OBGYN WEEK 1 Shelf stuff 4

ruhland1's version from 2015-07-22 14:26

Section 1

Question Answer
indicates cord compressionvariable decelerations V and W shapes
heart variableindicates O2 getting to fetal barin
cerebral tissue asphyxiaindicated from abnormal FHR variable
accel criteriaatleast 15bpm above base for 15 secs
prolong accel10min>x>2min, baseline change is 10min >
baseline changex>10min
earl decelhead compression
late deceluteroplacental insuff
prolonged decelx>15 bpm dn for x>2min
early decel patterndecel nadir(trough) at EXACT same time as uterine contract
vari decel patterndecel before/during/after uterine contract, shape is non symmetical or not bowl shape

Section 1a

Question Answer
late decel patternonset, nadir, recovery all shifted later than the UT contract (like onset is slightly after UT contract onset)
sinusoid FHT crit3-5/min for >20min,
sinusoid FHT etiopain meds, anemia, fetal distress
FHR category Inormal
FHR category IIindeterminate
FHR category IIIfetal pH change, requires prompt eval/intervention
FHR category III findingsrecurrent late decel/variable decel/bradycardia/sinusoidal
FHR category I findingstachy,minimal variablity, absence of induced accelations, prolonged decel
contraction timeatleast 40 sec long
normal contraction5 or less in 10 min
tachysystolegreater than 5 contractions in 10 min avg over 30 min
antepartum fetal testmaternal fetal movemt assess
NST (non-stress test)antepartum fetal test
antepartum fetal testcontraction stress test
BPP (biophysical profile)ante partum fetal test (


Question Answer
antepartum fetal testumbilical/middle cerebral artery dopple velocimetry
cardiff (fetal movement assess)"count to 10" so min of 10 fetal mvmt observed in 12 hr
NST normal findingFHR is REACTIVE (2 FHR acel, 15 bpm, 15 sec, in 20 min (x>32 wk)
NST bad findingnon reactive
who should have NSTpreggers with high risk utplacental insuff
up risk ut placental insuffpost 40 wk, DM, htn, IUGR suspect, old mom, multiple gest
OCT = oxytocin challenge test =CST(contraction STRESS test)=antepartum fetal test
CST definition "look for..."3 contract in 10 min looking for late decel(finding of utpla insuff)
(-) CSTno late decel or sig vari (good!)
finding in (+) CSTlate deceleration in greater than 50% of contractions
suspicious CSTintermittent late decel or sig variable decel
when do CSTto further investigate a non-reactive NST
CST contraPPrevia,uterine srx, PROM,dn cervix
BPP is test forfetal well being (use u/s for 4 param out of 5)
BPP paramterNST
fetal mvmtBPP paramter
BPP paramterfetal tone
accel in GA when gest age less than 32 wkgreater than 10 bpm for 15 sec

Section 3

Question Answer
fetal breathing mvmtBPP paramter
BPP paramteraminotic fluoid vol
BPP scoring0 or 2 per paramter max 10, no 1 scores!
BPP reassuring8-10
BPP * do intervention based on AFV(AFi)4-6
BPP "deliver the baby!" score0-2
ACUTE indic for fetal well beingby doing a NST (in modified BPP)
LONG-TERM indicator for fetal wellAFV(AFi) (in modified BPP)
up amniotic volfetus pissing
dn amni volfetus swallowing
when do BPPwhen non-reactive NST results
antepartum testing ultimately looks forshould you deliver or not (assess fetal well being)
antepartum 1st testNST (if reactive no more test)
antepartum non-reactive NSTthen do CST or BPP or mod-BPP

Section 4

Question Answer
intrapartum fetal/maternal heart monitoringfetal scalp electrode
a intrapartum fetal/maternal monitors forfetal scalp pH
IUPC (intrautering pressure cath)intrapartum fetal/maternal monitoring
when use fetal scalp electrode when unable to trace FHR with ext monitor
fetal scalp pHnot used
fetal pulse oxused when FHR is bad (not used tho)
IUPCdirect meaurement of contraction strength and duration
IUPC unitMontevideo (weird name...)
gold dx tool in assess fetal growthu/s
u/s measurementsbpd, abd circ, femur, cerebellar diam
common INDIRECT measure of fetal growthfetal activity
early fetal measurecrown-rump-length and gest sac diam
combines NST and AFI in assessmodified BPP (easier way to predict fetal well being) than BPP
L/Slecithin and sphingomyelin
marker of complete pulm maturationphosphatidylglycerol, present after 35 wk GA
goal of intra partum fetal surveilancerecognize changes in fetal oxygenation and resulting complications / diagnoses

Section 5

Question Answer
causes cerbral palsylow O2 during labor in baby
Only one type of cerebral palsy, __________, is associated with antepartum or intrapartum interruption of the fetal blood supply.spastic quadriplegia
goal of FHR monitoringdetect signs of fetal jeopardy
has hi false positive in predicting adversebad FHR patterns
FHR cat II HRtachy, or brady + absent baseline variability
FHR cat II variminimal/absent/marked are all bad
FHR cat II aceleration findingthe absence of induced accel after fetal stimulation
FHR cat II deceleration findingrecurrent , prolonged, late,
finding in FHR cat II decelreturning to base line "overshoots" or "shoulders"
accel onset to peakwithin 30 sec
FHR cat II meansindeterminate
FHR cat III meansnonreassuring