Intrapartum Fetal Surveillance

This set of flashcards covers the critical concepts related to intrapartum fetal surveillance, including fetal oxygenation, maternal factors affecting fetal health, patterns of fetal heart rate, and nursing interventions.

What are the requirements for adequate fetal oxygenation?

Normal maternal blood flow, normal oxygen saturation of maternal blood, normal fetal circulatory functions, an open circulatory path between placenta and fetus, adequate exchange of O2 and CO2 in the placenta.

What primarily increases fetal cardiac output?

An increase in fetal heart rate.

What effect does the sympathetic nervous system have on fetal heart rate (FHR)?

It increases FHR through the release of epinephrine and norepinephrine.

How does the parasympathetic nervous system affect fetal heart rate?

It decreases heart rate and maintains variability.

What conditions can compromise fetal oxygenation?

Maternal hypotension, hypertension, acid-base alterations, lower maternal oxygen tension.

What are some maternal risk factors for fetal compromise?

Previous stillbirth, chronic diseases, acute infections, drug use, and psychosocial stress.

What is the normal range for fetal heart rate (FHR)?

110-160 bpm.

What is the purpose of Electronic Fetal Monitoring (EFM)?

To assess and document fetal heart rate patterns and uterine contractions.

What types of decelerations are observed in fetal heart rate monitoring?

Early, late, and variable decelerations.

What are common signs of an intrapartum infection?

Fetal tachycardia, maternal fever, foul-smelling amniotic fluid.

How is preterm labor defined?

Labor that occurs between 20 weeks and 37 weeks of gestation.

What is the first line treatment to manage preterm labor?

Identify and treat any infections.

What is indicated if there is a recurrent late deceleration pattern during labor?

Possible placental insufficiency or fetal distress.

What are the types of EFM equipment used?

Ultrasound transducer and tocotransducer for external monitoring, fetal scalp electrodes and intrauterine pressure catheters for internal monitoring.

What is the nursing action when a nonreassuring fetal heart rate pattern is detected?

Identify the cause, evaluate FHR pattern, reposition the patient, and notify the provider.

What does prolonged pregnancy (>42 weeks) increase the risk for?

Placental insufficiency and fetal hypoxia.

What is an anaphylactoid syndrome and its risk factors?

Fetal particulate matter in amniotic fluid that obstructs pulmonary vessels, often caused by strong contractions.

What should be monitored in a patient with uterine rupture?

Signs of hypovolemia and fetal heart rate abnormalities.

What is the therapeutic management for preterm labor?

Education, hydration, and limiting activity among other treatment measures.

What are some complications associated with dysfunctional labor?

Maternal fatigue, fear of injury, ineffective contractions, and psychological stress.