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Relias - Fetal Heart Monitoring Notes and Summary

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Relias - Fetal Heart Monitoring Notes and Summary uterine blood supply -: - uterine arteries deliver oxygenated blood to spiral arteries which bring oxygen rich blood to intervillous space of placenta that has fetal capillaries - fetal capillaries carry the O2 rich blood to umbilical VEIN that goes to fetus

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Relias - Fetal Heart Monitoring Notes and Summary
uterine blood supply -: - uterine arteries deliver oxygenated blood to spiral arteries which bring oxygen
rich blood to intervillous space of placenta that has fetal capillaries



- fetal capillaries carry the O2 rich blood to umbilical VEIN that goes to fetus



-in contrast, the umbilical ARTERIES return waste products to that intervillous space that go into
mother's venous system



Potential issues that negatively affect fetal oxygenation -: *Maternal Oxygenation:* asthma, hyper- or
hypo- ventilation



*Maternal Circulation:* decreased maternal cardiac output, hypotension, decreased Hgb



*Placental O2 and CO2 Exchange:* postterm, abruption, HTN, hypotension, uterine tachysystole



*Fetal circulation:* cord compression or occlusion



Fetal hypoxemia -: - can occur d/t reduced fetal O2 reserves, excessive uterine activity, or reduced
uteroplacental blood flow



- worsening fetal hypoxemia can lead to abnormal FHR patterns, mostly minimal or absent variability
from acidemia



(1) hypoxemia vs. (2) hypoxia -: 1 - reduce O2 in blood



2 - reduced O2 delivery at tissue level

, Fetal anaerobic metabolism -: - occurs when long term O2 delivery is insufficient to meet cellular needs
of tissues



- results in production of lactic acid and other noncarbonic acids



- ACIDOSIS is the presence of excessive acids in tissues



acidosis -: pH below 7.35



pH is low



(acidosis is the process that leads to low blood pH, or acidemia)



alkalosis -: pH above 7.45



pH is high



buffers -: - help maintain acid base homeostasis



- 2 major fetal buffers are plasma bicarbonate and hgb



base excess and base deficit -: - base deficit is expressed as a positive number



- base excess is expressed as a negative number



~ they are equivalent and terms are used interchangeably ~



fetal acidosis -: - when O2 is decreased to fetus, tissue hypoxia results in acidosis, which then shows a
drop in pH, a loss of bicarb, and increase in base deficit
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