Heart block (fetal) 1st degree
resolve
Heart block (fetal) 2nd degree blocks
Associated with maternal collagen diseases/ autoimmune (RA, lupus, Sjogrens,
Scleroderma). ANti SSA and Anti SSB antibodies cross the placenta, latch on the the
fetal AV node. Treat with STEROIDS! BMZ
Heart block (fetal) 3rd degree block
(no talking between atrium and ventricle). Usually a structured defect, CMV & aPL
syndrome, usually leads to cardiomyopathy, bradycardia, may add beta drugs to
increase HR (beware monitor half counting). Pacing is TREATMENT
Vibroacoustic stim
Can be used during NST, try and place the transducer where you think the baby's head
is. Sound can be administered 3x no more than 3 seconds (Fetal Acoustic Stimulation
Test), no benefit before 26 weeks baby cant hear yet
NST
Two 15x 15 accels in 20 minutes once greater than 32 weeks gestations
Two, 10x 10 accels in 20 minutes if less than 32 weeks gestations
May be extended to 40 minutes to accommodate possible fetal sleep
If normal AFI, reactive NST indicates fetal well being 99% of the time
If you can get reactive stress test, do BPP
BPP
30 minute test, no standard for when to start testing (usually after 24 wks), may be more
than once a week
10/10
AFI: 6-25
rate, breathing, movement, tone, amniotic fluid
Real Baby Mommas Take Alfalfa
R: Rate
B: Breathing
M: Movement