NCC EFM Study Guide (Latest version 2022/2023) Verified Content, Exams of Electronics

Download NCC EFM Study Guide (Latest version 2022/2023) Verified Content and more Exams Electronics in PDF only on Docsity! NCC EFM Study Guide Causes of uteroplacental perfusion decrease: - THE CORRECT ASNWER IS • HTN • Pregnancy • DM • Hypotension • Excessive uterine contractions (hypertonus) • Decreased surface area, edema, degenerative calcifications, infarcts, infection FHR reflects fetal oxygenation from which extrinsic factors: - THE CORRECT ASNWER IS • Maternal oxygenation • Uterine blood flow • Placental change • Umbilical blood flow FHR reflects oxygenation from which intrinsic factors: - THE CORRECT ASNWER IS • Fetal circulation • Oxygenation of tissues • FHR regulation Fetal shunts: - THE CORRECT ASNWER IS • Ductus venosus- liver • PFO- Right to left atria • Ductus arteriosis- pulmonary a. to aorta Oxygen depletion cascade: - THE CORRECT ASNWER IS • Aerobic metabolism • Hypoxemia • Tissue hypoxia • Anaerobic metabolism • Lactic acid build up • Metabolic acidosis Sympathetic innervation: - THE CORRECT ASNWER IS • Releases Eip/norepi • Increases FHR Parasympathetic/Vagal innervation: - THE CORRECT ASNWER IS • Releases ach • Decreases FHR and transmits variability Early decel: - THE CORRECT ASNWER IS • Fetal head compression • ->vasovagal response Variable decel: - THE CORRECT ASNWER IS • Cord compression • ->increase BP/HTN • ->activation of baroreceptor • ->decrease FHR, BP, and CO Late decel: - THE CORRECT ASNWER IS • Inadequate uteroplacental blood flow- >decreased maternal fetal O2 transfer • ->activation of chemoreceptors to respond due to increased PCO2, decreased PO2, and decreased pH • ->Fetal bradycardia and hypertension Category I: - THE CORRECT ASNWER IS • Normal fetal acid base status • All the following are required: • Moderate variability • Baseline rate 110-160 • Late or variable decels are absent • Early decels present or absent • Accels present or absent Category II: - THE CORRECT ASNWER IS • Indeterminate compensatory response • Not category I or II Category III: - THE CORRECT ASNWER IS • Abnormal fetal acid-base status • Either required • Absent variability with: o Recurrent late decels, or o Recurrent variable decels, or o Bradycardia • Sinusoidal pattern In-Utero resuscitation: - THE CORRECT ASNWER IS • Change maternal position • Decrease uterine activity • IV fluid bolus • Correct maternal hypotension • Oxygen administration • Amnioinfusion • Alteration in 2nd stage maternal pushing efforts • If prolapsed cord, then elevate fetal presenting part while moving toward operative birth Baseline FHR: - THE CORRECT ASNWER IS • Approximate mean FHR excluding accelerations and decelerations or periods of marked variability (>25 bpm) • Minimum of 2 minutes of identifiable BL segments in any 10 min window • May need to refer to previous 10 min window Baseline variability: - THE CORRECT ASNWER IS • Irregular fluctuation in baseline FHR in both amplitude and frequency • Absent- Undetectable • Minimal- 0-5 • Moderate- 6-25 • DC oxytocin or cervical ripening • Consider tocolytic (terbutaline) • If in second stage, consider stop pushing temporarily or alter pushing Normal uterine contractions definition: - THE CORRECT ASNWER IS • <=5 in 10 min averaged over 30 min Tachysystole definition: - THE CORRECT ASNWER IS • >5 in 10 min averaged over 30 min Indications to attempt cord blood samples - THE CORRECT ASNWER IS • Abnormal FHR tracing • CS for fetal compromise • Thyroid dz • Severe growth restriction • Low 5 min Apgar • Intrapartum fever • Multifetal gestations Normal umbilical artery cord gas values: - THE CORRECT ASNWER IS • pH>7.1 • pCO2<60 • HCO3>22 • BE (base defecit) .-12 Respiratory acidemia: - THE CORRECT ASNWER IS • pCO2>60 Metabolic acidemia: - THE CORRECT ASNWER IS • HC03<22 • BE<-12 Mixed acidemia: - THE CORRECT ASNWER IS • pCO2>60 • HCO3<22 • BE<-12 Narcotics: - THE CORRECT ASNWER IS • Decrease variability • Decrease accelerations Butorphamon: - THE CORRECT ASNWER IS • Transient sinusoidal (pseudo- sinusoidal) Cocaine: - THE CORRECT ASNWER IS • Decrease variability Mag: - THE CORRECT ASNWER IS • Decrease variability Betamethasone: - THE CORRECT ASNWER IS • Decrease variability Terbutaline: - THE CORRECT ASNWER IS • Increased baseline FHR Zidovidine: - THE CORRECT ASNWER IS • No change B-Blockes: - THE CORRECT ASNWER IS • Decrease FHR CCBs: - THE CORRECT ASNWER IS • Decrease FHR