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 Powerpoint
Slides.
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 Guide
3-Tier FHR Interpretation System
CATEGORY I
CATEGORY II
CATEGORY III
FHR 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 on
the clinical situation, intrauterine
resuscitation should be initiated.
*POOF
FHR tracings include all
of the
following
Baseline rate 110–160 bpm
Baseline variability
moderate
Late or variable
deceleration absent; early
decelerations absent or
present
FHR tracings all
NOT category I
or III.
Bradycardia not
accompanied by absent
variability
Tachycardia
Minimal or absent baseline
variability
NO recurrent decelerations
Marked baseline variability
Absence of induced
accelerations
Recurrent or prolonged
decelerations with minimal
or moderate variability
FHR tracings that are
Absent variability with any of the
following:
o
Recurrent late
decelerations
o
Recurrent variable
decelerations
o
Bradycardia
o
Sinusoidal pattern
intrauterine resuscitation
.
*POOF
Position: left lateral
Oxytocin: STOP
Oxygen: 8-10 L of O
2
Fluids: IV Fluids
Intrauterine Fetal Resuscitation
*Stop Pitocin
Reposition to left lateral, Trendelenberg if needed
Oxygen via mask at 8-10 L/min
Increase IV fluids
SQ
terbutaline
(0.25 mg) if uterus not relaxing
Vaginal exam for possible cause:
prolapse, fetal descent, rupture, abruption
Amnioinfusion for variable decels
Notify MD/midwife
Labor
Signs/Symptoms of Labor
o
True Labor vs False Labor
True labor contractions occur at regular intervals and increase in frequency, duration, and intensity.
True
labor contractions bring about changes in cervical effacement and dilation.
False
labor is irregular contractions with little or no cervical changes.
False
labor
irregular contractions with little or no
cervical changes
Benign and irregular
contractions
Often disappear with
ambulation and sleep.
