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Causes of uteroplacental perfusion decrease: - • HTN • Pregnancy • DM • Hypotension • Excessive uterine contractions (hypertonus) • Decreased surface area, edema, degenerative calcifications, infarcts, infection FHR reflects fetal oxygenation from which extrinsic factors: - • Maternal oxygenation • Uterine blood flow • Placental change • Umbilical blood flow FHR reflects oxygenation from which intrinsic factors: - • Fetal circulation • Oxygenation of tissues • FHR regulation Fetal shunts: - • Ductus venosus- liver • PFO- Right to left atria • Ductus arteriosis- pulmonary a. to aorta Oxygen depletion cascade: - • Aerobic metabolism • Hypoxemia • Tissue hypoxia • Anaerobic metabolism • Lactic acid build up • Metabolic acidosi