Decreased fetal urine (decreased amniotic fluid index [AFI]) C. Tachycardia, Which fetal monitoring pattern is characteristic of cephalopelvic disproportion, especially when seen at the onset of labor? B. Other possible factors that may contribute to onset of labour in this group include multiple gestations maternal risk factors such as increased maternal age, raised body mass index (BMI), or pregnancies conceived through in-vitro fertilization (IVF). Position the woman on her opposite side An increase in the heart rate c. An increase in stroke volume d. No change, The vagus nerve . C. Variability may be in lower range for moderate (6-10 bpm), B. B. _______ is defined as the energy-consuming process of metabolism. B. Umbilical cord compression B. Prolapsed cord B. Tracing is a maternal tracing Hence, ST analyser is not recommended prior to 36 weeks of gestation as it may not be reliable due to changes in the myocardial composition described above. 99106, 1982. C. Increased FHR accelerations, Which of the following would likely be affected by betamethasone administration? a. Give the woman oxygen by facemask at 8-10 L/min With subsequent increase in gestational age, the frequency of accelerations increases along with amplitude over the baseline value [6]. Maximize placental blood flow Front Bioeng Biotechnol. C. Transient fetal asphyxia during a contraction, B. what characterizes a preterm fetal response to interruptions in oxygenation. Fetal systemic arterial blood pressure is considerably lower than that in an adult, averaging 55 mmHg (systolic/diastolic, approximately 70/45 mmHg) at term. The response was similar in both infants and adults with a time lag at the beginning of blood interruption, a subsequent linear decrease, a time lag at the end of blood interruption, and an . During labour, uterine contractions gradually build up and increase in intensity and frequency and may cause compression of the umbilical cord and/or the fetal head. T/F: A Doppler device used for intermittent auscultation of the fetal heart rate may be used to identify rhythm irregularities, such as supraventricular tachycardia. CTG of a fetus at 34 weeks of gestation: note baseline heart rate within the normal range, normal baseline variability with cycling. The preterm infant 1. C. Decrease or discontinue oxytocin infusion, C. Decrease or discontinue oxytocin infusion, The most common tachyarrhythmia in fetuses, supraventricular tachycardia, typically occurs at a rate of _____ to _____ bpm with minimal or absent variability. 10 min 7784, 2010. C. Variable, An appropriate initial treatment for recurrent late decelerations with moderate variability during first stage labor is Fetal circulation, unlike postnatal circulation, involves the umbilical cord and placental blood vessels which carry fetal blood between the fetus and the placenta . C. Well-being, Use of the terms "beat-to-beat" variability and "long-term" variability is not recommended by the NICHD because in clinical practice A. Onset time to the nadir of the deceleration A. Metabolic acidosis 200-240 The correlation between mean arterial blood pressure and tissue-oxygenation index in the frequency domain was assessed by using . This is because physiological maturity of the cardiovascular system and the neural control of the fetal heart rate during this gestational period is similar to that of a term fetus (Figure 3). This intervention may be required earlier compared to term fetuses as a consequence of these low fetal reserves. Afferent and efferent components of the cardiovascular reflex responses to acute hypoxia in term fetal sheep. Di 1,5-2 months of life expressed a syndrome of "heat release", marble skin pattern, cyanosis, rapid cooling, as well as edematous syndrome. d. Gestational age. In the normal fetus (left panel), the . A. Which of the following fetal systems bear the greatest influence on fetal pH? T/F: Corticosteroid administration may cause an increase in FHR accelerations. B. _____ cord blood sampling is predictive of uteroplacental function. A. Metabolic acidosis A. Preeclampsia B. Intervillous space flow what characterizes a preterm fetal response to interruptions in oxygenation. A. Arrhythmias Presence of late decelerations in the fetal heart rate The nurse reviews the arterial gas results and concludes that the fetus had _____ acidosis. Away from. C. Equivocal, *** As fetal hypoxia (asphyxia) worsens, the last component of the BPP to disappear is fetal A. C. Release of maternal prostaglandins, A. Maturation of the parasympathetic nervous system, Which of the following is not a type of supraventricular dysrhythmia? A. Idioventricular ACOG, Intrapartum fetal heart rate monitoring: nomenclature, interpretation, and general management principles, ACOG Practice Bulletin, vol. Green LR, McGarrigle HH, Bennet L, Hanson MA. Decreased C. Can be performed using an external monitor with autocorrelation technique, C. Can be performed using an external monitor with autocorrelation technique, The "overshoot" FHR pattern is highly predictive of Variable decelerations have been shown to occur in 7075% of intrapartum preterm patients, in comparison to the term patient where an intrapartum rate of 3050% is seen [7]. A premature ventricular contraction (PVC) In cases of utero-placental insufficiency, where carbon dioxide and hydrogen ion accumulate with resultant decrease in oxygen concentrations, the chemo-receptors are activated. T/F: Fetal tachycardia is a normal compensatory response to transient fetal hypoxemia. A. Fetal arterial pressure Turn the logic on if an external monitor is in place B. Hypoxia related to neurological damage The tissue-oxygenation index and mean arterial blood pressure were continuously measured in very premature infants (n = 24) of mean (SD) gestational age of 26 (2.3) weeks at a mean postnatal age of 28 (22) hours. Misan N, Michalak S, Kapska K, Osztynowicz K, Ropacka-Lesiak M, Kawka-Paciorkowska K. Int J Mol Sci. C. Supine hypotension, When the hydrogen ion content in the blood rises, the pH Continue counting for one more hour This response is mediated through the somatic nervous system and represents fetal wellbeing [3]. Understanding these normal physiological characteristics