NCC EFM
Maternal Hypovolemia - ANS-Tracing change: Tachycardia, minimal variability, late
decelerations
Maternal vital signs change after more than 30% of blood volume lost (700-800cc)
Placental abruption - ANS-EFM most sensitive to detect
Tracing: loss of variability, late or prolonged decelerations
ultrasound can diagnose abruption
90% of abruption will have uterine activity w/in 1st 4hrs
oligohydramnios - ANS-oligo: AFI < 5cm, max vertical pocket < 2cm
low normal = 5-10cm
leads to fetal malformation, umbilical cord compression, neonatal death
Category III - ANS-- absent variability + recurrent late decels
- absent variability + recurrent variable decels
- absent variability + bradycardia
- sinusoidal pattern
cord prolapse - ANS-umbilical cord slips into vagina before fetus and becomes
compressed and cuts off fetal blood supply.
risk: unengaged presenting part, non vertex presentation, premies, multiple birth,
breech delivery, long umbilical cord
tracing: recurrent decelers followed by prolong deceleration
Tx: relieve pressure of cord, trendelenburg, immediate c/s
amnioinfusion - ANS-indicated for recurrent variable decelerations
- not indicated to dilute meconimum
- not indicated if pre-infusion AFI normal
- bolus 250-500cc followed by 125-150cc/hr
increase risk of cord prolapse if iatrogenic polyhydramnios
periodic - ANS-with contractions
episodic - ANS-without contractions
recurrent variable decelerations - ANS-with equal or more than 50% of contractions
- If tx not alleviated by intrauterine resuscitative measures over 30min, immediate c/s
Maternal Hypovolemia - ANS-Tracing change: Tachycardia, minimal variability, late
decelerations
Maternal vital signs change after more than 30% of blood volume lost (700-800cc)
Placental abruption - ANS-EFM most sensitive to detect
Tracing: loss of variability, late or prolonged decelerations
ultrasound can diagnose abruption
90% of abruption will have uterine activity w/in 1st 4hrs
oligohydramnios - ANS-oligo: AFI < 5cm, max vertical pocket < 2cm
low normal = 5-10cm
leads to fetal malformation, umbilical cord compression, neonatal death
Category III - ANS-- absent variability + recurrent late decels
- absent variability + recurrent variable decels
- absent variability + bradycardia
- sinusoidal pattern
cord prolapse - ANS-umbilical cord slips into vagina before fetus and becomes
compressed and cuts off fetal blood supply.
risk: unengaged presenting part, non vertex presentation, premies, multiple birth,
breech delivery, long umbilical cord
tracing: recurrent decelers followed by prolong deceleration
Tx: relieve pressure of cord, trendelenburg, immediate c/s
amnioinfusion - ANS-indicated for recurrent variable decelerations
- not indicated to dilute meconimum
- not indicated if pre-infusion AFI normal
- bolus 250-500cc followed by 125-150cc/hr
increase risk of cord prolapse if iatrogenic polyhydramnios
periodic - ANS-with contractions
episodic - ANS-without contractions
recurrent variable decelerations - ANS-with equal or more than 50% of contractions
- If tx not alleviated by intrauterine resuscitative measures over 30min, immediate c/s
