Increase FHR Term newborns should begin at 21% oxygen (room air oxygen concentration), whereas preterm babies should be started at a higher oxygen concentration, such as 30% (Kattwinkel et al., 2010). A second transducer is placed on the mothers abdomen over the uterine fundus to record frequency and duration of uterine contractions. A. Insert a spiral electrode and turn off the logic A. Bradycardia Hence, a preterm fetus may have a higher baseline fetal heart rate with apparent reduction of baseline variability due to unopposed action of sympathetic nervous system. As fetal hemoglobin has slightly different absorption curves in the near-infrared range, this could also contribute to the higher rSO 2 levels. This intervention may be required earlier compared to term fetuses as a consequence of these low fetal reserves. No decelerations were noted with the two contractions that occurred over 10 minutes. Deceleration patterns, European Journal of Obstetrics Gynecology and Reproductive Biology, vol. C. Mixed acidosis, Which FHR tracing features must be assessed to distinguish arrhythmias from artifact? As the neonatal outcome is largely determined by the gestational maturity and fetal weight, operative intervention is likely to increase maternal morbidity and mortality without significantly improving perinatal survival. Smoking T/F: Contractions cause an increase in uterine venous pressure and a decrease in uterine artery perfusion. B. C. Delivery, Which intrinsic homeostatic response is the fetus demonstrating when abrupt variable decelerations are present? It is important to realize that physiological reserves available to combat hypoxia are less than those available to a term fetus. B. Maternal BMI C. Equivocal, *** As fetal hypoxia (asphyxia) worsens, the last component of the BPP to disappear is fetal Fetal hypoxia and acidemia are demonstrated by pH < _____ and base excess < _____. Xanthine oxidase and the fetal cardiovascular defence to hypoxia in late gestation ovine pregnancy. A. B. Oxygen saturation and heart rate during delivery room resuscitation of infants h30 weeks' gestation with air or 100% oxygen. A. Discontinue Pitocin B. B. FHR baseline Any condition that predisposes decreased uteroplacental blood flow can cause late decelerations. C. Homeostatic dilation of the umbilical artery, A. Physiological control of fetal heart rate and the resultant features observed on the CTG trace differs in the preterm fetus as compared to a fetus at term making interpretation difficult. C. Narcotic administration Positive A. Fetal hemoglobin is higher than maternal hemoglobin B. Fluctuates during labor A. A. Metabolic acidosis 2004 Jun 15;557(Pt 3):1021-32. doi: 10.1113/jphysiol.2004.061796. Increasing variability A. B. Intervillous space flow It carries oxygen from the lungs and nutrients from the gastrointestinal tract. True knot It should be remembered that the physiological reserves to combat hypoxia are not as robust as a term fetus, especially, if the onset of preterm labour is secondary to an infective process. Today she counted eight fetal movements in a two-hour period. Place patient in lateral position Find the stress in the rod when the temperature rises to 40.0C40.0^{\circ} \mathrm{C}40.0C. Increases variability Features of CTG classification into nonreassuring and reassuring (as outlined in Table 1) according to NICE guidelines could be considered. A. 's level of consciousness and respiratory effort significantly improve, allowing her to be extubated. In a normally grown fetus, acidosis in response to hypoxia could take up to 90 minutes to develop, however, in growth retarded or preterm fetuses, acidosis may develop more quickly, and one should therefore have a lower threshold for intervention. A. C. Transient fetal asphyxia during a contraction, B. Further assess fetal oxygenation with scalp stimulation B. Predicts abnormal fetal acid-base status 952957, 1980. The correlation between mean arterial blood pressure and tissue-oxygenation index in the frequency domain was assessed by using . D. Variable deceleration, With complete umbilical cord occlusion, the two umbilical arteries also become occluded, resulting in sudden fetal hypertension, stimulation of the baroreceptors, and a sudden _______ in FHR. 3. Further research is needed to determine the effects of variable decelerations observed in preterm fetuses on the short-term and long-term outcomes. T/F: There are two electronic fetal monitoring methods of obtaining the fetal heart rate: the ultrasound transducer and the fetal spiral electrode. Base deficit 16 C. Vagal stimulation, While caring for a 235-lb laboring woman who is HIV-seropositive, the external FHR tracing is difficult to obtain. This is likely to represent a variation of normal as accelerations may only be noted after 25 weeks gestation.Fetal heart rate decelerations are common at this gestation and is likely to represent normal development of cardioregulatory mechanisms. Copyright 2011 Karolina Afors and Edwin Chandraharan. C. Category III, Maternal oxygen administration is appropriate in the context of A. Norepinephrine release B. Zanini, R. H. Paul, and J. R. Huey, Intrapartum fetal heart rate: correlation with scalp pH in the preterm fetus, American Journal of Obstetrics and Gynecology, vol. Optimizing the management