week 2-1

Flashcards covering intrapartum fetal monitoring interpretation, antepartum diagnostic tests, risk factors, and high-risk pregnancy conditions based on lecture notes.

Electronic Fetal Monitoring (EFM)

The use of instruments to monitor fetal heart rate and uterine contractions to assess fetal health and response to the intrauterine environment.

Tocodynamometer (TOCO)

An external monitoring sensor placed on the maternal fundus to detect the frequency and duration of uterine contractions.

Ultrasound Transducer (U/S)

An external fetal monitoring device placed on the maternal abdomen over the fetal back to continuously measure fetal heart rate using sound waves.

Fetal Scalp Electrode (FSE)

An internal monitoring device attached directly to the fetal presenting part to measure fetal heart rate.

Intrauterine Pressure Catheter (IUPC)

An internal monitoring device placed inside the uterine cavity to measure exact intrauterine pressure and contraction strength in Montevideo units (MVUs).

Baseline Fetal Heart Rate

The mean fetal heart rate rounded to increments of $5\,bpm$ over a $10\text{-minute}$ segment, excluding accelerations, decelerations, and marked variability; normal range is $110\text{--}160\,bpm$.

Fetal Tachycardia

A baseline fetal heart rate of $\ge 160\,bpm$ lasting for at least $10\text{ minutes}$, commonly caused by maternal fever, infection, fetal anemia, or medications.

Fetal Bradycardia

A baseline fetal heart rate of $\le 110\,bpm$ lasting for at least $10\text{ minutes}$, potentially caused by fetal hypoxia, maternal hypoglycemia, hypothermia, heart blocks, or maternal hypotension.

FHR Variability

Irregular fluctuations in the baseline fetal heart rate, measured peak to trough, reflecting an intact central nervous system and adequate fetal oxygenation.

Absent Variability

Fetal heart rate baseline fluctuations where the amplitude range is undetectable, indicating severe fetal compromise.

Minimal Variability

Fetal heart rate baseline fluctuations with a detectable amplitude range of $< 5\,bpm$.

Moderate Variability

Fetal heart rate baseline fluctuations with an amplitude range of $6\text{--}25\,bpm$, indicating normal fetal acid-base status and good oxygenation.

Marked Variability

Fetal heart rate baseline fluctuations with an amplitude range of $> 25\,bpm$, requiring evaluation and intervention.

FHR Acceleration

A visually apparent abrupt increase in FHR above baseline of $\ge 15\,bpm$ lasting $\ge 15\text{ seconds}$ ($\ge 10\,bpm$ lasting $\ge 10\text{ seconds}$ if gestation is $\le 32\text{ weeks}$).

Periodic FHR Changes

Temporary changes in fetal heart rate baseline (accelerations or decelerations) that occur in direct association with uterine contractions.

Episodic FHR Changes

Temporary changes in fetal heart rate baseline that occur independently and are not associated with uterine contractions.

Early Deceleration

A gradual, symmetrical decrease and return of FHR that mirrors a uterine contraction, caused by fetal head compression during labor.

Variable Deceleration

An abrupt decrease in FHR of $\ge 15\,bpm$ below baseline lasting $\ge 15\text{ seconds}$ but $< 2\text{ minutes}$, caused by umbilical cord compression.

Late Deceleration

A gradual decrease in FHR below baseline where the lowest point (nadir) occurs after the peak of the contraction, caused by uteroplacental insufficiency.

Prolonged Deceleration

A decrease in FHR of $\ge 15\,bpm$ below baseline lasting $\ge 2\text{ minutes}$ but $< 10\text{ minutes}$.

VEAL CHOP

A nursing mnemonic matching FHR patterns to causes: Variable = Cord compression, Early = Head compression, Acceleration = Okay, Late = Placental insufficiency.

Contraction Frequency

The timing of uterine activity measured from the beginning of one contraction to the beginning of the next contraction.

Contraction Duration

The length of uterine activity measured from the beginning of a single contraction to the end of that same contraction.

Tachysystole

Excessive uterine activity defined as more than $5$ contractions in a $10\text{-minute}$ window averaged over $30\text{ minutes}$, or two contractions lasting longer than $120\text{ seconds}$.

Category I FHR Tracing

A normal fetal heart rate tracing characterized by baseline $110\text{--}160\,bpm$, moderate variability, absence of late or variable decelerations, and optional accelerations or early decelerations.

