumulation of fluid in the interstitial spaces, alveoli or cells within the lungs that inhibit adequate diffusion of CO2 and O2
What is pulmonary edema?
Visually apparent decrease in FHR below baseline
Decrease greater than 15 bpm
Duration greater than 2 minutes and less than 10 minutes from onset and return to baseline
What is a prolonged deceleration?
Considered reactive from 32 weeks to term if there are two or more fetal heart rate (FHR) accelerations reaching a peak of at least 15 beats per minute (bpm) above the baseline rate and lasting at least 15 seconds from onset to return to baseline (15 x 15) in a 20-minute period
What is NST?
Separation of uterine myomometrium or previous uterine scar, with ROM and possible extrusion of fetus or fetal parts into peritoneal cavity
What is uterine rupture?
Symptoms of cough/hemoptysis, sudden onset SOB, splinting of ribs with breathing, chest pain, hypotension, sudden collapse
What is a pulmonary embolus?
Regular contractions resulting in cervical dilation or effacement before 37 weeks gestation
What is preterm labor?
FHR range 120-160 bpm
Visual apparent smooth sine wave persists for > 20 minutes
Oscillations or undulating pattern
Amplitude of 5 to 15 bpm
Persistent cycle frequency 3-5 bpm that persists for 20 minutes
What is sinusoidal tracing?
A reflection of fetal oxygenation and an intake pathway from the brain to the vagus nerve and to the heart
Presence of it is a reflection of fetal reserve
What is variability?
Result of velamentous insertion of umbilical cord when cord is implanted into membranes rather than placenta and vessels traverse within membrane
What is vasa previa?
Has also been called anaphylactoid syndrome of pregnancy; historically thought to be result of entry of amniotic fluid, fetal cells, hair or other debris entering m
What is amniotic fluid embolism?
A treatment for cervical incompetence or insufficiency, when the cervix starts to shorten and open too early during a pregnancy causing either a late miscarriage or preterm birth
What is cerclage?
Persistent FHR above 160
Duration of 10 minutes with no maximum
Decreased variability common as rate increases, especially above 180
Above 180 bmp is considered severe
What is fetal tachycardia?
Absent baseline FHR variability and any of the following:
Recurrent late decelerations
Recurrent variable decelerations
Bradycardia
Sinusoidal pattern
What is Category 3 tracing?
All or part of the placenta detaches from the wall of the uterus
What is placental abruption?
Pathologic form of clotting that is diffuse and consumes large amounts of clotting factors
OB Risk factors include placental abruption, hemorrhage, preeclampsia/eclampsia, AFE, IUFD, sepsis, cardiopulmonary arrest, massive transfusion therapy, acute fatty liver of pregnancy
What is DIC (Disseminated Intravascular Coagulation)?
Affects approx. 15% of pregnancies of multiples that share a monochorionic placenta. Depending on the number, type and direction of the connecting vessels, blood can be transfused disproportionately from one twin (the donor) to the other twin (the recipient)
What is twin to twin transfusion syndrome?