Labor Stage 1: Fetal Heart Rate Tracing
Über den Vortrag
Der Vortrag „Labor Stage 1: Fetal Heart Rate Tracing“ von Veronica Gillispie, MD, MAS, FACOG ist Bestandteil des Kurses „Year 3 – Obstetrics/Gynecology“. Der Vortrag ist dabei in folgende Kapitel unterteilt:
- Fetal Heart Rate Tracing
- Fetal Heart Rate Tracing – Categories
Quiz zum Vortrag
What is the range for a normal baseline fetal heart tracing?
- 110-160 beats per minute
- 100-150 beats per minute
- 130-160 beats per minute
- 100-130 beats per minute
- 135-145 beats per minute
Which of the following describes an acceleration in the fetal heart tracing in a fetus with a gestational age greater than 32 weeks?
- An increase in fetal heart rate by 15 beats per minute for 15 seconds over a 2-minute tracing.
- An increase in fetal heart rate by 10 beats per minute for 15 seconds over a 2-minute tracing.
- An increase in fetal heart rate by 15 beats per minute for 10 seconds over a 2-minute tracing.
- An increase in fetal heart rate by 10 beats per minute for 10 seconds over a 20-minute tracing.
- An increase in fetal heart rate by 20 beats per minute for 15 seconds over a 20-minute tracing.
A 27-year-old female G1P0 at 42 weeks comes for induction of labor. The woman is on Pitocin, and her last cervical exam: 5 cm/ 80% effaced/ -2 station with a category I fetal heart tracing with contractions every 5-6 minutes. Pitocin infusion was increased. 20 minutes later, she is having one contraction every minute. FHR tracing has a baseline of 165 with absent variability and two late deceleration over a 20-minute strip. What describes the category of FHR tracing and best management?
- Category 3 and Pitocin must be stopped.
- Category 2, the patient has tachysystole, and the Pitocin should be stopped.
- Category 1, it is ok to continue the current course of management.
- Category 2, the patient is likely not taking deep breaths due to pain from regular contractions and should get oxygen supplementation.
- Category 2, the patient should be rotated to relieve cord compression.
Which of the following fetal heart tracings is a category II tracing?
- Baseline 135 with moderate variability, accelerations present, and minimal decelerations over a 20-minute strip.
- Baseline 145 with no variability and late decelerations over a 20-minute strip.
- Baseline 165 with no variability and variable decelerations over a 20-minute strip.
- Baseline 180 with no variability and no accelerations over a 20-minute strip.
- Baseline 80 with no variability and a few late decelerations over a 20-minute strip.
Which of the following is true of sinusoidal category III tracing?
- It indicates fetal anemia.
- It is a sign of maternal polycythemia.
- It indicates cord compression.
- It indicates head compression of the fetus.
- It is a sign of fetal death.
A 29-year-old G4P3 woman at 40 weeks gestational age was admitted to the labor ward in spontaneous active labor. Her last cervical exam was 7 cm dilation/90% effacement/-2 station with a bulging bag of water (intact membranes) and fetal heart tracing was unremarkable with a baseline heart rate of 140 beats per minute and moderate variability without any decelerations. 30 minutes later she felt a large gush of fluid and the fetal heart tracing showed regular early decelerations with each contraction. What occurred to cause this finding?
- Physiologic response to fetal head compression after rapid descent of the fetal head in the pelvis
- Cord compression due to prolapse of the cord
- Uteroplacental insufficiency due to maternal intravascular volume depletion
- Fetal anemia resulting in a sinusoidal fetal heart tracing pattern
- Fetal bradycardia due to uteroplacental insufficiency
Which of the following is NOT true of a sinusoidal pattern on a fetal heart tracing?
- It represents cord compression.
- It indicates fetal anemia.
- It is a category III FHR tracing.
- It requires immediate intervention.
- It suggests abnormal fetal acid/base status.
Which of the following statements is true of tachysystole?
- It is defined as more than 5 contractions over 10 minutes.
- It can only be determined by an internal uterine pressure catheter.
- It can be monitored without intervention as long as the fetal heart tracing is not category III.
- It is defined as more than 2 contractions in 10 minutes.
- It is defined as overlapping contractions without any uterine relaxation in between contractions.
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Dozent des Vortrages Labor Stage 1: Fetal Heart Rate Tracing
Veronica Gillispie, MD, MAS, FACOG
Dr. Veronica Gillispie is the Associate Professor, Senior Site Lead and Section Head of Obstetrics and Gynecology at Ochsner Health Center in Louisiana, USA.
She obtained her Medical Degree from Meharry Medical College in 2004. Currently, she is Director of Quality for Women’s Services for the Ochsner Health System, and Medical Director of the Minimally Invasive Center for the Treatment of Uterine Fibroids.
Due to her achievements, she earned the Association of Professors of Gynecology and Obstetrics (APGO) Excellence in Teaching Award.
Within Lecturio, Dr. Gillispie teaches courses on Obstetrics.
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I personally do not think that there was not enough of necessary depth taken for this topic that I had to rely on what I learned in medical school or look up information on external sites, which is FINE, but I thought the whole point of these videos were for review and the topics that needed review were not covered. I think the basic concept that of comparing the fetal heart tracing to the maternal tracing is missed. The explanation of the categories was so confusing. It should have just been Category I is this, Category III is this, and Category II is anything not above - this is so plain and simple. Instead, the lecture slide made it look like there were certain criteria that needed to be met for Category II. I do not think this was the best lecture by Dr. Gillispie and I recommend looking for outside sources to review this topic.
Thanks so much for making this complex topic clear and simple.
