Late decelerations were noted in two out of the five contractions in 10 minutes. B. B. b. pO2 2.1 A. B. D5L/R B.D. what characterizes a preterm fetal response to interruptions in oxygenation. 1, pp. 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. 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 B. Maternal hemoglobin is higher than fetal hemoglobin Which of the following factors can have a negative effect on uterine blood flow? B. Fluctuates during labor A. Marked variability By the 28th week, 90% of fetuses will survive ex utero with appropriate support. B. D. Fetal isoimmunization, Which of the following factors is not likely to cause uteroplacental insufficiency? Away from. fluctuations in the baseline FHR that are irregular in amplitude and frequency. 1. Pre-term fetus may exhibit accelerations with a peak of only 10 beats per minute lasting for 10 seconds [6]. An increase in the heart rate c. An increase in stroke volume d. No change, The vagus nerve . C. Umbilical vein compression, A transient decrease in cerebral blood flow (increased cerebral blood pressure) during a contraction may stimulate _____ and may cause a(n) _____ Fetal blood has a _______ affinity for oxygen compared with the mother's blood, which facilitates adaptation to the low PO2 at which the placenta oxygenates the fetus. The parasympathetic nervous system is activated by stimulation of baroreceptors situated in the carotid sinus or aortic arch secondary to increase in fetal systemic blood pressure, leading to a fall in heart rate mediated through the vagus nerve. C. Shifting blood to vital organs, Which factor influences blood flow to the uterus? No decelerations were noted with the two contractions that occurred over 10 minutes. B. B. J Physiol. True. C. Suspicious, A contraction stress test (CST) is performed. The preterm birth rate rose 4% in 2021, from 10.1% in 2020 to 10.5% in 2021. Pathophysiology of fetal heart rate changes. pH 6.86 Lower, Which statement best describes the relationship between maternal and fetal hemoglobin levels? 6 Olmos-Ramrez RL, Pea-Castillo M, Mendieta-Zern H, Reyes-Lagos JJ. B. 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 . Right ventricular pressure, 70/4 mmHg, is slightly greater (1 to 2 mmHg) than left ventricular pressure. Fetal in vivo continuous cardiovascular function during chronic hypoxia. Which of the following is the least likely explanation? 5-10 sec A. _____ cord blood sampling is predictive of uteroplacental function. B. B. Macrosomia Though the fetus and neonate have different hypoxia sensing mechanisms and respond differently to acute . March 17, 2020. Within this cohort, the risk of neonatal morbidity and mortality secondary to prematurity is significantly reduced with good survival outcomes. C. Category III, FHTs with minimal variability, absent accelerations, and a 3-minute prolonged deceleration would be categorized as Further assess fetal oxygenation with scalp stimulation The fetal brain sparing response matures as the fetus approaches term, in association with the prepartum increase in fetal plasma cortisol, and treatment of the preterm fetus with clinically relevant doses of synthetic steroids mimics this maturation. C. Sustained oligohydramnios, What might increase fetal oxygen consumption? A. Norepinephrine release Both signify an intact cerebral cortex B. 32, pp. 11, no. Which component of oxygen transport to the fetus could potentially be compromised by this bleeding? At the start (A), airway pressure is low, and FiO 2 is high, indicating a high degree of atelectasis . 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. 2023 Jan 13;13:1056679. doi: 10.3389/fendo.2022.1056679. Written by the foremost experts in maternity and pediatric nursing, the user-friendly Maternal Child Nursing Care, 6th Edition provides both instructors and students with just the right amount of maternity and pediatric content. D. Oligohydramnios, All of the following are likely causes of prolonged decelerations except: These mechanical compressions may result in decelerations in fetal heart resulting in early and variable decelerations, respectively. This clinical scenario of decelerations, followed by loss of accelerations, subsequent rise in baseline heart rate and gradual loss of variability is typical of a gradually evolving hypoxia (Figure 1). Recent ephedrine administration A. Feng G, Heiselman C, Quirk JG, Djuri PM. 5 Apply a fetal scalp electrode C. Can be performed using an external monitor with autocorrelation technique, C. Can be performed using an external monitor with autocorrelation technique, The "overshoot" FHR pattern is highly predictive of A. Terbutaline and antibiotics This cut off value yielded a sensitivity of 81% and specificity of 100% to predict scalp pH of <7.2 [14]. B. Umbilical cord compression Premature ventricular contraction (PVC) A. Which of the following fetal systems bear the greatest influence on fetal pH? A. B. FHR baseline Based on her kick counts, this woman should Fetal life elapses in a relatively low oxygen environment. Continuous fetal heart rate monitoring in this group is recommended, following agreement with the patient. B. (T/F) Metabolic acidosis is more easily reversible and potentially less detrimental to the fetus when compared to respiratory acidosis. Factors outside the fetus that may affect fetal oxygenation and FHR characteristics (e.g., maternal, placental, or umbilical cord factors). Lungs and kidneys T. Wheeler and A. Murrills, Patterns of fetal heart rate during normal pregnancy, British Journal of Obstetrics and Gynaecology, vol. D. Maternal fever, All of the following could likely cause minimal variability in FHR except A. Late decelerations are defined as a visually apparent, gradual decrease in the fetal . B. B. Dopamine C. Sinus tachycardia, Which of the following is not commonly caused by administration of indomethacin? 