1 AWHONN Fetal Heart monitoring
basics
-Duration (the time elapsed from starting to quit) 60-80 seconds = 6-8 small bins
-Frequency (time elapsed from starting of one contraction to the beginning of the next) 2 mins =
2 darker vertical lines - ANS-What is the period?
What is the frequency?
(Per AWHONN) If no danger factors are present at admission, compare the usual Q 30 min
inside the latent (four-five cm) and active stages of the first & 2nd stage passive fetal descent
segment and Q15min inside the 2d degree lively pushing degree of labor.
If threat factors present on admission or appear for the duration of labor examine Q 15 min in
the course of lively segment, the 2nd stage passive fetal descent, and at the least Q five mind
all through 2d stage energetic pushing.
If the FHR baseline adjustments in my 10 min window file what the tracing indicates you. Write a
word describing it. If baseline started out at 120 BPM and will increase to one hundred thirty
BPM...Write it. - ANS-Monitoring and intervention questions:
What should I do if the fetal heart charge (FHR) baseline changes?
What if the FHR baseline changes in my 10 min window?
*check all attachment factors
*verify role (can be displaced or perforated uterus or uterine rupture) have pt cough/valsalva if
place successfully tracing will spike with cough concurrently
palpate abd to affirm presence/absence of contractions
*a tracing and not using a seen resting tone may be improperly zeroed.
*abnorm wave form may be due to IUPC lodging against uterine wall or body component
*Notify MD if none of above facilitates and use any other technique to screen such as toco or
palpation - ANS-Discuss troubleshooting of the IUPC
*IUPC is assoc w/ accelerated risk of uterine, placental and wire perforation.
*is an invasive method
*limits maternal ambulation
*catheter tips may be wedged towards wall or frame part preventing accurate statistics
*higher stress readings may occur
*maternal function may additionally affect the pressure readings - ANS-Discuss the constraints
of the IUPC
>five contractions in 10 min (more frequently than Q 2 min) averaged over 30 min window.
Caused by oxytocin, aminoinfusion or in uncommon cases spontaneously. - ANS-Define
tachysystole contractions and the motive of.
,1 vein, 2 arteries encased in wharton's jelly.
O2 (excessive content) travels thru the vein
CO2 travels via 2 arteries again to placenta - ANS-element the umbilical twine
1. Higher baseline FHR
i.E. A 23 wk gest may additionally have a baseline of one hundred fifty five BPM however at
time period, the equal toddler may have a baseline of 130 BPM.
Any baseline above 160 BPM remains considered tachycardia.
2. Decreased variability
bc the significant apprehensive device isn't absolutely advanced, variability can be reduced.
3. Decrease amplitude accels in preterm (earlier than 32 wks) accels of as a minimum 10 BPM
above baseline for as a minimum 10 sec is acceptable.
Four. More common occurrences of variable decels - ANS-What are the one-of-a-kind
characteristics of a fetus previous to 32 wks gest. Than a time period fetus?
1. Mother (blood plasma, cardiac output, hemoglobin awareness & O2 saturation)
2. Placenta/intervillous area (uterine contractions & calcification's)
three. Fetus (vagal reaction aka decel or cord compression) - ANS-What elements impact
maternal oxygen transport?
1. Performing Leopold's maneuvers.
2. Applying the conduction gel.
3. Securing the ultrasound.
Four. Reading the FHR tracing. - ANS-List the 4 steps in using the outside ultrasound device.
1. Presentation (on the inlet of the pelvis)-palpate fundus if head is at fundus.
2. Position/lie (courting of the imparting part to the pelvis anterior, posterior or transverse) and
(long axis, fetal spine lengthy clean tough plane longitudinal, transverse or oblique.)
3. Descent (floating or engaged) grasp abd. Above symphysis pubis observe contour, size,
consistency of providing part. Head is corporation, globular, cell if unengaged and immoble if
engaged. Breech is smaller, softer and abnormal.
