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An in-depth overview of fetal heart rate monitoring and umbilical cord blood analysis. It covers the normal ranges for arterial and venous umbilical cord blood values, the various types of fetal heart rate decelerations (late, variable, and prolonged), the risk factors associated with each type, and the fhr features indicative of normal and developing fetal acidosis. The document also discusses the use of fetal scalp electrodes, fhr tachycardia, and the management of late and variable decelerations. Additionally, it covers the definition and management of tachysystole, the use of amnioinfusion, and the characteristics of a sinusoidal fhr pattern. The information presented in this document is highly relevant for healthcare professionals involved in fetal monitoring and management during labor and delivery.
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uterine blood supply
(1) hypoxemia vs. (2) hypoxia 1 - reduce O2 in blood 2 - reduced O2 delivery at tissue level Fetal anaerobic metabolism
mixed acidosis pH < 7.10 , high pCO2 > 60, and high base deficit >
pH 7. pCO2 33 - 50 base excess - 1 to - 8 factors for neonatal encephalopathy or cerebral palsy Data shows that intrapartum hypoxia-ischemia is rarely sole significant contributing factor for this Other contributing factors include:
Maternal factors for late decels Inhalation: asthma, sleep apnea Circulation: hypotension, HTN, hypovolemia, anemia, microvascular disease, tachycardia Risk factors for variable decels Uteroplacental:
causes of variable decels
oligo (in early labor or after ROM) during descent of presenting part d/t stretching of nuchal or short cord cord prolapse unusual issue like knot, short cord, tangle, occult prolapse prolonged decel
minimal variability
tachysystole more than 5 contractions in 10 minutes amnioinfusion requirements