AWHONN ADVANCED FETAL MONITORING EXAM LATEST
ACTUAL EXAM
What category rules out fetal acidemia? - ANSWER: Cat 1
What maternal conditions greatly impact fetal oxygenation? - ANSWER: Severe
astha, cardiac issues, and ecclampic seizures
Where does the exchange of O2 and nutrients take place? - ANSWER: intervillous
space
How is o2 blood transferred to the fetus? - ANSWER: O2 enters the intervillous space
via the maternal arteries, to the villi then the umbilical vein take the o2 blood to the
fetus. The umbilical arteries take the deO2 blood from the baby through the villi and
back to the mother
Diffusion - ANSWER: High to low concentration
Mom to fetus for O2
Low to high concentration for CO2 so baby to mom
How is O2 transferred from mom to baby - ANSWER: Diffusion
Explain spiral arteries in placenta - ANSWER: Carry O2 into intervillous space
Are maximally dilated so they can not be increased
What are factors that can decrease uteroplacental blood flow? - ANSWER: Maternal
conditions like pre-e and cardiac disease
Maternal hypotension
Placental changes- abruptions, infections, edema, or smaller size
Excessive uterine activity
Vasoconstriction
What happens to the spiral arteries during pre-e? - ANSWER: They are constricted
which decreases blood flow
Why does the supine position cause decreased uteroplactenal blood flow? -
ANSWER: The aorta and vena cava get compressed (20 weeks)
Why does maternal hypotension happen after regional analgesia? - ANSWER: Blocks
the sympathetic pathway
Pooling of blood in the lower extremities decreases blood flow back to moms heart
which decreases blood flow to the fetus
What percentage is uteroplacental blood flow decreased by during cxts? - ANSWER:
60%
, Explain the pathway for maternal- fetal exchange for fetal oxygenation (basic) -
ANSWER: Environment to lungs to heart to vasculature to uterus to placenta to
umbilical cord
Where is the least O2 blood in the fetus? - ANSWER: Limbs, kidneys, and descending
aorta
Where is the most O2 blood in the fetus? - ANSWER: Umbilical vein and ductous
venous
Connects the umbilical vein to the inferior vena cava, bypassing the liver
Shunt that allows most O2 blood to fetal heart - ANSWER: Ductus venosus
3 important shunts in fetal circulation - ANSWER: ductus venosus, foramen ovale,
ductus arteriosus
connects the two atria in the fetal heart
Allows O2 blood to flow through the heart and directly to the brain - ANSWER:
Foramen Ovale
a blood vessel in a fetus that bypasses pulmonary circulation by connecting the
pulmonary artery directly to the ascending aorta - ANSWER: Ductus Arteriosus
What is a normal blood volume for a fetus at term? - ANSWER: 80-100 mL/kg
What happens if you stimulate the sympathetic nervous system? - ANSWER:
Increased heart rate
What does the parasympathetic nervous system do? - ANSWER: Regulates the
sympathetic
What happens when catecholamines (sympathetic) get released? - ANSWER:
Increased heart rate
Why do pre-termers have increased heart rates? - ANSWER: The sympathetic
develops first so there is no parasympathetic to regulate the heart rate
What happens when the parasympathetic nervous system is stimulated? - ANSWER:
Acetylcholine is released which decreases the intrinsic heart rate
Vagus stimulation
What do baroreceptors do? - ANSWER: Protect
Regulates BP
What effect do baroreceptors have on the fetus? - ANSWER: Decreased FHR, BP and
CO
ACTUAL EXAM
What category rules out fetal acidemia? - ANSWER: Cat 1
What maternal conditions greatly impact fetal oxygenation? - ANSWER: Severe
astha, cardiac issues, and ecclampic seizures
Where does the exchange of O2 and nutrients take place? - ANSWER: intervillous
space
How is o2 blood transferred to the fetus? - ANSWER: O2 enters the intervillous space
via the maternal arteries, to the villi then the umbilical vein take the o2 blood to the
fetus. The umbilical arteries take the deO2 blood from the baby through the villi and
back to the mother
Diffusion - ANSWER: High to low concentration
Mom to fetus for O2
Low to high concentration for CO2 so baby to mom
How is O2 transferred from mom to baby - ANSWER: Diffusion
Explain spiral arteries in placenta - ANSWER: Carry O2 into intervillous space
Are maximally dilated so they can not be increased
What are factors that can decrease uteroplacental blood flow? - ANSWER: Maternal
conditions like pre-e and cardiac disease
Maternal hypotension
Placental changes- abruptions, infections, edema, or smaller size
Excessive uterine activity
Vasoconstriction
What happens to the spiral arteries during pre-e? - ANSWER: They are constricted
which decreases blood flow
Why does the supine position cause decreased uteroplactenal blood flow? -
ANSWER: The aorta and vena cava get compressed (20 weeks)
Why does maternal hypotension happen after regional analgesia? - ANSWER: Blocks
the sympathetic pathway
Pooling of blood in the lower extremities decreases blood flow back to moms heart
which decreases blood flow to the fetus
What percentage is uteroplacental blood flow decreased by during cxts? - ANSWER:
60%
, Explain the pathway for maternal- fetal exchange for fetal oxygenation (basic) -
ANSWER: Environment to lungs to heart to vasculature to uterus to placenta to
umbilical cord
Where is the least O2 blood in the fetus? - ANSWER: Limbs, kidneys, and descending
aorta
Where is the most O2 blood in the fetus? - ANSWER: Umbilical vein and ductous
venous
Connects the umbilical vein to the inferior vena cava, bypassing the liver
Shunt that allows most O2 blood to fetal heart - ANSWER: Ductus venosus
3 important shunts in fetal circulation - ANSWER: ductus venosus, foramen ovale,
ductus arteriosus
connects the two atria in the fetal heart
Allows O2 blood to flow through the heart and directly to the brain - ANSWER:
Foramen Ovale
a blood vessel in a fetus that bypasses pulmonary circulation by connecting the
pulmonary artery directly to the ascending aorta - ANSWER: Ductus Arteriosus
What is a normal blood volume for a fetus at term? - ANSWER: 80-100 mL/kg
What happens if you stimulate the sympathetic nervous system? - ANSWER:
Increased heart rate
What does the parasympathetic nervous system do? - ANSWER: Regulates the
sympathetic
What happens when catecholamines (sympathetic) get released? - ANSWER:
Increased heart rate
Why do pre-termers have increased heart rates? - ANSWER: The sympathetic
develops first so there is no parasympathetic to regulate the heart rate
What happens when the parasympathetic nervous system is stimulated? - ANSWER:
Acetylcholine is released which decreases the intrinsic heart rate
Vagus stimulation
What do baroreceptors do? - ANSWER: Protect
Regulates BP
What effect do baroreceptors have on the fetus? - ANSWER: Decreased FHR, BP and
CO
