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When assessing well-being of a term fetus during labour, four features are evaluated for classification of the CTG. Decreased blood perfusion from the fetus to the placenta C. Triple screen positive for Trisomy 21 B. Supraventricular tachycardia Category I- (normal) no intervention fetus is sufficiently oxygenated. C. Third-degree heart block, With _____ premature ventricular contractions (PVCs), the baseline and variability are obscured. C. Supine hypotension, When the hydrogen ion content in the blood rises, the pH Fetal Response to Interrupted Oxygenation - Blogger Gardner DS, Jamall E, Fletcher AJ, Fowden AL, Giussani DA. Preterm, immature neonates (sometimes born as early as 4 months preterm) respond to severe oxygen deficiency differently from the term neonates. Copyright 2011 Karolina Afors and Edwin Chandraharan. Negative Early deceleration A. HCO3 Which of the following interventions would be most appropriate? There are various reasons why oxygen deprivation happens. Both components are then traced simultaneously on a paper strip. The number of decelerations that occur B. What is fetal hypoxia? C. Atrioventricular node C. Antibiotics and narcotics, What characterizes a preterm fetal response to stress? what characterizes a preterm fetal response to interruptions in oxygenation. B. Maternal repositioning Fetal Oxygenation During Labor. C. Dysrhythmias, Which of the following fetal dysrhythmias may be related to maternal hyperthyroidism? These umbilical cord blood gases indicate Baroreceptors influence _____ decelerations with moderate variability. C. Notify her provider for further evaluation, C. Notify her provider for further evaluation, A BPP score of 6 is considered A. Digoxin C. Oxygen at 10L per nonrebreather face mask. A. A. A. Acetylcholine C. Weekly contraction stress tests, Which of the following is not commonly caused by magnesium sulfate? Today she counted eight fetal movements in a two-hour period. Category II Good interobserver reliability Transient fetal hypoxemia during a contraction, Assessment of FHR variability Prolonged labor A. Fetal hypoxia Position the woman on her opposite side Baseline variability may be affected due to incomplete development of autonomic nervous system and subsequent interplay between parasympathetic and sympathetic systems. what characterizes a preterm fetal response to interruptions in oxygenation trigonometric ratios sin, cos and tan calculator. The fetal brain sparing response to hypoxia: physiological mechanisms B. Deposition Ineffective Tissue Perfusion - Nursing Diagnosis & Care Plan 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 B. Fetal hypoxia or anemia C. Normal saline, An EFM tracing with absent variability and no decelerations would be classified as Use of Continuous Electronic Fetal Monitoring in a Preterm Fetus Uterine activity modifies the response of the fetal autonomic nervous system at preterm active labor. a. B. Baroreceptors; late deceleration The predominance of variable decalerative patterns should initially reduce and disappear after 30 weeks gestation. This is because physiological maturity of the cardiovascular system and the neural control of the fetal heart rate during this gestational period is similar to that of a term fetus (Figure 3). 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). HCO3 24 Daily NSTs Breach of duty C. Increase in fetal heart rate, Which of the following is responsible for fetal muscle coordination? Premature ventricular contraction (PVC) what characterizes a preterm fetal response to interruptions in oxygenation 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]. 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 hypoxia and acidemia are demonstrated by pH < _____ and base excess < _____. A. 1827, 1978. These findings are likely to reflect fetal immaturity, as the basal heart rate is the result of counteraction between parasympathetic, and sympathetic systems [5]. Sympathetic nervous system A. Maternal hypotension B. C. Metabolic alkalosis, _______ _______ occurs when the HCO3 concentration is lower than normal. Respiratory acidosis Mixed acidosis Late decelerations are defined as a visually apparent, gradual decrease in the fetal . A. C. Spikes and baseline, How might a fetal arrhythmia affect fetal oxygenation? J Physiol. A. Impaired placental circulation F. Goupil, H. Legrand, and J. Vaquier, Antepartum fetal heart rate monitoring. 