Use a logarithmic transformation to find a linear relationship between the given quantities and graph the resulting linear relationship on a log-linear plot. Uterine tachysystole is defined as more than five contractions in any 10-minute period, averaged over 30 minutes.2 Each normal uterine contraction causes a temporary decrease in uterine blood flow and fetal oxygenation, which is generally well tolerated.26,27 However, tachysystole increases the risk of acidosis.26,27 To correct tachysystole, physicians must reduce or stop uterine stimulants or add tocolytics.2,2729, Goals of intrapartum fetal monitoring include rapid identification and intervention for suspected fetal acidosis as well as reassurance and avoidance of unnecessary interventions in cases of adequate fetal oxygenation.4,26 Figure 1 provides an algorithm for suggested management.2,7,16,21,27,3033. 5. Faculty, Students, State Boards & Volunteers. For example, fetuses with intrauterine growth restriction are unusually susceptible to the effect of hypoxemia, which tends to progress rapidly.4, A growing body of evidence suggests that, when properly interpreted, FHR assessment may be equal or superior to measurement of fetal blood pH in the prediction of both good and bad fetal outcomes.13 Fetuses with a normal pH, i.e., greater than 7.25, respond with an acceleration of the fetal heart rate following fetal scalp stimulation. "The test results are within normal limits.". Progressive vagal dominance occurs as the fetus approaches term and, after birth, results in a gradual decrease in the baseline FHR. c. Reassure the family the finding is normal. Place the Doppler over the area of maximal intensity of fetal heart tones, 3. Category III tracings have been associated with fetal hypoxia, acidosis, and encephalopathy.2,5,26,37, Fetal tachycardia (FHR of more than 160 bpm for at least 10 minutes) can be caused by maternal or fetal factors (Table 52,5,7 and eFigure B). Although continuous EFM remains the preferred method for fetal monitoring, the following methodologies are active areas of research in enhancing continuous EFM or developing newer methodologies for fetal well-being during labor. Table 7 lists signs associated with variable decelerations indicating hypoxemia4,11,26 (Figures 9 and 10). the presence of moderate variability and/or accelerations offers reassurance in Category II tracings because the presence is predictive of a lack of fetal acidosis, Category II management should focus on first correcting reversible causes, including stopping uterotonic agents and placental fetal perfusion, through intrauterine resuscitation, Amnioinfusion has been shown to reduce cord compression, leading to resolution of FHR decelerations (RR = 0.53; 95% CI, 0.38 to 0.74; n = 1,000) and lowering the likelihood of cesarean delivery. Fetal heart rate decreases lasting 10 minutes are categorized as a new baseline heart rate. The key elements include assessment of baseline heart rate, presence or absence of variability, and interpretation of periodic changes. The practitioner ruptures a laboring patient's membranes and inserts a fetal spiral electrode because the nurse is unable to obtain FHR data by the external method.
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fetal heart tracing quiz 10