Fetal circulation, unlike postnatal circulation, involves the umbilical cord and placental blood vessels which carry fetal blood between the fetus and the placenta . Slowed conduction to sinoatrial node Fig. They are visually determined as a unit, Late decelerations of the FHR are associated most specifically with A. Prepare for possible induction of labor Proposed Management Algorithm ACUTE for intrapartum fetal monitoring (CTG) in preterm gestations (<34 weeks). C. Turn patient on left side B. PCO2 C. Dysrhythmias, Which of the following fetal dysrhythmias may be related to maternal hyperthyroidism? T/F: The most common artifact with the ultrasound transducer system for fetal heart rate is increased variability. C. Initially increase, then decrease FHR, Which of the following is not true when assessing preterm fetuses? Published by on June 29, 2022. The mixture of partly digested food that leaves the stomach is called$_________________$. A. Polyhydramnios C. Trigeminal, Which of the following dysrhythmias may progress to atrial fibrillation or atrial flutter? Early 609624, 2007. A. Metabolic acidosis . Allison BJ, Brain KL, Niu Y, Kane AD, Herrera EA, Thakor AS, Botting KJ, Cross CM, Itani N, Skeffington KL, Beck C, Giussani DA. D. Variable deceleration, With complete umbilical cord occlusion, the two umbilical arteries also become occluded, resulting in sudden fetal hypertension, stimulation of the baroreceptors, and a sudden _______ in FHR. The pattern lasts 20 minutes or longer, Vagal stimulation would be manifested as what type of fetal heart rate pattern? B. Succenturiate lobe (SL) Understanding these normal physiological characteristics is key in correctly interpreting fetal heart rate patterns. PCO2 72 Excessive Insufficient oxygenation, or hypoxia, is a major stressor that can manifest for different reasons in the fetus and neonate. Download scientific diagram | Myocyte characteristics. 21, no. technique used for fetal assessment based on the face that the FHR reflects fetal oxygenation. A. The placenta accepts the blood without oxygen from the fetus through blood vessels that leave the fetus . 34, no. The preterm birth rate rose 4% in 2021, from 10.1% in 2020 to 10.5% in 2021. 824831, 2008. Deceleration patterns, European Journal of Obstetrics Gynecology and Reproductive Biology, vol. 5 segundos ago 0 Comments 0 Comments B. Fetal pulse oximetry was first introduced in clinical practice in the 1980s. B. Fetal Oxygenation During Labor. a. During fetal development, the sympathetic nervous system that is responsible for survival (fight or flight response) develops much earlier than the parasympathetic nervous system (rest and sleep) that develops during the third trimester. A. Respiratory acidosis; metabolic acidosis 194, no. A. FHR arrhythmia, meconium, length of labor With increasing gestation the baseline fetal heart rate is likely to decrease from the upper limits of the normal range. C. Prepare for probable induction of labor, C. Prepare for probable induction of labor. T/F: Uterine resting tone may appear higher (25 to 40 mmHg) during amnioinfusion. B. Baroreceptors; late deceleration Several additional tests of fetal well-being are used in labour, which include fetal blood sampling (FBS), fetal pulse oximetry, and fetal electrocardiograph (STAN analysis). 143, no. C. Prepare for cesarean delivery, For a patient at 35 weeks' gestation with a BPP score of 4, select the most appropriate course of action. Marked variability Several theories have been proposed as a potential explanation for this fetal heart rate pattern, notably decreased amount of amniotic fluid, reduced the Wharton jelly component in the cord of the preterm fetus and lack of development of the fetal myocardium and, therefore, the resultant reduced force of contraction. A. Discontinue counting until tomorrow Fetal P a O 2 Peripheral chemoreflex Abstract A distinctive pattern of recurrent rapid falls in fetal heart rate, called decelerations, are commonly associated with uterine contractions during labour. C. Well-being, Use of the terms "beat-to-beat" variability and "long-term" variability is not recommended by the NICHD because in clinical practice A. 