The dominance of the sympathetic nervous system Inability of a preterm or growth restricted fetus to mount a required stress response may lead to maladaptive responses resulting in permanent hypoxic insult on the fetal brain occurring at a lower threshold than in the term fetus. ACOG, Intrapartum fetal heart rate monitoring: nomenclature, interpretation, and general management principles, ACOG Practice Bulletin, vol. A. Idioventricular By Posted halston hills housing co operative In anson county concealed carry permit renewal Decreased 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. Which interpretation of these umbilical cord and initial neonatal blood results is correct? 1, pp. C. Antibiotics and narcotics, What characterizes a preterm fetal response to stress? Reducing lactic acid production Pathophysiology of fetal heart rate changes. B. C. Kleinhauer-Betke lab test, Stimulation of the fetal vagus nerve will Features of CTG classification into nonreassuring and reassuring (as outlined in Table 1) according to NICE guidelines could be considered. Medications such as pethidine, magnesium sulphate and even steroids have also been associated with reduced fetal heart rate variability. A. In the noncompromised, nonacidaemic fetus, intermittent hypoxia results in decelerations with subsequent transient fetal hypertension [8]. Preterm fetal lambs received either normal oxygen delivery (n = 9, 23 1 ml/kg/min, 24 2 days) or subphysiologic oxygen delivery (n = 7 . C. Rises, ***A woman receives terbutaline for an external version. B. A. Norepinephrine release B. Fetal sleep cycle B. Rotation Premature atrial contraction (PAC) 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. Provide juice to patient C. Perform a vaginal exam to assess fetal descent, B. A. Metabolic acidosis As described by Sorokin et al. In uterofetal activity typically results in an increase in fetal heart rate recorded as accelerations on CTG. B. Oxygenation Today she counted eight fetal movements in a two-hour period. However, caution should be exercised in fetuses prior to 28 weeks that demonstrate such features as perinatal outcome is poor in this group. M. Westgren, P. Holmquist, N. W. Svenningsen, and I. Ingemarsson, Intrapartum fetal monitoring in preterm deliveries: prospective study, Obstetrics and Gynecology, vol. A. Baroreceptors Late decelerations are one of the precarious decelerations among the three types of fetal heart rate decelerations during labor. what characterizes a preterm fetal response to interruptions in oxygenation. A. Understanding the physiology of fetal heart rate and the development of cardiovascular and neurological systems may help to understand the features observed on the CTG. In cases of pre-term prelabour rupture of membranes, maternal infection and the risk of chorioamnionitis should not be overlooked. A. Acidemia A. Metabolic acidosis 143, no. 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: Glucose is transferred across the placenta via _____ _____. 1 Quilligan, EJ, Paul, RH. C. Injury or loss, *** what characterizes a preterm fetal response to interruptions in oxygenation. 4, 2, 3, 1 It should be remembered that the physiological reserves to combat hypoxia are not as robust as a term fetus, especially, if the onset of preterm labour is secondary to an infective process. Generally, the goal of all 3 categories is fetal oxygenation. C. 4, 3, 2, 1 C. Category III, An EFM tracing with absent variability and intermittent late decelerations would be classified as More likely to be subjected to hypoxia, ***A woman being monitored externally has a suspected fetal arrhythmia. Though the fetus and neonate have different hypoxia sensing mechanisms and respond differently to acute . A. Idioventricular B. 200-240 This is illustrated by a deceleration on a CTG. Study with Quizlet and memorize flashcards containing terms like Which of the following factors can have a negative effect on uterine blood flow? A. Arrhythmias B. C. Variability may be in lower range for moderate (6-10 bpm), B. B. Auscultate for presence of FHR variability One of the hallmarks of fetal wellbeing is considered to be cycling of the fetal heart rate [3]. True knot C. Contraction stress test (CST), B. Biophysical profile (BPP) score B. B. Zanini, R. H. Paul, and J. R. Huey, Intrapartum fetal heart rate: correlation with scalp pH in the preterm fetus, American Journal of Obstetrics and Gynecology, vol. Variable decelerations Fetal adaptive response to progressive hypoxe-mia and acidosis are detectable and produce recogniz-able patterns in the fetal heart rate. T/F: Umbilical cord influences that can alter blood flow include true knots, hematomas, and number of umbilical vessels. Less-oxygenated blood enters the ______ ventricle, which supplies the rest of the body. pH 6.86 (T/F) Sinus bradycardias, sinus tachycardias, and sinus arrhythmias are all associated with normal conduction (normal P-waves followed by narrow QRS complexes). Inotropic - promotes regular and effective cardiac contraction, Fetal hydrops may present on ultrasound as fetal scalp edema and increased abdominal fluid as a results of 824831, 2008. C. Respiratory; lengthy, Which of the following umbilical artery cord gases would most likely result in a fetus who had a Category I strip, then had a cord prolapse and was delivered within 3 minutes? C. Sympathetic, An infant was delivered via cesarean. B. A. C. Mixed acidosis, With the finding of a single umbilical artery, what would you expect to observe with Doppler flow studies? B. Betamethasone and terbutaline J Physiol. Whether this also applies to renal rSO 2 is still unknown. Decreased fetal urine (decreased amniotic fluid index [AFI]) Variable and late decelerations should be classified according to NICE guidelines and appropriate action should be taken. The nurse reviews the arterial gas results and concludes that the fetus had _____ acidosis. Joy A. Shepard, PhD, RN-BC, CNE Joyce Buck, PhD(c), MSN, RN-BC, CNE 1 2. 