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Flashcards in Monitoring Complex Labour Deck (53)
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31

What is considered as Non-reassuring late deceleration?

With >50% contractions and <30mins (no maternal or fetal risk factors – mec or bleeding)

32

What is considered as Abnormal late deceleration?

With >50% contractions and >30mins

33

How long does a Prolonged decelerations or acute hypoxia last for?

lasts at least 3mins

34

Name the 4 types of ways to manage a prolonged deceleration

Exclude placental abruption, uterine rupture and cord prolapse

May be secondary to uterine hyperstimulation or tonic contraction or hypotension

Give IV fluids and stop oxytocin or give tocolytic

35

What is the Rule of 3s?

3mins – call for help

6mins – prepare for transfer to theatre

9mins – in theatre

12mins – have started LSCS

36

FUN FACT!!!

Always abnormal but action dependent on cause and assessment of CTG before and after incident

37

What is considered as a NORMAL DR C BraVADO ?

All features reassuring

38

What is considered as a SUSPICIOUS DR C BraVADO ?

1 feature non-reassuring and 2 features reassuring*

39

What is considered as a PATHOLOGICAL DR C BraVADO ?

1 feature pathological OR 2 features non- reassuring*

40

What are 8C’s of physiological approach to CTG interpretation?

Clinical picture
Cumulative uterine activity
Cycling of FHR
Central organ oxygenation
Catecholamine surge
Chemo- or baroreceptor mediated decelerations
Cascade
Consider the next change on the CTG trace

41

What is subacute hypoxia?

Defined as when the HR spends more time decelerating than at the baseline
Iatrogenic cause = uterine hyperstimulation

42

What are the steps to a evolving hypoxia ?

Normal CTG
decelerations
loss of accelerations catecholamines released
raising baseline
reduced variability
baseline instability
terminal bradycardia
fetal demise

43

what does Acidaemia mean?

low blood pH

44

what does Acidosis mean?

low blood and tissue pH

45

What does Base Excess/Deficit mean?

measure of how much buffer has been used

46

What does Hypoxia?

low O2 levels in tissues

47

What does Hypoxaemia mean?

low O2 tension in blood (low pO2)

48

What does Metabolic acidosis mean?

low blood pH and high base excess due to the accumulation of CO2 and H+ ions using up buffers

49

What does Respiratory acideamia mean?

low blood pH due to the accumulation of CO2

50

What does Low pH and a normal BE cause?

respiratory acidaemia (accumulation of CO2 through impaired gas exchange)

51

What does Low pH and an abnormal BE cause

combined respiratory and metabolic acidaemia (accumulation of CO2 through impaired gas exchange and the build up lactate and H+ ions through anaerobic metabolism)

52

what does it mean If there is a large arterial – venous difference in pH?

acidaemia is likely to have occurred in the 2nd stage or if LSCS before full dilation an acute event or cord compression

53

what does it mean If there is a small arterial – venous difference in pH?

acidaemia is likely to be longstanding