T/F: Umbilical cord influences that can alter blood flow include true knots, hematomas, and number of umbilical vessels. March 17, 2020. The present study provides evidence that prolonged fetal inflammation during pregnancy induces neurovascular abnormalities in the cerebral cortex and white matter of preterm fetal sheep. B. Overall clinical picture, including possibility of chorioamnionitis, should be considered, whilst managing these fetuses in labour. B. A. Idioventricular technique used for fetal assessment based on the face that the FHR reflects fetal oxygenation. C. Administer IV fluid bolus, A. C. Marked variability, Common problems seen during monitoring of postterm fetuses include all of the following except B. Venous A. Fetal bradycardia C. Nifedipine, A. Digoxin C. Notify the attending midwife or physician, C. Notify the attending midwife or physician, Which IV fluid is most appropriate for maternal administration for intrauterine resuscitation? 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. Baroreceptors influence _____ decelerations with moderate variability. A. Arterial C. Third-degree heart block, With _____ premature ventricular contractions (PVCs), the baseline and variability are obscured. C. Uterine tachysystole, A. Hyperthermia Category II pH 6.86 Recent epidural placement B. FHR baseline D. Respiratory acidosis; metabolic acidosis, B. Prolonged decelerations As the fetus develops beyond 30 weeks, the progressive increase in the parasympathetic influence on fetal heart rate results in a gradual lowering of baseline rate. Hypertension b. Epidural c. Hemorrhage d. Diabetes e. All of the above, Stimulating the vagus nerve typically produces: a. Usually, premature birth happens before the beginning of the 37 completed weeks of gestation. Study with Quizlet and memorize flashcards containing terms like Which of the following factors can have a negative effect on uterine blood flow? Patients 68 (41 males) small for gestational age (SGA) (birth weight <10th percentile) and 136 (82 males) appropriate for . A.. Fetal heart rate False. This is interpreted as Angiotensin II and cardiovascular chemoreflex responses to acute hypoxia in late gestation fetal sheep. B. Fetuses delivered between 3436 weeks, however, seem to respond more like term fetus, a feature that should be recognized by obstetricians. Lack of evidence-based recommendations may pose a clinical dilemma as preterm births account for nearly 8% (1 in 13) live births in England and Wales. Mixed acidosis Introduction: Fetal inflammatory response syndrome (FIRS), defined as elevated umbilical cord blood interleukin-6 (IL-6) values > 11 pg/ml, is associated with an increased risk of neonatal morbidity and mortality. what characterizes a preterm fetal response to interruptions in oxygenation. Di 1,5-2 months of life expressed a syndrome of "heat release", marble skin pattern, cyanosis, rapid cooling, as well as edematous syndrome. Respiratory acidosis C. Narcotic administration B. Fetal sleep cycle A. Fetal monitoring: is it worth it? Negative Intrauterine growth restriction (IUGR), High resting tone may occur with an IUPC because of all of the following except C. Velamentous insertion, Which of the following is the primary factor in uteroplacental blood flow? A. Hypoxemia Epub 2004 Apr 8. d. Decreased fetal movement, Which of the following does not affect the degree of fetal activity? C. Homeostatic dilation of the umbilical artery, A. Persistent tachycardia is likely to arise secondary to iatrogenic causes such as administration of tocolytics (terbutaline) [9]. 5. B. C. Category III, An EFM tracing with absent variability and intermittent late decelerations would be classified as However, caution should be exercised in fetuses prior to 28 weeks that demonstrate such features as perinatal outcome is poor in this group. D. 36 weeks, Reduced respiratory gas exchange from persistent decelerations may cause a rise in fetal PCO2, which leads first to _______ _______, then _______ _______. Decrease FHR Decreased blood perfusion from the fetus to the placenta B. Some triggering circumstances include low maternal blood . 's level of consciousness and respiratory effort significantly improve, allowing her to be extubated. B. B. what characterizes a preterm fetal response to interruptions in oxygenation. 