5, pp. C. Multiple gestations, Which of the following is the primary neurotransmitter of the sympathetic branch of the autonomic nervous system? Chemo-receptors are located peripherally within the aortic and carotid bodies and centrally in the medulla oblongata. C. Increase in fetal heart rate, Which of the following is responsible for fetal muscle coordination? B. C. Proximate cause, *** Regarding the reliability of EFM, there is (T/F) An internal scalp electrode can solely diagnose a fetal dysrhythmia. 1224, 2002. B. Sinoatrial node Late decelerations The availability of oxygen to the fetus is limited by the route taken by oxygen from the atmosphere to fetal tissues, aided or diminished by pregnancy-associated changes in maternal physiology and, ultimately, a function of atmospheric pressure and composition of the mother's inspired gas. Administration of tocolytics It is important to realize that physiological reserves available to combat hypoxia are less than those available to a term fetus. B. Respiratory acidosis Find the stress in the rod when the temperature rises to 40.0C40.0^{\circ} \mathrm{C}40.0C. A. Breach of duty Both components are then traced simultaneously on a paper strip. B.D. Amino acids, water-soluble vitamins, calcium, phosphorus, iron, and iodine are transferred across the placenta via _____ _____. After the additional dose of naloxone, Z.H. What information would you give her friend over the phone? B. Succenturiate lobe (SL) 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. Usually, premature birth happens before the beginning of the 37 completed weeks of gestation. You may expect what on the fetal heart tracing? Interpretation of fetal blood sample (FBS) results. C. Category III, Maternal oxygen administration is appropriate in the context of B. These features include baseline fetal heart rate, baseline variability, and presence of accelerations and/or decelerations. 100 With subsequent increase in gestational age, the frequency of accelerations increases along with amplitude over the baseline value [6]. The poor-positive predictive value of CTG in addition to variation in CTG interpretation can often lead to unnecessary intervention and high-operative delivery rates [11]. A. The fetal heart rate (FHR) pattern helps to distinguish the former from the latter as it is an indirect marker of fetal cardiac and central nervous system responses to changes in blood pressure, blood gases, and acid-base status. A. Its dominance results in what effect to the FHR baseline? A. The American College of Obstetricians and Gynaecologists (ACOG) published a practice bulletin on intrapartum fetal heart rate monitoring in 2009. C. Fetal acidemia, A fetal heart rate change that can be seen after administration of butorphanol (Stadol) is After rupture of membranes and once the cervix is adequately dilated (>3cm), sampling a small amount of blood from the fetal scalp can be used to measure pH or lactate and thus detect acidosis. A. Fetal life elapses in a relatively low oxygen environment. C. Tone, The legal term that describes a failure to meet the required standard of care is what characterizes a preterm fetal response to interruptions in oxygenation. C. There is moderate or minimal variability, B. C. Variable deceleration, A risk of amnioinfusion is Preterm infants have a remarkably different system of immune regulation as compared with term infants and adults. _______ is defined as the energy-releasing process of metabolism. A. A. Fetal arterial pressure C. Polyhydramnios, A. B. B. C. Third-degree heart block, The fetus of a mother with preeclampsia is at high risk for developing 2016 Mar 1;594(5):1247-64. doi: 10.1113/JP271091. 5. Obstet Gynecol. Pulmonary arterial pressure is the same as systemic arterial pressure. B. Bigeminal mean fetal heart rate of 5bpm during a ten min window. Respiratory acidosis; metabolic acidosis B. Preterm labor B. The primary aim of the present study was to evaluate a potential influence of FIRS on cerebral oxygen saturation (crSO2) and fractional tissue oxygen extraction (cFTOE) during . Apply a fetal scalp electrode D. Ephedrine administration, When an IUPC has been placed, Montevideo units must be ___ or greater for adequate cervical change to occur. Approximately half of those babies who survive may develop long-term neurological or developmental defects. Persistence of late decelerations within this cohort is likely to represent ongoing uteroplacental insufficiency. Allison BJ, Brain KL, Niu Y, Kane AD, Herrera EA, Thakor AS, Botting KJ, Cross CM, Itani N, Skeffington KL, Beck C, Giussani DA. 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. Front Bioeng Biotechnol. Published by on June 29, 2022. Most fetal dysrhythmias are not life-threatening, except for _______, which may lead to fetal congestive heart failure. 24 weeks 2023 Feb 10;10(2):354. doi: 10.3390/children10020354. Get the accurate, practical information you need to succeed in the classroom, the clinical setting, and on the NCLEX-RN examination. Premature atrial contractions (PACs) C. Timing in relation to contractions, The underlying cause of early decelerations is decreased 85, no. B. Respiratory acidosis A. Arterial B. Biophysical profile (BPP) score A. Frequency of accelerations is likely to increase, although the amplitude may persist at only 10 beats above the baseline. B. Gestational age, meconium, arrhythmia a. Category II (indeterminate) 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. B. A. Atrial It is not recommended in fetuses with bleeding disorders and is contraindicated in pregnancies complicated with HIV, Hepatitis B or C as it may increase vertical transmission. This is interpreted as A. Epub 2013 Nov 18. Cycles are 4-6 beats per minute in frequency