what does a category I tracing predict? - ANSWER a normal acid-base balance
what is the baseline for a category I strip? - ANSWER 110 to 160 BPM
what is the variability for a category I strip? - ANSWER moderate (6 to 25 bpm)
what decelerations can be present in a category I strip? - ANSWER early decelerations
late and variable decelerations must be absent
does a category I tracing have to have accelerations? - ANSWER no; accelerations are not
required for a category I tracing
category I tracing example - ANSWER
what does a category II tracing mean? - ANSWER the acid-base balance is indeterminate
includes anything that is not category I or III
what is the baseline rate of a category II tracing? - ANSWER - bradycardia WITHOUT ab-
sent variability
- tachycardia
what is the variability of a category II tracing? - ANSWER - minimal baseline variability
- absent baseline variability WITHOUT recurrent decelerations
- marked variability
1
,minimal variability example - ANSWER less than 5 BPM
marked variability example - ANSWER greater than 25 BPM
are accelerations present in category II tracings after fetal stimulations? - ANSWER accel-
erations are not present after fetal stimulation to classify tracing as category II
what are the possible periodic or episodic decelerations present in category II tracings? - AN-
SWER - recurrent variable decelerations accompanied by minimal or moderate baseline
variability
- prolonged deceleration > 2 minutes but < 10 minutes
- recurrent late decelerations with moderate baseline variability
- variable decelerations with other characters (slow return to baseline or shoulders)
variable deceleration example - ANSWER an abrupt decrease in FHR below baseline;
greater than 15 BPM lasting greater than 15 seconds, but less than 2 minutes from onset to
return to baseline
prolonged deceleration example - ANSWER a decrease in FHR below the baseline of 15
bpm or more, lasting at least 2 minutes but < 10 minutes from onset to return to baseline
late deceleration example - ANSWER a gradual decrease and return to baseline of the fe-
tal heart rate associated with uterine contractions
what does a category III tracing predict? - ANSWER predicts abnormal acid-base status
a category III tracing includes either of the following... - ANSWER - absent baseline FHR
variability and ANY of the following:
- recurrent late decelerations
2
, - recurrent variable decelerations
- bradycardia
- sinusoidal pattern
what does absent variability with recurrent late decelerations or variable deceleration indi-
cate? - ANSWER predictive of current or impending fetal asphyxia so severe that fetus is
at risk for neurologic damage and death
what is a sinusoidal pattern? - ANSWER smooth, wave-like baseline appears 3 to 6 time
per minute
can be documented if pattern lasts for > 20 minutes
what do indeterminate and abnormal (category II or III) tracings require? - ANSWER trac-
ings require evaluation of possible etiology
what are some initial assessments and interventions for category II or III tracings? - AN-
SWER - discontinuation of labor stimulating agents
- vaginal examination
- maternal repositioning
- correction of maternal hypotension
- IV fluid bolus of LR solution
- assessment of tachysystole (reduce uterine activity if noted)
- amnioinfusion
- modification of maternal pushing maternal efforts in 2nd stage
- maternal O2 at 10L per non-rebreather (used with minimal variability or recurrent lates
that have not resolved with initial uterine measures)
what is an amnioinfusion? - ANSWER a transvaginal infusion of room temperature iso-
tonic fluid (normal saline or lactated ringers) by gravity of infusion pump to compensate for
the loss of amniotic fluid
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what is the baseline for a category I strip? - ANSWER 110 to 160 BPM
what is the variability for a category I strip? - ANSWER moderate (6 to 25 bpm)
what decelerations can be present in a category I strip? - ANSWER early decelerations
late and variable decelerations must be absent
does a category I tracing have to have accelerations? - ANSWER no; accelerations are not
required for a category I tracing
category I tracing example - ANSWER
what does a category II tracing mean? - ANSWER the acid-base balance is indeterminate
includes anything that is not category I or III
what is the baseline rate of a category II tracing? - ANSWER - bradycardia WITHOUT ab-
sent variability
- tachycardia
what is the variability of a category II tracing? - ANSWER - minimal baseline variability
- absent baseline variability WITHOUT recurrent decelerations
- marked variability
1
,minimal variability example - ANSWER less than 5 BPM
marked variability example - ANSWER greater than 25 BPM
are accelerations present in category II tracings after fetal stimulations? - ANSWER accel-
erations are not present after fetal stimulation to classify tracing as category II
what are the possible periodic or episodic decelerations present in category II tracings? - AN-
SWER - recurrent variable decelerations accompanied by minimal or moderate baseline
variability
- prolonged deceleration > 2 minutes but < 10 minutes
- recurrent late decelerations with moderate baseline variability
- variable decelerations with other characters (slow return to baseline or shoulders)
variable deceleration example - ANSWER an abrupt decrease in FHR below baseline;
greater than 15 BPM lasting greater than 15 seconds, but less than 2 minutes from onset to
return to baseline
prolonged deceleration example - ANSWER a decrease in FHR below the baseline of 15
bpm or more, lasting at least 2 minutes but < 10 minutes from onset to return to baseline
late deceleration example - ANSWER a gradual decrease and return to baseline of the fe-
tal heart rate associated with uterine contractions
what does a category III tracing predict? - ANSWER predicts abnormal acid-base status
a category III tracing includes either of the following... - ANSWER - absent baseline FHR
variability and ANY of the following:
- recurrent late decelerations
2
, - recurrent variable decelerations
- bradycardia
- sinusoidal pattern
what does absent variability with recurrent late decelerations or variable deceleration indi-
cate? - ANSWER predictive of current or impending fetal asphyxia so severe that fetus is
at risk for neurologic damage and death
what is a sinusoidal pattern? - ANSWER smooth, wave-like baseline appears 3 to 6 time
per minute
can be documented if pattern lasts for > 20 minutes
what do indeterminate and abnormal (category II or III) tracings require? - ANSWER trac-
ings require evaluation of possible etiology
what are some initial assessments and interventions for category II or III tracings? - AN-
SWER - discontinuation of labor stimulating agents
- vaginal examination
- maternal repositioning
- correction of maternal hypotension
- IV fluid bolus of LR solution
- assessment of tachysystole (reduce uterine activity if noted)
- amnioinfusion
- modification of maternal pushing maternal efforts in 2nd stage
- maternal O2 at 10L per non-rebreather (used with minimal variability or recurrent lates
that have not resolved with initial uterine measures)
what is an amnioinfusion? - ANSWER a transvaginal infusion of room temperature iso-
tonic fluid (normal saline or lactated ringers) by gravity of infusion pump to compensate for
the loss of amniotic fluid
3