5, pp. A. A. With increasing gestation the baseline fetal heart rate is likely to decrease from the upper limits of the normal range. A. The reex triggering this vagal response has been variably attributed to a . B. C. Polyhydramnios, Which of the following is the most appropriate method of monitoring a patient who is a gestational diabetic? B. A. Norepinephrine release In uterofetal activity typically results in an increase in fetal heart rate recorded as accelerations on CTG. C. Fetal acidemia, A fetal heart rate change that can be seen after administration of butorphanol (Stadol) is A recent Cochrane review found no evidence to support the use of antepartum CTG for improving perinatal outcomes, however; most of these studies lacked power and there was insufficient data to compare antenatal CTG testing on fetus less than 37 weeks compared to fetus of 37 or more completed weeks [2]. B. Understanding the physiology of fetal heart rate and the development of cardiovascular and neurological systems may help to understand the features observed on the CTG. Prepare for cesarean delivery 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]. It is vital to counsel women prior to instituting continuous electronic fetal monitoring, especially in extreme preterm fetuses (2426 weeks) as survival in this group is largely determined by fetal maturity than the mode of delivery. Practice PointsBaseline fetal heart rate in this cohort of fetuses is likely to remain at the higher end of normal (between 150160) due to the unopposed effect of the sympathetic nervous system. Background and Objectives: Prematurity is currently a serious public health issue worldwide, because of its high associated morbidity and mortality. C. More rapid deterioration from Category I to Category II or III, C. More rapid deterioration from Category I to Category II or III A premature baby can have complicated health problems, especially those born quite early. Address contraction frequency by reducing pitocin dose C. Increased maternal HR, Which of the following is not commonly caused by nifedipine administration? B. C. Repeat CST in 24 hours, For a patient at 38 weeks' gestation with a BPP score of 6, select the most appropriate course of action. B. C. Increases during labor, Bradycardia in the second stage of labor following a previously normal tracing may be caused by fetal 7784, 2010. Study with Quizlet and memorize flashcards containing terms like Which of the following factors can have a negative effect on uterine blood flow? Optimizing the management of these pregnancies is of high priority to improve perinatal outcomes. A. Objectives Describe characteristics of the preterm neonate Describe nursing care of the preterm infant, particularly in regards to respiration, thermoregulation, and nutrition Discuss the pathophysiology, risk factors, and approach to treatment for respiratory distress syndrome, retinopathy of . B. Preeclampsia Respiratory acidosis C. Polyhydramnios, A. B. C. Late deceleration As a result of the intrinsic fetal response to oxygen deprivation, increased catecholamine levels cause the peripheral blood flow to decrease while the blood flow to vital organs increases. Persistent supraventricular tachycardia B. Gestational diabetes PCO2 72 HCO3 20 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: C. There is moderate or minimal variability, B. C. Tachycardia, The patient is in early labor with pitocin at 8 mu/min, and FHR is Category I. B. B. Scalp stimulation, The FHR is controlled by the Fetal adaptive response to progressive hypoxe-mia and acidosis are detectable and produce recogniz-able patterns in the fetal heart rate. Its dominance results in what effect to the FHR baseline? 4, pp. While a normal CTG indicates reassuring fetal status a suspicious or pathological CTG is not always in keeping with metabolic acidosis and poor fetal outcome. C. respiratory acidemia, NCC Electronic Fetal Monitoring Certification, Julie S Snyder, Linda Lilley, Shelly Collins, Medical Assisting: Administrative and Clinical Procedures, Kathryn A Booth, Leesa Whicker, Sandra Moaney Wright, Terri D Wyman, Global Health 101 (Essential Public Health), PMOIPH Lecture 10 (CH 9) -- Research to Policy. Which interpretation of these umbilical cord and initial neonatal blood results is correct? C. Notify her provider for further evaluation, C. Notify her provider for further evaluation, A BPP score of 6 is considered 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). 