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Samenvatting STAN

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Uitgebreide samenvatting voor het STAN-examen. Met enkele voorbeeldcasussen.

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  • February 18, 2023
  • 9
  • 2022/2023
  • Summary
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Hoogrisico verloskunde STAN


 Inleiding
 Stan: ganse foetale EKG registreren
 Wnr
 Immobilitiet
 Geen goede registratie
 Verwachten als er iets mis kan gaan


 Voorwaarden
 Stabiele basislijn
 Nrm variabiliteit (niet bij saltatoir)
 Bij cycling (= patroon van slaap waak en wakker worden)


 Wnr niet - Nu toco eiken op 0 (niet meer op 20)
- 1 kruisje is 1 foetaal ekg (vanonder)
 Prematuriteit - Event krijgen: nagaan wat is er gebeurd
 Hartafwijkingen
 Water
 Tens.




 Richtlijnen
 Type hypoxie nagaan (STAN gaat dit na)
 Geen hypoxie
 BL voldoet aan zw.sch.duur
 Nrm var
 Geen dec
 Cycling (waak-slaap-wakker)
 Te doen:
 CTG gerust laten
 Chronische hypoxie
 (Vanaf start CTG) hogere BL voor zw.sch.duur
 Verminderde var
 Shallow dec
= kleine dec
 Geen cycling
 Geenn acc
 Te doen:
 Verdere stress vermijden
 Verlossen versnellen

,  Gradueel toenemende hypoxie
 Meer tijd op BL dan in dec
 2 soorten
 Compensatiereactie
 Goede moment op STAN te plaatsen
=> men kan overgang van comp. naar decomp. goed zien.
 BL stijgt
 Persisterende dec
 Geen acc
 Te doen:
o Houdingwissel
o Elke 30-60min herevalueren
 Decompensatiereactie
 Verminderde of verhoogde (saltatoire) var
 Onstabiele BL
 Te doen:
o Synto stop
o Verlossen versnellen
 Subacute hypoxie
 Meer tijd in dec dan op BL
 Verhoogde (saltatoir) var
 Te doen:
 Synto stop
 Tocolytica
 Verlossen versnellen
 Kunstverlossing
 Acute hypoxie
 Verlengde dec > 3min
 Te doen:
 Onomkeerbaar
 Verlossen
 Omkeerbaar
 Nagaan of er geen NSprolaps is, placenta abruptio of uterusruptuur is
 Verlossen versnellen

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