of these pregnancies is of high priority to improve perinatal outcomes. what characterizes a preterm fetal response to interruptions in oxygenation. The basic physiology and adaptive responses that regulate the fetal heart rate and physiological fetal adaptations to stress as reflected in the FHTs are described. Fetal Circulation. B. 7379, 1997. Fetal life elapses in a relatively low oxygen environment. Late decelerations According to National Institute of Health and Clinical Excellence (NICE) guidelines on electronic fetal monitoring in labour, these features, which are present in labour, are further categorized into reassuring and nonreassuring as outlined in Table 1 below. B. Bigeminal Recent ephedrine administration Characteristics of antepartum and intrapartum fetal heart rate tracings differ in the preterm fetus as compared to a term fetus. 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. A. Doppler flow studies Impaired placental circulation these decelerations have a lower depth and duration, but can be seen frequently on intrapartum CTG tracings [4]. Inotropic - promotes regular and effective cardiac contraction, Fetal hydrops may present on ultrasound as fetal scalp edema and increased abdominal fluid as a results of C. Trigeminal, With _____ premature ventricular contractions (PVCs), the upward spikes will be slightly longer than the downward spikes. B. Includes quantification of beat-to-beat changes At the start (A), airway pressure is low, and FiO 2 is high, indicating a high degree of atelectasis . These adjuvants to electronic fetal monitoring were introduced to reduce the false-positive rate associated with CTG monitoring [10]. C. Metabolic acidosis. B. A. CTG of a fetus at 34 weeks of gestation: note baseline heart rate within the normal range, normal baseline variability with cycling. C. Gestational diabetes B. 2016 Mar 1;594(5):1247-64. doi: 10.1113/JP271091. a. The fetal brain sparing response matures as the fetus approaches term, in association with the prepartum increase in fetal plasma cortisol, and treatment of the preterm fetus with clinically relevant doses of synthetic steroids mimics this maturation. Published by on June 29, 2022. Study with Quizlet and memorize flashcards containing terms like Which of the following factors can have a negative effect on uterine blood flow? Hence, a woman should be counseled that the risks of operative intervention may outweigh the benefits. C. Category III, An EFM tracing with absent variability and intermittent late decelerations would be classified as B. Atrial fibrillation D. Oligohydramnios, All of the following are likely causes of prolonged decelerations except: This is an open access article distributed under the. Which of the following factors can have a negative effect on uterine blood flow? Decrease maternal oxygen consumption 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]. Consider induction of labor Assist the patient to lateral position, In a patient with oxytocin-induced tachysystole with indeterminate or abnormal fetal heart tones, which of the following should be the nurse's initial intervention? B. A balance between these two opposing nervous systems results in resting baseline fetal heart rate and baseline variability. Pre-term fetus may exhibit accelerations with a peak of only 10 beats per minute lasting for 10 seconds [6]. B. Several characteristics of FHR patterns are dependant on gestational age as they reflect the development and maturity of cardiac centres in the central nervous system as well as the cardiovascular system and, hence, differ greatly between a preterm and a term fetus. In this situation, the blood flow within the intervillous space is decreased resulting in accumulation of carbon dioxide and hydrogen ion concentrations. High glucose levels lead to increased oxidative stress and activate caspase with consequent reactive oxygen species (ROS) production, which are in turn known to be involved in the pathogenesis of BPD. B. A. Growth-restricted human fetuses have preserved respiratory sinus arrhythmia but reduced heart rate variability estimates of vagal activity during quiescence. C. Injury or loss, *** The preterm infant 1. 4: Schematic presentation using oxygenation to optimize lung volume in preterm infants. Persistent supraventricular tachycardia Fetal circulation, unlike postnatal circulation, involves the umbilical cord and placental blood vessels which carry fetal blood between the fetus and the placenta . doi: 10.14814/phy2.15458. D. Maternal fever, All of the following could likely cause minimal variability in FHR except A. 824831, 2008. The reex triggering this vagal response has been variably attributed to a . It has been demonstrated that HG induces an increased proinflammatory cytokine response in the blood of preterm and term neonates . C. Suspicious, A contraction stress test (CST) is performed. A. 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). Continuing Education Activity. C. Category III, Which of the following is not a likely cause of a sinusoidal FHR pattern? Both components are then traced simultaneously on a paper strip. Daily NSTs The primary aim of the present study was to evaluate a potential influence of FIRS on cerebral oxygen saturation (crSO2) and fractional tissue oxygen extraction (cFTOE) during .