Flashcards in Monitoring Complex Labour Deck (53)
What is considered as Non-reassuring late deceleration?
With >50% contractions and <30mins (no maternal or fetal risk factors – mec or bleeding)
What is considered as Abnormal late deceleration?
With >50% contractions and >30mins
How long does a Prolonged decelerations or acute hypoxia last for?
lasts at least 3mins
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
What is the Rule of 3s?
3mins – call for help
6mins – prepare for transfer to theatre
9mins – in theatre
12mins – have started LSCS
Always abnormal but action dependent on cause and assessment of CTG before and after incident
What is considered as a NORMAL DR C BraVADO ?
All features reassuring
What is considered as a SUSPICIOUS DR C BraVADO ?
1 feature non-reassuring and 2 features reassuring*
What is considered as a PATHOLOGICAL DR C BraVADO ?
1 feature pathological OR 2 features non- reassuring*
What are 8C’s of physiological approach to CTG interpretation?
Cumulative uterine activity
Cycling of FHR
Central organ oxygenation
Chemo- or baroreceptor mediated decelerations
Consider the next change on the CTG trace
What is subacute hypoxia?
Defined as when the HR spends more time decelerating than at the baseline
Iatrogenic cause = uterine hyperstimulation
What are the steps to a evolving hypoxia ?
loss of accelerations catecholamines released
what does Acidaemia mean?
low blood pH
what does Acidosis mean?
low blood and tissue pH
What does Base Excess/Deficit mean?
measure of how much buffer has been used
What does Hypoxia?
low O2 levels in tissues
What does Hypoxaemia mean?
low O2 tension in blood (low pO2)
What does Metabolic acidosis mean?
low blood pH and high base excess due to the accumulation of CO2 and H+ ions using up buffers
What does Respiratory acideamia mean?
low blood pH due to the accumulation of CO2
What does Low pH and a normal BE cause?
respiratory acidaemia (accumulation of CO2 through impaired gas exchange)
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)
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