Fetal Heart Monitoring
Dr MCQ BrAVaDO - ANS-Dr - Define Risk (IOL? Epidural...?)
M - Movements
C- Contractions (Frequency, length, strength)
Q - Quality of Trace
Br - Baseline Rate (110-160)
A - Accelerations (present?)
Va - Variability (5bpm or more)
D - Dcelerations (None?)
O - Overall (Normal, suspicious, Pathological?)
How to listen to the fetal heart? - ANS-Pinnard
FSE
Doppler
CTG
What are we trying to spot by listening in? - ANS-Hypoxia
Cardiac Output = HR x SV - ANS-Cardiac output = oxygen supply to the brain
Adults can increase SV
Fetus can only increase HR
What affects the amount of oxygen received by baby? - ANS-Contractions may
compress myometrium and reduce blood circulation in placental bed, compression of
cord, compound by pushing.
Mother may be in supine position or circulatory issues due to epidural/ respiratory
issues, pathological conditions.
Uterine problems such as placental abruption, uterine rupture, cord prolapse, shoulder
dystocia.
Statistics... - ANS-Using a CTG increases Caesarean section rates by 66% and
instrumental by 16%
50% reduction in neonatal seizures (hypoxia - ischemic encephalopathy)
What are the different types of hypoxia? - ANS-Acute: Very rapid. Problem can't be
resolved.
Subacute: sudden but resolvable
Gradually evolving: Occurs slowly as repeated lack of oxygen
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