's level of consciousness and respiratory effort significantly improve, allowing her to be extubated. 4, pp. Predict how many people will be living with HIV/AIDS in the next two years. Additional tests of fetal well-being such as fetal blood sampling (FBS) and fetal electrocardiograph (Fetal ECG or ST-Analyser) also cannot be used in this gestation. 10 min C. Notify her provider for further evaluation, C. Notify her provider for further evaluation, A BPP score of 6 is considered C. Tachycardia, *** Baseline FHR variability is determined in what amount of time, excluding accelerations and decelerations? Late deceleration B. D. Parasympathetic nervous system. pH 6.86 A decrease in the heart rate b. A. Category II C. Uterine tachysystole, A. Hyperthermia Joy A. Shepard, PhD, RN-BC, CNE Joyce Buck, PhD(c), MSN, RN-BC, CNE 1 2. Decreased FHR variability In instances of cord or head compression the parasympathetic system is activated leading to a reflex variable or early deceleration, respectively, with rapid return of fetal heart rate to its normal baseline [3]. Mecha- B. Umbilical cord compression Chronic fetal bleeding Medications such as pethidine, magnesium sulphate and even steroids have also been associated with reduced fetal heart rate variability. A. C. Hypercapnia, _______ _______ occurs when there is low bicarbonate (base excess) in the presence of normal pressure of carbon dioxide (PCO2) values. B. Category II T/F: There are two electronic fetal monitoring methods of obtaining the fetal heart rate: the ultrasound transducer and the fetal spiral electrode. More frequently occurring late decelerations C. Medulla oblongata, During periods of fetal tachycardia, FHR variability is usually diminished due to Fetal Circulation. Would you like email updates of new search results? Negative Despite the lack of evidence-based recommendations, clinicians are still required to provide care for these fetuses. C. Supine hypotension, When the hydrogen ion content in the blood rises, the pH C. Tachycardia, Which fetal monitoring pattern is characteristic of cephalopelvic disproportion, especially when seen at the onset of labor? The most likely cause is Good interobserver reliability B. Decreased uterine blood flow Fetal in vivo continuous cardiovascular function during chronic hypoxia. B. Late decelerations are defined as a visually apparent, gradual decrease in the fetal . C. 240-260, In a patient with oxytocin-induced tachysystole with normal fetal heart tones, which of the following should be the nurse's initial intervention? Mixed acidosis Frequency of accelerations is likely to increase, although the amplitude may persist at only 10 beats above the baseline. B. Metabolic; short B. D5L/R These brief decelerations are mediated by vagal activation. C. Shifting blood to vital organs, Which factor influences blood flow to the uterus? Onset of-labour in gestational ages between 2426 week represents a high-risk group in which greater than two thirds of cases are driven by an underlying infective process. B. Negligence If the pH value is <7.20, immediate delivery is recommended, whereas a pH of 7.207.25 is considered borderline and repeating FBS within 60 minutes is recommended [12]. Premature atrial contractions (PACs) A. Extraovular placement C. Maternal hypotension A. Arrhythmias A. Metabolic acidosis The American College of Obstetricians and Gynaecologists (ACOG) published a practice bulletin on intrapartum fetal heart rate monitoring in 2009. B. She is not bleeding and denies pain. Hence, pro-inflammatory cytokine responses (e.g . The fetal heart rate (FHR) pattern helps to distinguish the former from the latter as it is an indirect marker of fetal cardiac and central nervous system responses to changes in blood . Crossref Medline Google Scholar; 44. However, fetal heart rate variability is an important clinical indicator of fetal acid base balance, especially oxygenation of the autonomic nerve centres within the brain, and absent variability is therefore predictive of cerebral asphyxia. Higher B. Fetal adaptive response to progressive hypoxe-mia and acidosis are detectable and produce recogniz-able patterns in the fetal heart rate. In this situation, the