FLYI NGHI GHER
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
*Maternal
Circulation:*
decreased
maternal
cardiac
output,
hypotension,
decreased
Hgb
*Placental
O2
and
CO2
Exchange:*
postterm,
abruption,
HTN,
hypotension,
uterine
tachysystole FLYI NGHI GHER
*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 FLYI NGHI GHER
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
~
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