OB antepartum fetal surveillance
About this set
Created by:
dobiegiles on November 20, 2011
Subjects:
Description:
PB 9, 106, 116, 12, 100, 52, 90
CO 326, 348
Order by
54 terms
Terms | Definitions |
|---|---|
 What is reassuring fetal kick counts? | 10 distinct movements in 2 hours |
| What does a contraction stress test Test? | the response of the fetal heart rate to uterine contractions. |
| You must have what to have a CST? | 3 contractions of 40 seconds' duration each or longer in a 10 minute period |
| What can you use to get contractions? | oxytocin (0.5 mU/min and double every 20 mins until adequate contractions) or nipple stim (rub for 2 minutes through clothes) |
| What is a negative CST? | no late or significant variable decelerations |
| What is a positive CST? | Late decelerations following 50% or more contractions |
| What is an equivocal CST? | equivocal-susicious = intermittent late decels or significant variable decals equivocal-hyperstimulatory= decels occuring in the presence of ctxs more freq than q 2 mins |
| What are contraindications to CST? | PTL, PROM, h/o uterine surgery, previa |
| What is a reactive NST | two or more fetal heart accelerations that peak at least 15 bpm above baseline and last 15 seconds from baseline to baseline. Tracing may be 20 minutes to take into account fetal sleep cycle. |
| What is a nonreactive NST | one that lacks sufficient fetal heart rate accelerations over a 40 minute period |
| How often will you see variable decelerations on a NST? | on up to 50% of NSTs. if non-repetitive and brief (<30 seconds), they indicate neither fetal compromise nor need for obstetric intervention |
| What makes up a Biophysical Profile? | 1. NST (if all 4 U/S components are nml then may be omitted without compromising validity of test) 2. Fetal breathing movements - 30 seconds or more within 30 minutes 3. Fetal movement - 3 or more discrete body movements 4. Fetal tone - 1 or more extension of extremity with return to flexion (or opening and closing of hand) 5. Determine AFV - single pocket > 2 cm is adequate |
| How is BPP scored | each component gets a 0 or a 2 |
| What is a normal BPP score? | 8 or 10 |
| What is an abnormal BPP score? | 4 or less |
| What is a modified BPP? | NST + AFI |
| What is a normal AFI? | more than 5 |
| What is a normal modified BPP? | reactive NST and AFI >5 |
| What is an abnormal umbilical artery doppler? | absent end diastolic flow (or reversed). see this with IUGR |
| When do you start antenatal testing? | 32-34 weeks for most patients if very worried (Chronic HTN, IUGR) then 26-28 weeks |
| How frequently do you test? | twice-weekly NST or BPP or modified BPP |
| What should you do if you have an abnormal NST or modified BPP? | either CST or full BPP |
| What do you do with a + CST | deliver |
| What do you do with a BPP of 6 | Term - deliver Preterm - repeat in 24 hours |
| What is the best antepartum test | None has been shown to be the best |
| Is middle cerebral artery testing beneficial for antepartum surveillence? | investigational |
| what is the normal amount of contractions in labor in 10 minutes | 5 or less averaged over 30 minutes |
| What is tachysystole? | >5 ctx in 10 minutes averaged over 30 minutes. You should always say if there are the presence or absence of associated FHR decelerations |
| What are category I FHT? | normal strongly predictive of normal fetal acid-base status No late or variable decals |
| What are category II FHT? | indeterminate require evaluation and continued surveillance and re-evaluation |
| What are category III FHT? | abnormal require prompt evaluation abnormal fetal acid-base status absent baseline variability and (recurrent lates or recurrent variables or bradycardia) sinusoidal pattern |
| What is a normal baseline? | 110-160 bpm. must be a minimum of 2 minutes in any 10 minute segment. Tachy = >160 bpm Brady = <110 bpm |
| What is baseline variability? | fluctuations in baseline that are irregular absenet - undetectable minimal - 5 bpm or fewer moderate - 6-25 bpm marked > 25 bpm |
| What is an acceleration? | visually apparent abrupt increase (onset to peak in < 30 seconds) prolonged acceleration = between 2-10 minutes (if greater then is a baseline change) |
| What is an early deceleration? | From onset to nadir is 30 seconds or more Nadir occurs at same time as peak of contraction |
| What is a late deceleration? | From onset to nadir is 30 seconds or more Nadir occurs after the peak of the contraction |
| What is a variable deceleration? | From onset to nadir is 30 seconds or LESS |
| What is a sinusoidal pattern | cycle of 3-5 per minute and persists for 20 minutes |
| How do you treat category II or III FHT? | oxygen, maternal positional changes, discontinue labor stimulation, cervical exam, treatment of maternal hypotension, treatment of tachysystole |
| How often do you review strips? | 1st stage of labor - q 30 minutes 2nd stage - q 15 minutes |
| What has EFM done for babies? | decreased risk of neonatal seizures. Increased CD and operative delivery |
| What can be done for recurrent variable decelerations? | amnioinfusion to relieve cord compression |
| What is Acute Intrapartum Hypoxic Event | An event sufficient to cause Cerebral Palsy. Need all four 1. metabolic acidosis (pH < 7 and base deficit >12 mmol/L) - artery crosses over veins 2. early onset severe or moderate neonatal encephalopathy in infants born 34 wks or greater 3. CP of the spastic quadriplegic or dyskinetic type 4. Exclude everything else |
| What is IUGR? | birth weight in the 10% |
| What broad categories can IUGR be broken down into? | maternal fetal placental |
| Once IUGR is suspected, what is next possible step in assessment? | doppler velocimetry of umbilical artery. Then figure of if it is due to mom or baby. possible viral infection? |
| What treatment options are available for IUGR? | None. If mature - deliver |
| treat of nausea and emesis of pregnancy | (taking multivitamin at time of conception can decrease severity of N&V) vitamin B6 (12.5 mg tid) + Doxylamine 12.5 mg tid promethazine 12.5 - 25 mg q 4 hr zofran 8 mg q 12 hr |
| what are the classifications of asthma? | mild intermittent mild persistent moderate persistent severe persistent |
| What is the treatment for mild intermittent asthma? | no daily meds, albuterol prn |
| What is the treatment for mild persistent asthma? | low-dose inhaled corticosteroid |
| What is the treatment for moderate persistent asthma? | low-dose inhaled corticosteriod and salmeterol |
| What is the treatment for severe persistent asthma? | High-dose inhaled corticosteroid and salmeterol and oral corticosteroid |
| What is a mallory-weiss tear? | tear in the mucous membrane of the lower part of the esophagus. treat with PPI (omeprazole 20 mg daily) or H2 blockers |
First Time Here?
Welcome to Quizlet, a fun, free place to study. Try these flashcards, find others to study, or make your own.