Category III FHR Tracing

An abnormal fetal heart rate tracing characterized by a sinusoidal pattern or absent variability accompanied by recurrent late decelerations, recurrent variable decelerations, or bradycardia.

Sinusoidal FHR Pattern

A smooth, undulating sine wave-like baseline pattern in fetal heart rate associated with severe fetal anemia, classified as Category III.

Vibroacoustic Stimulation (VAS)

An antepartum assessment technique applying sound and vibration to the maternal abdomen for $< 3\text{ seconds}$ to elicit FHR accelerations.

Amnioinfusion

The instillation of normal saline into the uterine cavity via an IUPC to relieve repetitive variable decelerations caused by umbilical cord compression.

Biophysical Risks

Risk factors that originate within the mother or fetus and affect development, such as genetic considerations, nutritional status, and medical or obstetric disorders.

Psychosocial Risks

Risk factors arising from maternal behaviors and adverse lifestyle choices, such as smoking, alcohol, substance use, and mental illness.

Sociodemographic Risks

Risk factors originating from the mother and her family situation, such as low income, lack of prenatal care, maternal age, parity, marital status, and ethnicity.

Environmental Factors

Hazards in the workplace or general environment, including chemicals, mercury, radiation, infection, and substance exposure.

Daily Fetal Kick Counts

A biophysical assessment where the mother lies on her side after eating or drinking and counts $10$ fetal movements within a $2\text{-hour}$ window.

Biophysical Profile (BPP)

A noninvasive antepartum assessment evaluating five criteria (fetal breathing, movement, tone, amniotic fluid volume, and nonstress test), each scored $0$ or $2$ up to a total of $10$.

Lecithin/Sphingomyelin (L/S) Ratio

An amniotic fluid ratio measuring pulmonary surfactant components, where a $2:1$ ratio (reached around $35\text{ weeks}$) indicates mature fetal lungs and low risk of respiratory distress syndrome (RDS).

Phosphatidylglycerol (PG)

A phospholipid component of surfactant in amniotic fluid whose presence indicates low risk for neonatal respiratory distress syndrome.

Chorionic Villus Sampling (CVS)

An antepartum procedure performed between $10$ and $13\text{ weeks}$ gestation involving biopsy of placental tissue for early fetal genetic diagnosis.

Percutaneous Umbilical Blood Sampling (PUBS)

Direct insertion of a needle into a fetal umbilical vessel under ultrasound guidance to obtain fetal blood samples.

Alpha-Fetoprotein (AFP) Screen

A maternal blood test performed at $16\text{--}18\text{ weeks}$ gestation where elevated levels indicate neural tube defects and low levels indicate Down syndrome.

Quad Screen

A maternal serum test performed around $16\text{ weeks}$ gestation evaluating AFP, hCG, unconjugated estriol, and Inhibin-A for fetal chromosomal abnormalities.

Rho(D) Immune Globulin (RhoGAM)

An intramuscular or intravenous medication given to Rh-negative mothers at $28\text{ weeks}$ gestation and within $72\text{ hours}$ post-delivery to prevent maternal Rh isoimmunization.

Indirect Coombs Test

A maternal blood screening test used to detect Rh antibodies in the mother's circulation.

Direct Coombs Test

A blood test performed on newborn blood to detect maternal antibodies bound to fetal red blood cells.

Reactive Non-Stress Test (NST)

A reassuring antepartum EFM result defined as $2$ or more FHR accelerations occurring within a $20\text{-minute}$ period.

Non-Reactive Non-Stress Test

An abnormal antepartum EFM result characterized by insufficient FHR accelerations over a $40\text{-minute}$ monitoring period.

Contraction Stress Test (CST)

An antepartum evaluation of FHR response to induced contractions ($3$ contractions lasting $40\text{--}60\text{ seconds}$ in $10\text{ minutes}$) to assess uteroplacental function.

Gestational Diabetes Mellitus (GDM)

Carbohydrate intolerance resulting in hyperglycemia with onset or first recognition during pregnancy, routinely screened between $24$ and $28\text{ weeks}$ gestation.

Physiologic Anemia of Pregnancy

A reduction in maternal hemoglobin ($< 11\text{ g/dL}$) caused by a greater expansion of plasma volume relative to red blood cell mass.

Intrahepatic Cholestasis of Pregnancy (ICP)

A liver condition of pregnancy presenting with severe pruritus on the palms and soles that worsens at night, elevated bile acids, and increased risk for poor fetal outcomes.