FETAL HEALTH SURVEILLANCE QUESTIONS AND
CORRECT DETAILED ANSWERS (VERIFIED ANSWERS)
|ALREADY GRADED A+||BRAND NEW!!
Tachysystole Ans✓✓✓Any excessive uterine activity (UA); >5
contractions in a 10 minute window, averaged over 30 mins.
Repetitive Decelerations Ans✓✓✓3 or more decels in a row
Recurrent Decelerations Ans✓✓✓Decels that occur with >50% of
contractions in a 20 minute period
Intermittent Decelerations Ans✓✓✓Decels that occur with <50% of
contractions in a 20 minute period
Gradual Deceleration Ans✓✓✓≥30 seconds from onset to nadir
Episodic Gradual Deceleration Ans✓✓✓A gradual decel NOT
associated with a contraction
Interpretable Electronic Fetal Monitoring Ans✓✓✓Electronic fetal
monitoring tracing that has a continuous display of the fetal heart rate
and uterine activity with minimal gaps.
Uterine Activity - How is this documented? Ans✓✓✓Number of
contractions present in a 10-minute window, averaged over 30 minutes
,(e.g. 3 contractions in 10 minutes) - UNLESS atypical/abnormal in the
first 10 minutes of tachysystole - initiate a response without averaging
over 30 minutes
Recommended (minimum) tracing for EFM Ans✓✓✓20 Minutes
Early Deceleration Ans✓✓✓*safe*. Begin prior to peak of the
contraction and end by the end of it. Caused by head compression (E.G
associated with fetal descent in the pelvis / full dilation). No need for
intervention if variability is within normal range and the FHR is within
normal range. Characteristic of nadir occurring at same time as peak of
contraction. *Usually symmetrical*. Return to normal by end of
contraction.
**Early decelerations are said to be a mirror image of the
contractions.**
Uncomplicated variable deceleration Ans✓✓✓Caused by cord
compression. 15 BPM below baseline lasting >15s. Often have
shoulders (initial accel, followed by rapid decel to the nadir, rapid return
to baseline, followed by secondary brief accel). Common in late 1st
stage.
*NORMAL* if occasional uncomplicated variable decelerations occur
*ATYPICAL* if repetitive (greater than or equal to 3) uncomplicated
variable decelerations occur
,Complicated Variable Deceleration Ans✓✓✓*Not ok - May be
indicative of fetal hypoxia / acidemia* Also caused by cord
compression, but does not return to baseline by end of contraction. Any
of: May last >60s AND go down to <60BPM OR decrease by >60BPM
below baseline; overshoot of 20BPM X 20secs after decel; variable
decel in presence of minimal or absent baseline variability, OR baseline
tachycardia/ bradycardia. Can occur in 1st or 2nd stage.
Late decelerations Ans✓✓✓*Also not ok - indicates uteroplacental
insufficiency, or decreased uteroplacental blood flow during contraction
/ associated with fetal hypoxia and acidemia* . = lowered fetal pO2.
Symmetrical - gradual drop and return to baseline, but unlike early
decels, the onset, nadir and recovery occurs AFTER the peak of the
contraction.
**Gradual, smooth, delayed deceleration**
IA during 1st stage - how often? Ans✓✓✓q15 mins
IA during 2nd stage - how often? Ans✓✓✓q5 mins
EFM During 2nd stage - interpret how often? Ans✓✓✓At least
q15mins, otherwise q5mins
, Spontaneous Accelerations Ans✓✓✓*Good* - Reassuring, but not
required to classify EFM as 'normal'.
Recommended in Response to atypical EFM and abnormal IA
Ans✓✓✓Digital Fetal Scalp Stimulation
Primary factors that regulate the FHR Ans✓✓✓The medulla oblongata
(in the brainstem), the autonomic nervous system, baroreceptors, and
chemoreceptors
Secondary factors that regulate the FHR Ans✓✓✓Humoral or endocrine
factors, blood composition and volume, blood vessel diameter, cardiac
contractility and amniotic fluid composition, as well as substances
released from the: hypothalamus, pituitary gland, adrenal glands,
adipose tissue, pancreas, kidneys, intestines, liver, spleen, bone marrow
and heart
CNS - Medulla Oblongata... Ans✓✓✓Serves as the integrative centre
for central and peripheral neural control of the cardiovascular and
respiratory system. Blood pressure, heart rate, and vascular resistance
are controlled at this level.
CNS - Higher Brain Centres (mid-brain to cerebral cortex)...
Ans✓✓✓Responsible for variations in fetal heart rate and variability in
response to fetal behavioural states including quiet sleep, active sleep,
and arousal states.
