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The Study Guide for Week 3's content is now posted. Please also review the FHR Categories (I, II and III) from the last few slides at the end of Week 2's PowerpointSlides. GBS was also introduced in Week 1, but please take a look at the content in the book, since it is explained in Chapter 8. There will NOT be any questions from Chapter 13 (Transition to Parenthood) on the quiz.Quiz for Week 4 Study Guide3-Tier FHR Interpretation SystemCATEGORY ICATEGORY IICATEGORY IIIFHR tracings are normal. They are strongly predictive of normal fetal acid-base balance. They may be followed in a routine manner, and no action is required.FHR tracings are indeterminate. They are not predictive of abnormal fetal acid-base status, yet there is not adequate evidence to classify them as category I or III. They require evaluation and continued surveillance and reevaluation in the context of the clinical circumstances.FHR tracings are abnormal. They are predictive of abnormal fetal acid-base status and require prompt evaluation. Depending onthe clinical situation, intrauterine resuscitation should be initiated. *POOFFHR tracings include allof the followingBaseline rate 110–160 bpmBaseline variability moderateLate or variable deceleration absent; early decelerations absent or presentFHR tracings allNOT category I or III.Bradycardia not accompanied by absent variabilityTachycardiaMinimal or absent baselinevariabilityNO recurrent decelerationsMarked baseline variabilityAbsence of induced accelerationsRecurrent or prolonged decelerations with minimalor moderate variabilityFHR tracings that areAbsent variability with any of the following:oRecurrent late decelerationsoRecurrent variable decelerationsoBradycardiaoSinusoidal patternintrauterine resuscitation.*POOFPosition: left lateralOxytocin: STOPOxygen: 8-10 L of O2Fluids: IV FluidsIntrauterine Fetal Resuscitation *Stop PitocinReposition to left lateral, Trendelenberg if neededOxygen via mask at 8-10 L/minIncrease IV fluidsSQ terbutaline (0.25 mg) if uterus not relaxingVaginal exam for possible cause: prolapse, fetal descent, rupture, abruptionAmnioinfusion for variable decelsNotify MD/midwife
LaborSigns/Symptoms of LaboroTrue Labor vs False LaborTrue labor contractions occur at regular intervals and increase in frequency, duration, and intensity.Truelabor contractions bring about changes in cervical effacement and dilation.Falselabor is irregular contractions with little or no cervical changes.Falselaborirregular contractions with little or nocervical changesBenign and irregular contractionsOften disappear with ambulation and sleep.