Four. Prominence of the pinnacle over the pelvic brim. Press in course of the pelvic inlet for
cephalic prominence. If prominence is on contrary of fetal back is likely the brow and is in vertex
or properly tucked role. - ANS-Describe the the four maneuvers of Leopold's maneuvers.
1. When exertions and not progressing & evaluation of the adequacy of the contraction is
wanted.
2. When the nature or event of previous uterine scarring necessitates internal monitoring
three. Amnioinfusion is needed
four. Differentiation of FHR styles relative to contractions is wanted - ANS-What are warning
signs for IUPC tracking?
10-20 mm Hg (that is an arbitrary #)
, Toco detects will increase and reduces but cannot quantify pressure. - ANS-When the usage of
toco what do you place the uterine resting tone or baseline to?
What is toco measuring?
A hundred and forty BPM
Minimal variability
Late decelerations
Normal uterine activity
Present accelerations - ANS-Identify the tracing traits:
FHR Baseline
FHR variability
FHR Decelerations
Uterine Activity
FHR Accelerations
140 BPM
Moderate variability
No decelerations
Normal uterine hobby
Present accelerations - ANS-Identify this tracing's characteristics:
FHR Baseline
FHR variability
FHR Decelerations
Uterine Activity
FHR Accelerations
17g/dl, fetal hgb has a better oxygen affinity than an person to expand in an oxygen bad
environment. The fetal circulatory sample guarantees blood with better O2 and vitamins content
material is added to the vital organs (mind and coronary heart) to tolerate the pressure of labor.
- ANS-What is the normal predicted cost for a time period fetal HGB?
30-50%
lateral recumbent or semi-Fowler's - ANS-By what % does maternal cardiac output growth
above the non-pregnant kingdom and what function facilitates this uteroplacental blood go with
the flow?
500-700ml to the uterus consistent with minute, 80% is directed to the placenta - ANS-How an
awful lot blood usually flows to the placenta?
A baseline FHR of <110 BPM for at least 10 min.
Contributing factor include stimulation the fetal vagus nerve possibly due to prolonged head
compression or application of the forceps or vacuum, fetal cardiac conduction defect such as
basics
-Duration (the time elapsed from starting to quit) 60-80 seconds = 6-8 small bins
-Frequency (time elapsed from starting of one contraction to the beginning of the next) 2 mins =
2 darker vertical lines - ANS-What is the period?
What is the frequency?
(Per AWHONN) If no danger factors are present at admission, compare the usual Q 30 min
inside the latent (four-five cm) and active stages of the first & 2nd stage passive fetal descent
segment and Q15min inside the 2d degree lively pushing degree of labor.
If threat factors present on admission or appear for the duration of labor examine Q 15 min in
the course of lively segment, the 2nd stage passive fetal descent, and at the least Q five mind
all through 2d stage energetic pushing.
If the FHR baseline adjustments in my 10 min window file what the tracing indicates you. Write a
word describing it. If baseline started out at 120 BPM and will increase to one hundred thirty
BPM...Write it. - ANS-Monitoring and intervention questions:
What should I do if the fetal heart charge (FHR) baseline changes?
What if the FHR baseline changes in my 10 min window?
*check all attachment factors
*verify role (can be displaced or perforated uterus or uterine rupture) have pt cough/valsalva if
place successfully tracing will spike with cough concurrently
palpate abd to affirm presence/absence of contractions
*a tracing and not using a seen resting tone may be improperly zeroed.
*abnorm wave form may be due to IUPC lodging against uterine wall or body component
*Notify MD if none of above facilitates and use any other technique to screen such as toco or
palpation - ANS-Discuss troubleshooting of the IUPC
*IUPC is assoc w/ accelerated risk of uterine, placental and wire perforation.
*is an invasive method
*limits maternal ambulation
*catheter tips may be wedged towards wall or frame part preventing accurate statistics
*higher stress readings may occur
*maternal function may additionally affect the pressure readings - ANS-Discuss the constraints
of the IUPC
>five contractions in 10 min (more frequently than Q 2 min) averaged over 30 min window.
