Intrapartum Fetal Heart Rate Monitoring and Obstetric Pain Management

Vocabulary practice flashcards covering electronic fetal heart rate monitoring patterns, variability classifications, non-stress testing criteria, and labor analgesia and anesthesia techniques.

Contraction Frequency

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

Contraction Duration

The length of an individual contraction measured from its beginning to its end.

Normal Baseline Fetal Heart Rate

A resting fetal heart rate that ranges between $110\,\text{beats per minute}$ and $160\,\text{beats per minute}$.

Absent Variability

A fetal heart rate pattern showing virtually no accelerations or fluctuations, indicating fetal cerebral asphyxia due to lack of oxygen.

Minimal Variability

Fluctuations in the baseline fetal heart rate that are greater than $2\,\text{beats per minute}$ but less than $5\,\text{beats per minute}$, often seen during fetal sleep cycles or maternal drug use (such as oxycodone).

Moderate Variability

Baseline fetal heart rate fluctuations ranging from $6\,\text{beats per minute}$ to $25\,\text{beats per minute}$, serving as the best indicator of fetal well-being and adequate oxygenation.

Reactive Non-Stress Test (NST)

A reassuring tracing containing at least two fetal heart rate accelerations within a $20\text{-minute}$ window, where each acceleration peaks at least $15\,\text{beats per minute}$ above baseline and lasts for at least $15\text{ seconds}$.

Acme

The highest peak or point of maximum intensity of a maternal uterine contraction.

Nadir

The lowest point or lowest segment of a fetal heart rate deceleration.

Early Decelerations

Symmetrical drops in fetal heart rate that mirror maternal uterine contractions or begin at the acme; present in $83\%\text{ to }85\%$ of all labors and considered normal.

Late Decelerations

Gradual decreases in fetal heart rate that begin right at the acme of a uterine contraction and return to baseline only after the contraction ends, signaling insufficient oxygen supply to the fetus.

Variable Decelerations

Irregular, jagged, or jigsaw-shaped drops in fetal heart rate caused by umbilical cord compression or umbilical cord prolapse.

Prolonged Deceleration

A severe, extended drop in fetal heart rate lasting across multiple contractions or several minutes, requiring urgent medical attention and intervention.

Fetal Tachycardia

A sustained baseline fetal heart rate above the normal limit of $160\,\text{beats per minute}$, reaching levels such as $175\,\text{beats per minute}$ to $180\,\text{beats per minute}$.

Fetal Bradycardia

A baseline fetal heart rate that drops below the normal threshold of $110\,\text{beats per minute}$.

Tachysystole

An inadequate interval of resting tone between uterine contractions, characterized by contractions occurring excessively close together.

Stadol

A narcotic analgesic used for labor pain relief that is considered safe and does not interfere with the central nervous system of the fetus.

Demerol

A central nervous system depressant historically used for labor pain management that is no longer administered.

Narcan

An emergency opioid reversal agent that must always be readily available when administering narcotic analgesics during labor.

Pre-Epidural IV Hydration Protocol

The rapid administration of $500\,\text{mL}$ of IV fluid (such as lactated Ringer's or normal saline) through an $18\text{-gauge}$ catheter prior to epidural placement to counteract severe maternal hypotension.

Epidural Anesthesia

Regional anesthesia administered into the epidural space providing pain blockage from the waist down, typically taking about $20\text{ to }30\text{ minutes}$ to take effect.

Spinal Anesthesia

Regional anesthesia injected directly into the spinal space providing immediate anesthesia from the level of the diaphragm down.

Blood Patch

A postpartum procedure in which maternal blood drawn from the hand is injected into the spinal space to form a clot and seal a cerebrospinal fluid leak causing a spinal headache.