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Relias - Fetal Heart Monitoring – Questions With Complete Solutions
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Relias - Fetal Heart Monitoring – Questions With Complete Solutions
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Relias - Fetal Heart Monitoring – Questions With Complete Solutionsuterine blood supply ✔ Ans -- uterine arteries deliver oxygenated blood to spiral arteries which bring oxygen rich blood to intervillous space of placenta that has fetal capillaries
- fetal capillaries carry the O2 rich blood to umbilical VEIN that goes to fetus
-in contrast, the umbilical ARTERIES return waste products to that intervillous space that go into mother's venous system
Potential issues that negatively affect fetal oxygenation ✔ Ans -*Maternal Oxygenation:* asthma, hyper- or hypo- ventilation
*Maternal Circulation:* decreased maternal cardiac output, hypotension, decreased Hgb
*Placental O2 and CO2 Exchange:* postterm, abruption, HTN, hypotension, uterine tachysystole
*Fetal circulation:* cord compression or occlusion
Fetal hypoxemia ✔ Ans -- can occur d/t reduced fetal O2 reserves, excessive
uterine activity, or reduced uteroplacental blood flow
- worsening fetal hypoxemia can lead to abnormal FHR patterns, mostly minimal or absent variability from acidemia
(1) hypoxemia vs. (2) hypoxia ✔ Ans -1 - reduce O2 in blood
2 - reduced O2 delivery at tissue level
Fetal anaerobic metabolism ✔ Ans -- occurs when long term O2 delivery is insufficient to meet cellular needs of tissues
- results in production of lactic acid and other noncarbonic acids - ACIDOSIS is the presence of excessive acids in tissues
acidosis ✔ Ans -pH below 7.35
pH is low
(acidosis is the process that leads to low blood pH, or acidemia)
alkalosis ✔ Ans -pH above 7.45
pH is high
buffers ✔ Ans -- help maintain acid base homeostasis
- 2 major fetal buffers are plasma bicarbonate and hgb
base excess and base deficit ✔ Ans -- base deficit is expressed as a positive number
- base excess is expressed as a negative number
~ they are equivalent and terms are used interchangeably ~
fetal acidosis ✔ Ans -- when O2 is decreased to fetus, tissue hypoxia results in acidosis, which then shows a drop in pH, a loss of bicarb, and increase in base deficit
acidemia ✔ Ans -assoc w/ widespread, deleterious effects on vital organ and body function
fetal hypoxia during birth ✔ Ans -assoc w/ neonatal depression, low apgars, neonatal encephalopathy, and cerebral palsy
respiratory acidosis ✔ Ans -*low pH (< 7.10), high pCO2 (> 60), normal base deficit ( < 12)*
- increase of pCO2 for fetus that lowers pH but doesn't affect base deficit
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