is key in correctly interpreting fetal heart rate patterns. A. C. Increase in fetal heart rate, Which of the following is responsible for fetal muscle coordination? Obtain physician order for CST This is interpreted as Fetal P a O 2 Peripheral chemoreflex Abstract A distinctive pattern of recurrent rapid falls in fetal heart rate, called decelerations, are commonly associated with uterine contractions during labour. Additional tests of fetal well-being such as fetal blood sampling (FBS) and fetal electrocardiograph (Fetal ECG or ST-Analyser) also cannot be used in this gestation. A. Repeat in 24 hours A. The pattern lasts 20 minutes or longer Spontaneous rupture of membranes occurs; fetal heart rate drops to 90 beats per minute for four minutes and then resumes a normal pattern. C. Clinical management is unchanged, A. A. Etiology of a baseline FHR of 165bpm occurring for the last hour can be: The most prevalent risk factor associated with fetal death before the onset of labor is: Negative A. Baroceptor response B. B. Between the 25th and 28th weeks, lung development continues and surfactant secretion begins. B. Cerebral cortex A. In the noncompromised, nonacidaemic fetus, intermittent hypoxia results in decelerations with subsequent transient fetal hypertension [8]. 60, no. B. Interruption of the pathway of oxygen transfer from the environment to the fetus caused by a uterine contraction with reduced perfusion of the intervillous space of the placenta can result in a late deceleration (utero-placental insufficiency). royal asia vegetable spring rolls microwave instructions; B. Much of our understanding of the fetal physiological response to hypoxia comes from experiments . Baseline variability of greater than five beats per minute with signs of cycling is likely to develop, between 3032 weeks gestation. C. Maternal hypotension With results such as these, you would expect a _____ resuscitation. At how many weeks gestation should FHR variability be normal in manner? Baseline variability may be affected due to incomplete development of autonomic nervous system and subsequent interplay between parasympathetic and sympathetic systems. In view of the absence of guidelines and recommendations monitoring preterm fetuses, we have produced a management algorithm ACUTE to aid continuous intrapartum fetal monitoring in fetuses prior to 34 weeks (Table 3). Late deceleration A. Metabolic acidosis A. The main purpose of this model is to illustrate the kind of information that is needed to make further progress in this . Intrauterine growth restriction (IUGR) B. Adrenocortical responsiveness is blunted in twin relative to singleton ovine fetuses. (T/F) There is a strong correlation between arterial cord blood gas results and Apgar scores. Decreased tissue perfusion can be temporary . Fetal heart rate accelerations are also noted to change with advancing gestational age. C. Variable deceleration, A risk of amnioinfusion is A. B. 2023 Jan 13;13:1056679. doi: 10.3389/fendo.2022.1056679. R. M. Grivell, Z. Alfirevic, G. M. Gyte, and D. Devane, Antenatal cardiotocography for fetal assessment, Cochrane Database of Systematic Reviews, no. A. Bradycardia B. Supraventricular tachycardia For children with II-III degree of prematurity, respiratory failure (rhythmic surface breathing), which lasts up to 2-3 months of life, is characteristic. C. Early decelerations 1 Quilligan, EJ, Paul, RH. C. Water intoxication, A fetal heart rate pattern that can occur when there is a prolapsed cord is B. Maternal hemoglobin is higher than fetal hemoglobin In uterofetal activity typically results in an increase in fetal heart rate recorded as accelerations on CTG. Late decelerations Most fetuses tolerate this process well, but some do not. Fetal development slows down between the 21st and 24th weeks. B. Pre-term fetus may exhibit accelerations with a peak of only 10 beats per minute lasting for 10 seconds [6]. B. C. Perform a vaginal exam to assess fetal descent, B. B. Liver In the presence of other reassuring features of the CTG (as outlined above), these decelerations should not be considered as indicative of hypoxia, and interventions should be avoided based on this parameter alone. In non-reassuring CTG traces, pulse oximetry was initially felt to provide a more sophisticated way of detecting adverse neonatal outcome. B. C. Umbilical vein compression, A transient decrease in cerebral blood flow (increased cerebral blood pressure) during a contraction may stimulate _____ and may cause a(n) _____ Respiratory acidosis During this period, the white matter of the brain is developing rapidly, and the oligodendroglia responsible for myalinisation of the tracts within the brain is particularly vulnerable during this . Assist the patient to lateral position Premature atrial contraction (PAC) 3, p. 606, 2006. A decrease in the heart rate b. _______ is defined as the energy-releasing process of metabolism. B. Maturation of the control of breathing, including the increase of hypoxia chemosensitivity, continues postnatally. 1827, 1978. Decreased blood perfusion from the fetus to the placenta In the next 15 minutes, there are 18 uterine contractions. The dominance of the parasympathetic nervous system, Periodic accelerations can indicate all of the following except A. Acetylcholine Category II A. A. Preterm Birth. C. Prepare for cesarean delivery, For a patient at 35 weeks' gestation with a BPP score of 4, select the most appropriate course of action. A. Acidemia C. Decrease BP and increase HR This high rate of dramatic fetal acidosis in the preterm may represent an alternative intrapartum compensatory mechanism. D. Decrease BP and decrease HR, During a term antepartum NST (non-stress test), you notice several variable decelerations that decrease at least 15 bpm and last at least 15 sec long. The Effect of External Cephalic Version on Fetal Circulation: A Prospective Cohort Study. C. Premature atrial contraction (PAC). What information would you give her friend over the phone? A. T/F: Variable decelerations are the most frequently seen fetal heart rate deceleration pattern in labor. Breathing B. 5. Dramatically increases oxygen consumption

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