Reading the Fetus We Cannot See

Tracing

The tracing is on the right. Upper channel is the fetal heart rate, lower channel is uterine activity. Decide what the pattern is before you decide what to do.

Pattern recognition0 / 0

Non-stress test

Gestational age

Accelerations in 20 min Peak above baseline (bpm)

Duration of each acceleration (seconds)

Biophysical profile — 2 points each

Reactive non-stress test Fetal breathing movements Gross body movement Fetal tone (flexion and extension) Amniotic fluid volume adequate

Amniotic fluid and contraction stress test

Amniotic fluid index (cm, sum of four quadrants) Contraction stress test result Placenta praevia, PPROM, prior classical incision or myomectomy entering the cavity, or cervical insufficiency is present

Criteria are the chapter’s: reactive is 2 accelerations of 15 bpm for 15 s in 20 minutes at 32 weeks or more, 10 bpm for 10 s below 32 weeks. BPP 8–10 reassuring, 6 equivocal, 4 or less deliver. AFI 5–24 cm.

Labour room 2 · 39 weeks · induction

Recurrent late decelerations

Oxytocin is infusing at 12 milliunits per minute. The last three contractions have each been followed by a gradual deceleration to 110 that returns to baseline after the contraction ends. Baseline 150, minimal variability. The patient is supine.

Click the actions in the order you would actually do them. Two of these buttons do not belong on the list at all.

Steps placed correctly0 / 5

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