EFM Exam Questions and Answers Latest Updated 2022 Graded A+

EFM Exam Questions and Answers Latest Updated 2022 Graded A+ Hypoxemia Decreased oxygen in blood Hypoxia Not enough oxygen to supply organs Normal fetal PO2 15-25 mmhm What factors can change the maternal HR? Intrinsic pacemakers (SA & AV node) Cardiac conduction system Autonomic regulation... Sympathetic, parasympathetic Humoral factors (catecholamines) Extrinsic factors (medications) Local factors (Ca, K) What are the 3 most common causes of decrease cardiac output in the OB patient? Reduced preload (HypoTN) from -hypovolemia -compression of inferior vena cava -anesthesia In what area of the placenta does exchange of gases, nutrients, waste, hormones, antibodies & medications occur? Maternal blood in the intervillous space and fetal blood in the villous capillaries These are separated by the blood-blood barrier Oxygen, CO2, NaCl, lipids, vitamins and some drugs are exchanged by... Simple diffusion Glucose & carbohydrates are exchanged by... Facilitated diffusion Amino acids, water-soluble vitamins & large ions are transported by... Active transport What conditions decrease the volume of the blood in the intervillous space? Abruption Infarction Thrombosis Infection ...These can also decrease the surface area of the chorionic villous thus decreasing O2 absorption (less surface area = less absorption) Diffusion across the blood-blood barrier is inversely proportional to _ Distance. Greater distance = less diffusion Villous hemorrhage, thrombosis, infarction, deems, fibrosis...can increase distance What could result from trauma that causes damages chorionic vessels? Maternal-fetal hemorrhage! Ruptured vasa previa Vasa previa is a placental vessels that crosses the chorionic membrane and is close to the cervical os. It can be damaged from just a cervical exam or cervical check! What 3 shunts/mechanisms direct oxygenated blood to vital organs in the fetus? Ductus venous, foramen ovale, ductus arteriosus When fetus is born, what changes are responsible for the fetus's transition to neonate life? Umbilical-placental circulation is eliminated Clamping of umbilical cord eliminates umbilica.-placental circulation and raises the BP in neonate's aorta Flow across ductus arteriosus is reversed Catecholamines release increases BP & HR Expansion of neonate's lungs occurs The fetal circulation is designed to send oxygenated blood primarily to what 3 organs in the fetus? brain, heart, adrenal gland Which ventricle is dominant in the fetal heart? Right ventricle Because fetal circulation works in parallel rather than in series like adult circulation Umbilical vein - type of blood it carries & where? Carries oxygenated blood from placenta to fetus Compression of umbilical vein Can cause acceleration, sometimes before a variable or prolonged accelerations Umbilical artery Carries deoxygenated blood from fetus to placenta Compression of umbilical artery Variable Oxygen depletion cascade aerobic metabolism hypoxemia tissue hypoxia anaerobic metabolism lactic acid build up metabolic acidosis CO = HR x SV for a fetus Cardiac output for a fetus is only related to their heart rate, not their stroke volume. a fetus cannot regulate their stroke volume, only their heart rate Aerobic metabolism O2 ATP by products are CO2 & H2O Hypoxia can lead to what time of metabolism? Anaerobic metabolism... by product = lactic acid Sustained hypoxia sustained anaerobic metabolism with by product of lactic acid leads to _ Metabolic acidosis Metabolic acidosis Accumulation of lactic acid in the body (Low pH) The body then tries to use buffer bases (bicarbonate) to help increase the pH to a more basic/neutral level Eventually the buffering capacity is exceeded and the pH is low and cannot be raised to a normal level Sustained metabolic acidosis leads to _ Metabolic acidemia When the body cannot raise the pH to a normal level with buffering bases, sustained low pH What will sustained hypoxia & metabolic acidosis lead to? Loss of peripheral vascular smooth muscle contraction, which decreases peripheral vascular resistance Leads to Fetal Hypotension Hypoxic injuries to fetal heart & brain Distinguish between metabolic & respiratory academia Metabolic acidemia is ^ lactic acid Respiratory academia is ^ CO2 Causes of respiratory acidemia increased CO2 cord compression/true knot -can develop rapidly and can correct rapidly Intermittent Auscultation done with 4 devices Stethoscope Fetoscope Doppler