Advanced Fetal Monitoring Exam 2023

Cat 1 - What category rules out fetal acidemia? Severe astha, cardiac issues, and ecclampic seizures - What maternal conditions greatly impact fetal oxygenation? intervillous space - Where does the exchange of O2 and nutrients take place? O2 enters the intervillous space via the maternal arteries, to the villi then the umbilical vein take the o2 blood to the fetus. The umbilical arteries take the deO2 blood from the baby through the villi and back to the mother - How is o2 blood transferred to the fetus? High to low concentration Mom to fetus for O2 Low to high concentration for CO2 so baby to mom - Diffusion Diffusion - How is O2 transferred from mom to baby Carry O2 into intervillous space Are maximally dilated so they can not be increased - Explain spiral arteries in placenta Maternal conditions like pre-e and cardiac disease Maternal hypotension Placental changes- abruptions, infections, edema, or smaller sizeExcessive uterine activity Vasoconstriction - What are factors that can decrease uteroplacental blood flow? They are constricted which decreases blood flow - What happens to the spiral arteries during pre-e? The aorta and vena cava get compressed (20 weeks) - Why does the supine position cause decreased uteroplactenal blood flow? Blocks the sympathetic pathway Pooling of blood in the lower extremities decreases blood flow back to moms heart which decreases blood flow to the fetus - Why does maternal hypotension happen after regional analgesia? 60% - What percentage is uteroplacental blood flow decreased by during cxts? Environment to lungs to heart to vasculature to uterus to placenta to umbilical cord - Explain the pathway for maternal- fetal exchange for fetal oxygenation (basic) Limbs, kidneys, and descending aorta - Where is the least O2 blood in the fetus? Umbilical vein and ductous venous - Where is the most O2 blood in the fetus? Ductus venosus - Connects the umbilical vein to the inferior vena cava, bypassing the liver Shunt that allows most O2 blood to fetal heartductus venosus, foramen ovale, ductus arteriosus - 3 important shunts in fetal circulation