200 The initial neonatal hemocrit was 20% and the hemoglobin was 8. B. Baroreceptors; late deceleration B. Variable decelerations Fetal breathing decreased with betamethasone administration, Which of the following is not typically associated with a postterm pregnancy? Extreme preterm is less than 28 weeks, very early preterm birth is between 28 and 32 weeks, early preterm birth occurs between 32 and 36 weeks, late preterm birth is between 34 and 36 weeks' gestation. Premature birth or preterm birth occurs more than three weeks before the baby's expected due date. Increased oxygen consumption B. Chemoreceptors, When a fetus is stressed, catecholamine release (epinephrine, norepinephrine) occurs from the medulla oblongata, shunting blood _______ the brain, heart, and adrenal glands. Sympathetic nervous system A. C. Increased maternal HR, Which of the following is not commonly caused by nifedipine administration? Interruption of oxygen transfer from the environment to the fetus at the level of the uterus commonly results from uterine contractions that compress intramural blood vessels and impede the flow of blood. B. Published by on June 29, 2022. Daily NSTs C. E. East and P. B. Colditz, Intrapartum oximetry of the fetus, Anesthesia & Analgesia, vol. C. Maximize umbilical circulation, Which of the following is most responsible for producing FHR variability as the fetus grows? A. A. Late decelerations Higher Decrease FHR F. Goupil, H. Legrand, and J. Vaquier, Antepartum fetal heart rate monitoring. The nurse reviews the arterial gas results and concludes that the fetus had _____ acidosis. 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 . We have proposed an algorithm ACUTE to aid management. C. 32 weeks Base excess 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. Antibiotics and narcotics, What characterizes a preterm fetal response to stress? Increased FHR baseline The preterm infant 1. Preterm birth is when a baby is born too early, before 37 weeks of pregnancy have been completed. Engel O, Arnon S, Shechter Maor G, Schreiber H, Piura E, Markovitch O. Epub 2004 Apr 8. They may have fewer accels, and if <35 weeks, may be 10x10, One of the side effects of terbutaline as a tocolytic is If hypoxic or mechanical insults persist for a longer period, then the fetus utilizes its adrenal gland to cope with this ongoing stress, leading to a stress response This stress response that occurs through the release of catecholamines from the adrenal glands and represents a physiological mechanism for coping with mechanical or hypoxic insults of labour may not be fully operational in a preterm baby. camp green lake rules; A thorough history of each case should be determined prior to CTG interpretation, and instances where variability is persistently reduced without explanation, should be viewed with caution.Accelerations at this gestation may not be present or may be significantly reduced with a lower amplitude (rise of 10 beats from the baseline rather than 15 beats). A. Onset time to the nadir of the deceleration Due to the lack of research and evidence that exists on electronic fetal monitoring (EFM) of the preterm fetus the definition of a normal fetal heart pattern also presents a challenge. 4. C. Damages/loss, Elements of a malpractice claim include all of the following except At this gestation, there is a high risk of neonatal morbidity and mortality, and survival is dependant more on fetal weight and maturity rather than mode of delivery. HCO3 19 B. B. Giussani DA, Spencer JA, Moore PJ, Bennet L, Hanson MA. Place patient in lateral position C. Clinical management is unchanged, A. A. A. Amnioinfusion C. Hypercapnia, _______ _______ occurs when there is low bicarbonate (base excess) in the presence of normal pressure of carbon dioxide (PCO2) values. C. Supine hypotension, When the hydrogen ion content in the blood rises, the pH Lack of evidence-based recommendations may pose a clinical dilemma as preterm births account for nearly 8% (1 in 13) live births in England and Wales. Although, National Guidelines on electronic fetal monitoring exist for term fetuses, there is paucity of recommendations based on scientific evidence for monitoring preterm fetuses during labour. C. No change, Sinusoidal pattern can be documented when The oxygen supply of the fetus depends on the blood oxygen content and flow rate in the uterine and umbilical arteries and the diffusing capacity of the placenta.