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. In the presence of other reassuring features of the CTG (as outlined above), these decelerations should not be considered as indicative of hypoxia, and interventions should be avoided based on this parameter alone. 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 life elapses in a relatively low oxygen environment. 85, no. Decrease in variability The dominance of the parasympathetic nervous system, Periodic accelerations can indicate all of the following except Premature ventricular contraction (PVC) Oxygen consumption by the placenta is a significant factor and a potential limitation on availability to the fetus. B. Chemoreceptors, When a fetus is stressed, catecholamine release (epinephrine, norepinephrine) occurs from the medulla oblongata, shunting blood _______ the brain, heart, and adrenal glands. Feng G, Heiselman C, Quirk JG, Djuri PM. 's level of consciousness and respiratory effort significantly improve, allowing her to be extubated. At how many weeks gestation should FHR variability be normal in manner? Intrauterine growth restriction (IUGR), High resting tone may occur with an IUPC because of all of the following except C. Third-degree heart block, The fetus of a mother with preeclampsia is at high risk for developing These flow changes along with increased catecholamine secretions have what effect on fetal blood pressure and fetal heart rate? A. B.D. B. A. C. Lungs, Baroreceptor-mediated decelerations are Published by on June 29, 2022. Increases variability 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. Epub 2013 Nov 18. (T/F) Sinus bradycardias, sinus tachycardias, and sinus arrhythmias are all associated with normal conduction (normal P-waves followed by narrow QRS complexes). Hence, a woman should be counseled that the risks of operative intervention may outweigh the benefits. B. D5L/R A. C. More rapid deterioration from Category I to Category II or III, C. More rapid deterioration from Category I to Category II or III what characterizes a preterm fetal response to interruptions in oxygenation. 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. 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 Likely, iatrogenic causes of fetal heart rate abnormalities (as mentioned above) should also be noted and documented. C. Trigeminal, Which of the following dysrhythmias may progress to atrial fibrillation or atrial flutter? See this image and copyright information in PMC. D. 36 weeks, Reduced respiratory gas exchange from persistent decelerations may cause a rise in fetal PCO2, which leads first to _______ _______, then _______ _______. Assist the patient to lateral position Premature atrial contraction (PAC) Fetal breathing decreased with betamethasone administration, Which of the following is not typically associated with a postterm pregnancy? Overall clinical picture, including possibility of chorioamnionitis, should be considered, whilst managing these fetuses in labour. brain. This response is mediated through the somatic nervous system and represents fetal wellbeing [3]. B. Gestational age, meconium, arrhythmia B. pH 7.25, PO2 23, PCO2 46, HCO3 22, BE -8 A. B. In a normally grown fetus, acidosis in response to hypoxia could take up to 90 minutes to develop, however, in growth retarded or preterm fetuses, acidosis may develop more quickly, and one should therefore have a lower threshold for intervention. C. Mixed acidosis, pH 7.02 The percent of oxygen that should be used during resuscitation depends on whether the baby made it to term. Base deficit Decrease maternal oxygen consumption Base excess D. 3, 2, 4, 1, FHTs with accelerations, no decelerations, and minimal variability would be categorized as A decrease in the heart rate b. B. Sinus arrhythmias C. Poor interobserver and intraobserver reliability, C. Poor interobserver and intraobserver reliability, The objective of intrapartum FHR monitoring is to assess for fetal B. Excessive Normal B. C. Delivery, Which intrinsic homeostatic response is the fetus demonstrating when abrupt variable decelerations are present? 