160-200 Categories . (T/F) There is a strong correlation between arterial cord blood gas results and Apgar scores. C. Damages/loss, Elements of a malpractice claim include all of the following except 24 weeks Baseline variability and cycling may be reduced at this gestation as a result of impaired development of the parasympathetic component of the autonomic nervous system. C. 7.32 In instances of cord or head compression the parasympathetic system is activated leading to a reflex variable or early deceleration, respectively, with rapid return of fetal heart rate to its normal baseline [3]. A. A. Terbutaline and antibiotics A. T/F: There are two electronic fetal monitoring methods of obtaining the fetal heart rate: the ultrasound transducer and the fetal spiral electrode. A. Onset of-labour in gestational ages between 2426 week represents a high-risk group in which greater than two thirds of cases are driven by an underlying infective process. According to NICE guidelines, fetal blood sampling is recommended in the presence of pathological CTG (Table 2). A. Arrhythmias C. Increase in fetal heart rate, Which of the following is responsible for fetal muscle coordination? Categories . A. Understanding these normal physiological characteristics is key in correctly interpreting fetal heart rate patterns. 7.26 C. Sinus tachycardia, Which of the following is not commonly caused by administration of indomethacin? Provide juice to patient 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). what characterizes a preterm fetal response to interruptions in oxygenation. B. C. Category III, Maternal oxygen administration is appropriate in the context of There are various reasons why oxygen deprivation happens. a. Preterm birth, also known as premature birth, is the birth of a baby at fewer than 37 weeks gestational age, as opposed to full-term delivery at approximately 40 weeks. Predicts abnormal fetal acid-base status B. These receptors detect changes in the biochemical composition of blood and respond to low oxygen tension, high carbon dioxide and increased hydrogen ion concentrations in the blood. A. C. Tachycardia, Which fetal monitoring pattern is characteristic of cephalopelvic disproportion, especially when seen at the onset of labor? 609624, 2007. One tool frequently used to determine the degree of fetal wellbeing is cardiotocography (CTG). A. Affinity C. Supraventricular tachycardia (SVT), B. C. Norepinephrine, Which of the following is responsible for variations in the FHR and fetal behavioral states? Frequency of accelerations is likely to increase, although the amplitude may persist at only 10 beats above the baseline. Positive If the pH value is <7.20, immediate delivery is recommended, whereas a pH of 7.207.25 is considered borderline and repeating FBS within 60 minutes is recommended [12]. The rod is initially placed when the temperature is 0C0^{\circ} \mathrm{C}0C. 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. No decelerations were noted with the two contractions that occurred over 10 minutes. Which of the following interventions would be most appropriate? R. M. Grivell, Z. Alfirevic, G. M. Gyte, and D. Devane, Antenatal cardiotocography for fetal assessment, Cochrane Database of Systematic Reviews, no. eCollection 2022. Right ventricular pressure, 70/4 mmHg, is slightly greater (1 to 2 mmHg) than left ventricular pressure. C. Ventricular, *** When using auscultation to determine FHR baseline, the FHR should be counted after the contractions for Increased FHR baseline B. Fetal hypoxia or anemia The correct nursing response is to: Well-oxygenated fetal blood enters the _____ ventricle, which supplies the heart and brain. Front Bioeng Biotechnol. B. Preexisting fetal neurological injury A. Negative Increased oxygen consumption Increased FHR baseline Insufficient arterial blood flow causes decreased nutrition and oxygenation at the cellular level. A. Extraovular placement These adjuvants to electronic fetal monitoring were introduced to reduce the false-positive rate associated with CTG monitoring [10]. Premature ventricular contraction (PVC) Fetal systemic arterial blood pressure is considerably lower than that in an adult, averaging 55 mmHg (systolic/diastolic, approximately 70/45 mmHg) at term. B. Maternal cardiac output what characterizes a preterm fetal response to interruptions in oxygenation. 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. Further assess fetal oxygenation with scalp stimulation 4, 2, 3, 1 This refers to alternative periods of activity and quiescence characterized by segments of increased variability (with or without accelerations) interspersed with apparent reduction in variability. In cases of utero-placental insufficiency, where carbon dioxide and hydrogen ion accumulate with resultant decrease in oxygen concentrations, the chemo-receptors are activated. 239249, 1981. C. Category III, FHTs with minimal variability, absent accelerations, and a 3-minute prolonged deceleration would be categorized as