Flashcards in Week 2 FHR Interpretation (everything)- not presented Deck (48)
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1
Fetal HR Monitoring =
Fetal brain monitoring
2
Brain monitors and responds to what :
1. extrinsic Influences
2. Intrinsic influences
3. Homeostatic interactions b/w the fetus and the environment
3
The Goal of FHR Monitoring is to
maintain optimal blood flow (oxygenation) of the brain w/o compromising other organs
4
Strip Review / Essential characteristics for tracing interpretation:
Clinical Setting -
provides the background risk
5
Strip Review / Essential characteristics for tracing interpretation:
Baseline -
Important to determine all other freatures
6
Strip Review / Essential characteristics for tracing interpretation:
Variability-
a marker of normal pH
7
Strip Review / Essential characteristics for tracing interpretation:
Decelerations -
A marker of ongoing O2 deprivation
8
Strip Review / Essential characteristics for tracing interpretation:
Contractions -
potential cause of O2 deprivation
9
Strip Review / Essential characteristics for tracing interpretation:
Accelerations -
a marker of normal pH
10
Strip Review / Essential characteristics for tracing interpretation:
Change over time -
evidence of an evolving process and marker of time course
11
Order of Oxygen transfer from Environment to fetus:
Environment
Lungs
Heart
vasculature
Placenta
Cord
Fetus
12
The subsequent fetal response if oxygen transfer is disrupted (fetal response); in order:
Hypoxemia
Hypoxia
Metabolic Acidosis
Hypotension
Potential Injury
13
Types of decelerations
Early, Late, Variable (videos)
PPT:
variable
late
prolonged
14
Significant FHR decelerations (variable, late, prolonged) represent
interruptions in fetal oxygen transfer
15
Interruptions in fetal oxygen transfer are represented by
decelerations
16
Disrupted oxygen transfer does not cause injury unless
there is progression to metabolic acidemia
17
Metabolic acidemia + disrupted oxygen transfer =
injury potential
18
the presence of FHR variability and/or accelerations predict
the ABSENCE of metabolic acidosis
*** the converse is not always true***
19
The absence of metabolic acidosis is seen by
the presence of FHR variability and/or accelerations
20
Three Tier System:
Describe Category 1 -
- "Go to" definition of normal.
Baseline: 110-160 bpm
Variability: moderate (6-25 bpm)
Accelerations: present or absent
Decelerations: No late/variable/prolonged
21
Baseline: 110-160 bpm
Category 1
22
Variability: moderate (6-25 bpm)
Category 1
23
Decelerations: No late/variable/prolonged
Category 1
24
Accelerations: present or absent
Category 1
25
Three Tier System:
Describe Category 3
Absent variability WITH any one of the following:
- recurrent late decelerations
- recurrent variable decelerations
- bradycardia
Sinusoidal Pattern
-cycle frequency 3-5/min last at least 20"
*If persists, likely evidence that you are "in deep doo doo"
26
Absent variability WITH any one of the following:
- bradycardia
Category?
Category 3
27
Absent variability WITH any one of the following:
- recurrent late decelerations
Category?
Category 3
28
Sinusoidal Pattern
-cycle frequency 3-5/min last at least 20"
Category?
Category 3
29
Three Tier System:
Describe Category 2
Baseline:
-Bradycardia (<110bpm) with preserved variability
-Tachycardia (>160bpm)
Variability
-Minimal (< or = to 5bpm but detectable)
-Absent (undetectable) *But NOT accompanied by recurrent decelerations
-Marked (>25bpm)
Accelerations
-Absence of acceleration with scalp stimulation
Decelerations:
-Late/Variable/recurrent/Prolonged
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