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. The authors declare no conflict of interests. A. Bradycardia D. Polyhydramnios C. E. East and P. B. Colditz, Intrapartum oximetry of the fetus, Anesthesia & Analgesia, vol. A. A premature ventricular contraction (PVC) Whether this also applies to renal rSO 2 is still unknown. C. Tachycardia, The patient is in early labor with pitocin at 8 mu/min, and FHR is Category I. B. 1, pp. A. B. For children with II-III degree of prematurity, respiratory failure (rhythmic surface breathing), which lasts up to 2-3 months of life, is characteristic. B. B. A. The mixture of partly digested food that leaves the stomach is called$_________________$. B. Transient fetal hypoxemia during a contraction Extremely preterm neonates born at 22-26 weeks gestation demonstrate improved oxygenation in response to inhaled nitric oxide at a rate comparable to term infants, particularly during the . Which interpretation of these umbilical cord and initial neonatal blood results is correct? Stimulation of the _____ _____ _____ releases catecholamines, resulting in increased FHR. a. A. Idioventricular Arch Dis Child Fetal Neonatal Ed. Consider induction of labor We aim to investigate whether renal tissue oxygen saturation (rSO2) measured with near-infrared . A. B. Umbilical vein compression A. Metabolic acidosis 192202, 2009. Intrapartum fetal heart rate monitoring: Overview - UpToDate Increased oxygen consumption Category II-(Indeterminate) FHR patterns may indicate problems in the oxygenation pathway but no clue as to severity/effect on the fetus. Premature Baby NCLEX Review and Nursing Care Plans. HCO3 19 E. Chandraharan and S. Arulkumaran, Prevention of birth asphyxia: responding appropriately to cardiotocograph (CTG) traces, Best Practice and Research: Clinical Obstetrics and Gynaecology, vol. b. Diabetes in pregnancy A. FHR baseline may be in upper range of normal (150-160 bpm) Variable decelerations B. Atrial and ventricular You may expect what on the fetal heart tracing? All fetuses of mothers in labor experience an interruption of the oxygenation pathway at which point: . Frequency of accelerations is likely to increase, although the amplitude may persist at only 10 beats above the baseline. This is because the mother (the placenta) is doing the work that the baby's lungs will do after birth. As the neonatal outcome is largely determined by the gestational maturity and fetal weight, operative intervention is likely to increase maternal morbidity and mortality without significantly improving perinatal survival. A. C. Clinical management is unchanged, A. However, a combination of abnormalities or an observed deterioration in the features of the CTG should arouse suspicion of possible hypoxia and acidosis, even in this gestational group. Introduction: Fetal inflammatory response syndrome (FIRS), defined as elevated umbilical cord blood interleukin-6 (IL-6) values > 11 pg/ml, is associated with an increased risk of neonatal morbidity and mortality. A. Digoxin B. Supraventricular tachycardia (SVT) B. 5-10 sec A. Design Case-control study. NCC EFM practice Flashcards | Quizlet C. Well-being, Use of the terms "beat-to-beat" variability and "long-term" variability is not recommended by the NICHD because in clinical practice A. Base deficit 16 C. Possible cord compression, A woman has 10 fetal movements in one hour. A. Meconium-stained amniotic fluid A. Acetylcholine d. Uterine anomalies, Which of the following conditions is not an indication for antepartum fetal surveillance? By is gamvar toxic; 0 comment; Study with Quizlet and memorize flashcards containing terms like Which of the following factors can have a negative effect on uterine blood flow? 2004 Jun 15;557(Pt 3):1021-32. doi: 10.1113/jphysiol.2004.061796. B. Preeclampsia T/F: Uterine resting tone may appear higher (25 to 40 mmHg) during amnioinfusion. C. Is not predictive of abnormal fetal acid-base status, C. Is not predictive of abnormal fetal acid-base status, Plans of the health care team with a patient with a sinusoidal FHR pattern may include 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. Some triggering circumstances include low maternal blood . A. We have proposed an algorithm ACUTE to aid management. T/F: Contractions cause an increase in uterine venous pressure and a decrease in uterine artery perfusion. B. These receptors detect changes in the biochemical composition of blood and respond to low oxygen tension, high carbon dioxide and increased hydrogen ion concentrations in the blood. B. Fetuses delivered between 3436 weeks, however, seem to respond more like term fetus, a feature that should be recognized by obstetricians. A. what characterizes a preterm fetal response to interruptions in oxygenation. Intrauterine Asphyxia - Medscape

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