RELIAS - FETAL HEART MONITORING 2023
QUESTIONS AND ANSWERS 100% CORRECT
GRADED A+
uterine blood supply - CORRECT 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 - CORRECT 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 - CORRECT 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 - CORRECT ANS 1 - reduce O2 in blood
2 - reduced O2 delivery at tissue level
Fetal anaerobic metabolism - CORRECT 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
,RELIAS - FETAL HEART MONITORING 2023
QUESTIONS AND ANSWERS 100% CORRECT
GRADED A+
acidosis - CORRECT ANS pH below 7.35
pH is low
(acidosis is the process that leads to low blood pH, or acidemia)
alkalosis - CORRECT ANS pH above 7.45
pH is high
buffers - CORRECT ANS - help maintain acid base homeostasis
- 2 major fetal buffers are plasma bicarbonate and hgb
base excess and base deficit - CORRECT 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 - CORRECT 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 - CORRECT ANS assoc w/ widespread, deleterious effects on vital organ and
body function
fetal hypoxia during birth - CORRECT ANS assoc w/ neonatal depression, low apgars,
neonatal encephalopathy, and cerebral palsy
respiratory acidosis - CORRECT 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 - CORRECT ANS - sudden decrease in placental
or cord perfusion
- uterine tachysystole
, RELIAS - FETAL HEART MONITORING 2023
QUESTIONS AND ANSWERS 100% CORRECT
GRADED A+
- maternal hypoventilation
metabolic acidosis - CORRECT ANS *ph < 7.10 , normal pCO2 (<60), high base deficit
(>12)*
- a higher base deficit (such as > 12) has been assoc w/higher risk for severe neonatal
complications
- most common cause of metabolic acidosis in fetus is r/t inadequate O2 delivery
- prolonged hypoxic insult to fetus results in depletion of bicarb, which is a base buffer that
normalizes pH levels
mixed acidosis - CORRECT ANS *pH < 7.10 , high pCO2 > 60, and high base deficit >12*
- may develop when resp acidosis persists for a prolonged period of time
-outcome for neonates is dependent on degree and severity, but typically the lower pH and
higher base deficit means worse neonatal outcomes
- most often seen in prolonged bradycardia at time of birth
what is used to evaluate fetal acidosis? - CORRECT ANS arterial umbilical cord blood
artery values (fetus to placenta) - CORRECT ANS Normal ranges:
pH 7.20-7.28
pCO2 35-70
Base excess -3 to -9
venous values (placenta to fetus) - CORRECT ANS Normal ranges:
pH 7.35
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