CORRECT DETAILED ANSWERS (VERIFIED ANSWERS)
|ALREADY GRADED A+||BRAND NEW!!
Tachysystole Ans✓✓✓Any excessive uterine activity (UA); >5
contractions in a 10 minute window, averaged over 30 mins.
Repetitive Decelerations Ans✓✓✓3 or more decels in a row
Recurrent Decelerations Ans✓✓✓Decels that occur with >50% of
contractions in a 20 minute period
Intermittent Decelerations Ans✓✓✓Decels that occur with <50% of
contractions in a 20 minute period
Gradual Deceleration Ans✓✓✓≥30 seconds from onset to nadir
Episodic Gradual Deceleration Ans✓✓✓A gradual decel NOT
associated with a contraction
Interpretable Electronic Fetal Monitoring Ans✓✓✓Electronic fetal
monitoring tracing that has a continuous display of the fetal heart rate
and uterine activity with minimal gaps.
Uterine Activity - How is this documented? Ans✓✓✓Number of
contractions present in a 10-minute window, averaged over 30 minutes
,(e.g. 3 contractions in 10 minutes) - UNLESS atypical/abnormal in the
first 10 minutes of tachysystole - initiate a response without averaging
over 30 minutes
Recommended (minimum) tracing for EFM Ans✓✓✓20 Minutes
Early Deceleration Ans✓✓✓*safe*. Begin prior to peak of the
contraction and end by the end of it. Caused by head compression (E.G
associated with fetal descent in the pelvis / full dilation). No need for
intervention if variability is within normal range and the FHR is within
normal range. Characteristic of nadir occurring at same time as peak of
contraction. *Usually symmetrical*. Return to normal by end of
contraction.
**Early decelerations are said to be a mirror image of the
contractions.**
Uncomplicated variable deceleration Ans✓✓✓Caused by cord
compression. 15 BPM below baseline lasting >15s. Often have
shoulders (initial accel, followed by rapid decel to the nadir, rapid return
to baseline, followed by secondary brief accel). Common in late 1st
stage.
*NORMAL* if occasional uncomplicated variable decelerations occur
*ATYPICAL* if repetitive (greater than or equal to 3) uncomplicated
variable decelerations occur
,Complicated Variable Deceleration Ans✓✓✓*Not ok - May be
indicative of fetal hypoxia / acidemia* Also caused by cord
compression, but does not return to baseline by end of contraction. Any
of: May last >60s AND go down to <60BPM OR decrease by >60BPM
below baseline; overshoot of 20BPM X 20secs after decel; variable
decel in presence of minimal or absent baseline variability, OR baseline
tachycardia/ bradycardia. Can occur in 1st or 2nd stage.
Late decelerations Ans✓✓✓*Also not ok - indicates uteroplacental
insufficiency, or decreased uteroplacental blood flow during contraction
/ associated with fetal hypoxia and acidemia* . = lowered fetal pO2.
Symmetrical - gradual drop and return to baseline, but unlike early
decels, the onset, nadir and recovery occurs AFTER the peak of the
contraction.
**Gradual, smooth, delayed deceleration**
IA during 1st stage - how often? Ans✓✓✓q15 mins
IA during 2nd stage - how often? Ans✓✓✓q5 mins
EFM During 2nd stage - interpret how often? Ans✓✓✓At least
q15mins, otherwise q5mins
, Spontaneous Accelerations Ans✓✓✓*Good* - Reassuring, but not
required to classify EFM as 'normal'.
Recommended in Response to atypical EFM and abnormal IA
Ans✓✓✓Digital Fetal Scalp Stimulation
Primary factors that regulate the FHR Ans✓✓✓The medulla oblongata
(in the brainstem), the autonomic nervous system, baroreceptors, and
chemoreceptors
Secondary factors that regulate the FHR Ans✓✓✓Humoral or endocrine
factors, blood composition and volume, blood vessel diameter, cardiac
contractility and amniotic fluid composition, as well as substances
released from the: hypothalamus, pituitary gland, adrenal glands,
adipose tissue, pancreas, kidneys, intestines, liver, spleen, bone marrow
and heart
CNS - Medulla Oblongata... Ans✓✓✓Serves as the integrative centre
for central and peripheral neural control of the cardiovascular and
respiratory system. Blood pressure, heart rate, and vascular resistance
are controlled at this level.
CNS - Higher Brain Centres (mid-brain to cerebral cortex)...
Ans✓✓✓Responsible for variations in fetal heart rate and variability in
response to fetal behavioural states including quiet sleep, active sleep,
and arousal states.
