AWHONN Advanced FHM Course
CASE STUDY A) SIL-
VIA. Silvia, a 28-year-old
G1P0000 at 39 1/7 weeks
by sonogram, and her part-
ner arrived on the labor
unit at 0730 for scheduled
induction for IUGR/FGR.
Silvia's family history is
negative for medical prob- Variable decelerations
lems with the exception
of her mother's long-term Rationale for answer:
history of diabetes. Silvia Umbilical cord compres-
has no history of medical sion is the physiologic ba-
problems and she has nev- sis for variable fetal heart
er had any surgeries. She rate decelerations. Having
developed gestational dia- a single umbilical artery in-
betes with this pregnancy, creases the possibility of
but her other prenatal labs variable decelerations.
were all normal. During
one of the ultrasound ex-
aminations performed to
evaluate the IUGR/FGR, a
single umbilical artery was
noted. On her most recent
biophysical profile (BPP),
the amniotic fluid index
, AWHONN Advanced FHM Course
(AFI) was 11 cm (AFI
less than 5 cm is defined
as oligohydramnios) and
the estimated fetal weight
(EFW) was 2524 grams
(7th percentile). WHAT FE-
TAL HEART RATE DE-
CELERATION IS MORE
LIKELY TO OCCUR IN
THE PRESENCE OF SIL-
VIA'S SINGLE UMBILI-
CAL ARTERY?
The single umbilical artery
impacts which component
Oxygen delivery
of the oxygen transfer sys-
tem?
Which of Silvia's findings
Intrauterine growth restric-
indicates a potential for
tion (IUGR)
chronic fetal hypoxemia?
With the finding of a sin-
Decreased blood perfu-
gle umbilical artery, what
sion from the fetus to the
would you expect to occur
placenta
with fetal perfusion?
, AWHONN Advanced FHM Course
Silvia's admission vital
signs were BP 109/60,
pulse 83 bpm, respira-
tions 18/minute, temper-
ature 97F (36.6C). Vagi-
nal examination findings
were 2-3 cm dilated,
50% effaced, -1 station,
membranes intact, and
cephalic presentation. Ex-
ternal electronic fetal mon-
itor devices were placed Enhanced communica-
(ultrasound and tocody- tion among health care
namometer). She denied providers and promotion of
having contractions, vagi- patient safety
nal leaking or bleeding.
Following this admission
tracing, oxytocin was or-
dered and initiated at 2
mU/min. Within an hour,
the rate was increased
to 5 mU/min. PRIMARY
BENEFITS ASSOCIATED
WITH THE USE OF STAN-
DARDIZED TERMINOLO-
GY FOR FHM INTERPRE-
CASE STUDY A) SIL-
VIA. Silvia, a 28-year-old
G1P0000 at 39 1/7 weeks
by sonogram, and her part-
ner arrived on the labor
unit at 0730 for scheduled
induction for IUGR/FGR.
Silvia's family history is
negative for medical prob- Variable decelerations
lems with the exception
of her mother's long-term Rationale for answer:
history of diabetes. Silvia Umbilical cord compres-
has no history of medical sion is the physiologic ba-
problems and she has nev- sis for variable fetal heart
er had any surgeries. She rate decelerations. Having
developed gestational dia- a single umbilical artery in-
betes with this pregnancy, creases the possibility of
but her other prenatal labs variable decelerations.
were all normal. During
one of the ultrasound ex-
aminations performed to
evaluate the IUGR/FGR, a
single umbilical artery was
noted. On her most recent
biophysical profile (BPP),
the amniotic fluid index
, AWHONN Advanced FHM Course
(AFI) was 11 cm (AFI
less than 5 cm is defined
as oligohydramnios) and
the estimated fetal weight
(EFW) was 2524 grams
(7th percentile). WHAT FE-
TAL HEART RATE DE-
CELERATION IS MORE
LIKELY TO OCCUR IN
THE PRESENCE OF SIL-
VIA'S SINGLE UMBILI-
CAL ARTERY?
The single umbilical artery
impacts which component
Oxygen delivery
of the oxygen transfer sys-
tem?
Which of Silvia's findings
Intrauterine growth restric-
indicates a potential for
tion (IUGR)
chronic fetal hypoxemia?
With the finding of a sin-
Decreased blood perfu-
gle umbilical artery, what
sion from the fetus to the
would you expect to occur
placenta
with fetal perfusion?
, AWHONN Advanced FHM Course
Silvia's admission vital
signs were BP 109/60,
pulse 83 bpm, respira-
tions 18/minute, temper-
ature 97F (36.6C). Vagi-
nal examination findings
were 2-3 cm dilated,
50% effaced, -1 station,
membranes intact, and
cephalic presentation. Ex-
ternal electronic fetal mon-
itor devices were placed Enhanced communica-
(ultrasound and tocody- tion among health care
namometer). She denied providers and promotion of
having contractions, vagi- patient safety
nal leaking or bleeding.
Following this admission
tracing, oxytocin was or-
dered and initiated at 2
mU/min. Within an hour,
the rate was increased
to 5 mU/min. PRIMARY
BENEFITS ASSOCIATED
WITH THE USE OF STAN-
DARDIZED TERMINOLO-
GY FOR FHM INTERPRE-
