The management of high-risk pregnancy is the focus of maternal health care, early screening of high-risk pregnant women and their systematic management is an important measure to protect the health of mothers and children, and can effectively reduce perinatal maternal and infant morbidity, mortality and disability.
Means of monitoring high-risk pregnant women and their fetuses mainly include measurement of uterine height and abdominal circumference, fetal movement monitoring, electronic fetal monitoring, B-mode ultrasonography, placental function examination, fetal maturity examination, fetal hypoxia examination, and examination of congenital hereditary diseases of the fetus. Electronic fetal monitoring is a commonly used monitoring measure in obstetrics, which can continuously observe the relationship between fetal heartbeat, fetal movement, and contraction, assess the intrauterine safety and reserve capacity of the fetus, and understand whether the fetus shows signs of hypoxia and acidosis. Through these monitoring means, you can assess whether the fetus is normal or not, the following Tianjin Health Talent Network experts take you together to understand the examination process is often involved in some of the results of the monitoring of normal and abnormal situations:
First of all, monitor the fetal heart rate : the normal value of 110 ~ 160 beats / min. When the fetal heart rate <110 beats/min or >160 beats/min, suggests fetal hypoxia.
The number of fetal movements: Fetal movement is about 3 to 5 times per hour. 12-hour fetal movement count <10 times or day by day more than 50% decline, or fetal movement count increased significantly after the disappearance of fetal movement, suggests that the fetus has intrauterine distress.
Then there is B-mode ultrasound: to understand fetal development. It is used in early pregnancy to confirm the diagnosis, and in mid and late pregnancy to assess: (1) the fetus; (2) the placenta; (3) the amniotic fluid; and (4) the umbilical cord.
Final electronic fetal monitoring: (1) baseline fetal heart rate variability. Fetal heart rate baseline in the amplitude and frequency of irregular fluctuations and small cyclic fluctuations, swing frequency normal value of ?6 times / min, indicating that the fetus has a certain reserve capacity, is a manifestation of fetal health; swing frequency decreased or disappeared, that is, the fetal heart rate baseline flattening, the loss of fetal reserve capacity. (2) Transient changes in fetal heart rate. Stimulated by fetal movement, contraction, palpation or sound, the fetal heart rate undergoes temporary acceleration or deceleration. Acceleration is a sign that the fetus is in good condition; early deceleration suggests that the fetus is at risk of hypoxia; variant deceleration suggests that the umbilical cord is likely to be compressed and that intrauterine hypoxia may be present; late deceleration suggests that the placenta is dysfunctional and that the fetus is suffering from intrauterine hypoxia. (3) Prediction of intrauterine reserve capacity of the fetus. Non-stress test (NST): NST reactive, i.e., 2 or more fetal heart accelerations during the monitoring time, is normal; NST unresponsive, meaning that there is no sufficient fetal heart acceleration for more than 40 minutes, is abnormal. (4) Oxytocin provocation test (OCT): also known as contraction stress test (CST), for the observation and recording of changes in fetal heart rate after contraction. It assesses the intrauterine reserve capacity of the fetus by graphically interpreting whether late deceleration occurs, and late deceleration is positive, which is a sign of insufficient reserve capacity.
Through the study of the above monitoring tools, the following two questions to test the results of your learning.
1. Indicators that cannot be monitored by auscultation of the fetal heart are:
A. The variability of the fetal heart rate B. Whether the fetus is viable or not
C. Whether the fetus is suffering from intrauterine hypoxia D. Strength of the fetal heart
E. Rhythm of the fetal heart
1. Answer A. A. The variability of the fetal heart rate has to be monitored by electronic fetal monitoring.
2. The purpose of the contraction stress test is to:
A. Observe the variability of the baseline fetal heart B. Observe the rate of increase in fetal heart rate after fetal movement
C. Observe the sensitivity of the uterus to oxytocin D. Observe the effect of contractions on the fetal heart rate
E. Observe the uterine response to fetal movement
2. Answer D. A. The contraction agonist test ( OCT): also known as the contraction stress test (CST), is performed to observe and record changes in the fetal heart rate after contractions.