Advanced Fetal Monitoring (UPDATED VERSION)
Cat 1 - ✔◻✔◻What category rules out fetal acidemia?
Page | 1 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 size Excessive 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?
STUDYGUIDESOLUTIONS
, Advanced Fetal Monitoring (UPDATED VERSION)
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)
Page | 2
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 heart
ductus venosus, foramen ovale, ductus arteriosus - ✔◻✔◻3 important shunts in fetal circulation Foramen Ovale -
✔◻✔◻connects the two atria in the fetal heart
Allows O2 blood to flow through the heart and directly to the brain
Ductus Arteriosus - ✔◻✔◻a blood vessel in a fetus that bypasses pulmonary circulation by connecting the pulmonary
artery directly to the ascending aorta
80-100 mL/kg - ✔◻✔◻What is a normal blood volume for a fetus at term?
Increased heart rate - ✔◻✔◻What happens if you stimulate the sympathetic nervous system? Regulates the sympathetic -
✔◻✔◻What does the parasympathetic nervous system do?
Increased heart rate - ✔◻✔◻What happens when catecholamines (sympathetic) get released?
The sympathetic develops first so there is no parasympathetic to regulate the heart rate - ✔◻✔◻Why do pre-termers have
increased heart rates?
Acetylcholine is released which decreases the intrinsic heart rate
Vagus stimulation - ✔◻✔◻What happens when the parasympathetic nervous system is stimulated? Protect
Regulates BP - ✔◻✔◻What do baroreceptors do?
Decreased FHR, BP and CO - ✔◻✔◻What effect do baroreceptors have on the fetus?
The cord gets compressed and then fetal BP increased which triggers baroreceptors that decreased the FHR which produces
a variable - ✔◻✔◻What happens when there is cord compression (in regards to baroreceptors)?
Variables - ✔◻✔◻What decels relate to baroreceptors?
STUDYGUIDESOLUTIONS
Cat 1 - ✔◻✔◻What category rules out fetal acidemia?
Page | 1 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 size Excessive 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?
STUDYGUIDESOLUTIONS
, Advanced Fetal Monitoring (UPDATED VERSION)
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)
Page | 2
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 heart
ductus venosus, foramen ovale, ductus arteriosus - ✔◻✔◻3 important shunts in fetal circulation Foramen Ovale -
✔◻✔◻connects the two atria in the fetal heart
Allows O2 blood to flow through the heart and directly to the brain
Ductus Arteriosus - ✔◻✔◻a blood vessel in a fetus that bypasses pulmonary circulation by connecting the pulmonary
artery directly to the ascending aorta
80-100 mL/kg - ✔◻✔◻What is a normal blood volume for a fetus at term?
Increased heart rate - ✔◻✔◻What happens if you stimulate the sympathetic nervous system? Regulates the sympathetic -
✔◻✔◻What does the parasympathetic nervous system do?
Increased heart rate - ✔◻✔◻What happens when catecholamines (sympathetic) get released?
The sympathetic develops first so there is no parasympathetic to regulate the heart rate - ✔◻✔◻Why do pre-termers have
increased heart rates?
Acetylcholine is released which decreases the intrinsic heart rate
Vagus stimulation - ✔◻✔◻What happens when the parasympathetic nervous system is stimulated? Protect
Regulates BP - ✔◻✔◻What do baroreceptors do?
Decreased FHR, BP and CO - ✔◻✔◻What effect do baroreceptors have on the fetus?
The cord gets compressed and then fetal BP increased which triggers baroreceptors that decreased the FHR which produces
a variable - ✔◻✔◻What happens when there is cord compression (in regards to baroreceptors)?
Variables - ✔◻✔◻What decels relate to baroreceptors?
STUDYGUIDESOLUTIONS
