OB NotesTEST 3:Feta Reserve: determines amount of reserveIf placenta is not working baby is not working. 1.Integrity of placenta: Diabetes, smoking etc. affects the placenta. 2.Wellbeing of the baby. Term baby has more reserves then a pre-term baby. If baby needs more oxygen Won’t move. Will go from moderate to minimal variability Minimal variability = caution light Absent BAD (Getting close to death)No more reserves. Don’t move as much. Minimal variability Move from aerobic to anaerobic stage to conserve oxygen If has to do this, end stage is lactic acid. The baby will build up lactic acid, the baby gets acidotic = brain damage / cerebral palsies. What to do to mamma, to get more reserves to baby: 1.Turn mamma to left lateral to get her to breathe better. 2.IV fluid bolus: 500 – 1000 ml3.Put mom on oxygen. 10L non-rebreatherMinimal Caution Less than 5 of a change from baseline. Cause Minimal Variability1.Sleep (up to 20-30 min at a time in belly)2.Sedation (Mom given drugs, mom drunk = baby drunk)3.Sick if you can rule out the other two then the baby is ‘sick’. Moderate Best/Good (What we want!!!!!)Tells us this baby is oxygenated at that time. 5-25 from baseline. Has good reserves. Mart: Baby is using a lot of its reserves Yellow light. Greater than 25 from baseline. Baby need 60 – 90 seconds between contractions to have time to recoverEvery time there is a contraction a baby uses its reserves.
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