Caused by oxytocin, aminoinfusion or in uncommon cases spontaneously. - ANS-Define
tachysystole contractions and the motive of.
,1 vein, 2 arteries encased in wharton's jelly.
O2 (excessive content) travels thru the vein
CO2 travels via 2 arteries again to placenta - ANS-element the umbilical twine
1. Higher baseline FHR
i.E. A 23 wk gest may additionally have a baseline of one hundred fifty five BPM however at
time period, the equal toddler may have a baseline of 130 BPM.
Any baseline above 160 BPM remains considered tachycardia.
2. Decreased variability
bc the significant apprehensive device isn't absolutely advanced, variability can be reduced.
3. Decrease amplitude accels in preterm (earlier than 32 wks) accels of as a minimum 10 BPM
above baseline for as a minimum 10 sec is acceptable.
Four. More common occurrences of variable decels - ANS-What are the one-of-a-kind
characteristics of a fetus previous to 32 wks gest. Than a time period fetus?
1. Mother (blood plasma, cardiac output, hemoglobin awareness & O2 saturation)
2. Placenta/intervillous area (uterine contractions & calcification's)
three. Fetus (vagal reaction aka decel or cord compression) - ANS-What elements impact
maternal oxygen transport?
1. Performing Leopold's maneuvers.
2. Applying the conduction gel.
3. Securing the ultrasound.
Four. Reading the FHR tracing. - ANS-List the 4 steps in using the outside ultrasound device.
1. Presentation (on the inlet of the pelvis)-palpate fundus if head is at fundus.
2. Position/lie (courting of the imparting part to the pelvis anterior, posterior or transverse) and
(long axis, fetal spine lengthy clean tough plane longitudinal, transverse or oblique.)
3. Descent (floating or engaged) grasp abd. Above symphysis pubis observe contour, size,
consistency of providing part. Head is corporation, globular, cell if unengaged and immoble if
engaged. Breech is smaller, softer and abnormal.
Four. Prominence of the pinnacle over the pelvic brim. Press in course of the pelvic inlet for
cephalic prominence. If prominence is on contrary of fetal back is likely the brow and is in vertex
or properly tucked role. - ANS-Describe the the four maneuvers of Leopold's maneuvers.
1. When exertions and not progressing & evaluation of the adequacy of the contraction is
wanted.
2. When the nature or event of previous uterine scarring necessitates internal monitoring
three. Amnioinfusion is needed
four. Differentiation of FHR styles relative to contractions is wanted - ANS-What are warning
signs for IUPC tracking?
10-20 mm Hg (that is an arbitrary #)
, Toco detects will increase and reduces but cannot quantify pressure. - ANS-When the usage of
toco what do you place the uterine resting tone or baseline to?
What is toco measuring?
A hundred and forty BPM
Minimal variability
Late decelerations
Normal uterine activity
Present accelerations - ANS-Identify the tracing traits:
FHR Baseline
FHR variability
FHR Decelerations
Uterine Activity
FHR Accelerations
140 BPM
Moderate variability
No decelerations
Normal uterine hobby
Present accelerations - ANS-Identify this tracing's characteristics:
FHR Baseline
FHR variability
FHR Decelerations
Uterine Activity
FHR Accelerations
17g/dl, fetal hgb has a better oxygen affinity than an person to expand in an oxygen bad
environment. The fetal circulatory sample guarantees blood with better O2 and vitamins content
material is added to the vital organs (mind and coronary heart) to tolerate the pressure of labor.
- ANS-What is the normal predicted cost for a time period fetal HGB?
30-50%
lateral recumbent or semi-Fowler's - ANS-By what % does maternal cardiac output growth
above the non-pregnant kingdom and what function facilitates this uteroplacental blood go with
the flow?
500-700ml to the uterus consistent with minute, 80% is directed to the placenta - ANS-How an
awful lot blood usually flows to the placenta?
A baseline FHR of <110 BPM for at least 10 min.
Contributing factor include stimulation the fetal vagus nerve possibly due to prolonged head
compression or application of the forceps or vacuum, fetal cardiac conduction defect such as
