Relias - Fetal Heart Monitoring
uterine blood supply - ANS-- uterine arteries deliver oxygenated blood to spiral arteries
which bring oxygen rich blood to intervillous space of placenta that has fetal capillaries
- fetal capillaries carry the O2 rich blood to umbilical VEIN that goes to fetus
-in contrast, the umbilical ARTERIES return waste products to that intervillous space
that go into mother's venous system
Potential issues that negatively affect fetal oxygenation - ANS-*Maternal Oxygenation:*
asthma, hyper- or hypo- ventilation
*Placental O2 and CO2 Exchange:* postterm, abruption, HTN, hypotension, uterine
tachysystole
*Fetal circulation:* cord compression or occlusion
Fetal hypoxemia - ANS-- can occur d/t reduced fetal O2 reserves, excessive uterine
activity, or reduced uteroplacental blood flow
- worsening fetal hypoxemia can lead to abnormal FHR patterns, mostly minimal or
absent variability from acidemia
(1) hypoxemia vs. (2) hypoxia - ANS-1 - reduce O2 in blood
2 - reduced O2 delivery at tissue level
Fetal anaerobic metabolism - ANS-- occurs when long term O2 delivery is insufficient to
meet cellular needs of tissues
- results in production of lactic acid and other noncarbonic acids
- ACIDOSIS is the presence of excessive acids in tissues
acidosis - ANS-pH below 7.35
, pH is low
(acidosis is the process that leads to low blood pH, or acidemia)
alkalosis - ANS-pH above 7.45
pH is high
buffers - ANS-- help maintain acid base homeostasis
- 2 major fetal buffers are plasma bicarbonate and hgb
base excess and base deficit - ANS-- base deficit is expressed as a positive number
- base excess is expressed as a negative number
~ they are equivalent and terms are used interchangeably ~
fetal acidosis - ANS-- when O2 is decreased to fetus, tissue hypoxia results in acidosis,
which then shows a drop in pH, a loss of bicarb, and increase in base deficit
acidemia - ANS-assoc w/ widespread, deleterious effects on vital organ and body
function
fetal hypoxia during birth - ANS-assoc w/ neonatal depression, low apgars, neonatal
encephalopathy, and cerebral palsy
respiratory acidosis - ANS-*low pH (< 7.10), high pCO2 (> 60), normal base deficit ( <
12)*
- increase of pCO2 for fetus that lowers pH but doesn't affect base deficit
factors that contribute to resp acidosis - ANS-- sudden decrease in placental or cord
perfusion
- uterine tachysystole
- maternal hypoventilation
metabolic acidosis - ANS-*ph < 7.10 , normal pCO2 (<60), high base deficit (>12)*
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