blood flow within the intervillous space is decreased resulting in accumulation of carbon dioxide and hydrogen ion concentrations. A. B. C. Can be performed using an external monitor with autocorrelation technique, C. Can be performed using an external monitor with autocorrelation technique, The "overshoot" FHR pattern is highly predictive of B. Venous B. Preterm labor Requires a fetal scalp electrode B. 2023 Jan 13;13:1056679. doi: 10.3389/fendo.2022.1056679. A. A. Fetal arterial pressure They may have fewer accels, and if <35 weeks, may be 10x10 A. 4. The transcutaneous PO2 (tcPO2) response to blood interruption (BIS test) was measured in 6 healthy adults and 28 infants, including premature infants. C. 7.32 Hypertension b. Epidural c. Hemorrhage d. Diabetes e. All of the above, Stimulating the vagus nerve typically produces: a. In cases of pre-term prelabour rupture of membranes, maternal infection and the risk of chorioamnionitis should not be overlooked. It has been demonstrated that HG induces an increased proinflammatory cytokine response in the blood of preterm and term neonates . S. M. Baird and D. J. Ruth, Electronic fetal monitoring of the preterm fetus, Journal of Perinatal and Neonatal Nursing, vol. An increase in the heart rate c. An increase in stroke volume d. No change, The vagus nerve . C. PO2, The following cord blood gasses are consistent with: pH 7.10, pCO2 70, pO2 25, base excess -10 B. 2023 Feb 10;10(2):354. doi: 10.3390/children10020354. The mother was probably hypoglycemic Base deficit Category II-(Indeterminate) FHR patterns may indicate problems in the oxygenation pathway but no clue as to severity/effect on the fetus. B. Macrosomia The basic physiology and adaptive responses that regulate the fetal heart rate and physiological fetal adaptations to stress as reflected in the FHTs are described. The rod is initially placed when the temperature is 0C0^{\circ} \mathrm{C}0C. PG/10/99/28656/BHF_/British Heart Foundation/United Kingdom, FS/12/74/29778/BHF_/British Heart Foundation/United Kingdom, PG/14/5/30547/BHF_/British Heart Foundation/United Kingdom, RG/11/16/29260/BHF_/British Heart Foundation/United Kingdom, RG/06/006/22028/BHF_/British Heart Foundation/United Kingdom. C. Norepinephrine, Which of the following is the primary neurotransmitter of the parasympathetic branch of the autonomic nervous system? Home; are flights to cuba cancelled today; what characterizes a preterm fetal response to interruptions in oxygenation C. Supraventricular tachycardia (SVT), B. B. B. The aim of intrapartum continuous electronic fetal monitoring using a cardiotocograph (CTG) is to identify a fetus exposed to intrapartum hypoxic insults so that timely and appropriate action could be instituted to improve perinatal outcome. C. Maternal arterial vasoconstriction, ***Betamethasone given to the mother can transiently affect the FHR by A. Baroreceptors influence _____ decelerations with moderate variability. Category II (indeterminate) D. Accelerations, Place the following interventions for a sinusoidal FHR in the correct order: Fetal hypoxia, also known as intrauterine hypoxia, occurs when a fetus is starved of oxygen. Practice PointsBaseline fetal heart rate in this cohort of fetuses is likely to remain at the higher end of normal (between 150160) due to the unopposed effect of the sympathetic nervous system. 2023 Jan 19;24(3):1965. doi: 10.3390/ijms24031965. B. Cycles are 4-6 beats per minute in frequency A. Decreased Amino acids, water-soluble vitamins, calcium, phosphorus, iron, and iodine are transferred across the placenta via _____ _____. Children (Basel). E. Chandraharan, Rational approach to electronic fetal monitoring during labour in "all" resource settings, Sri Lanka journal of Obstetrics and Gynaecology, vol. B. B. Decreased FHR baseline 1, pp. T/F: The parasympathetic nervous system is a cardioaccelerator. J Physiol. C. Category III, FHTs with minimal variability, absent accelerations, and a 3-minute prolonged deceleration would be categorized as A. Normal response; continue to increase oxytocin titration A. Metabolic acidosis 6 Fetal heart rate accelerations are also noted to change with advancing gestational age. B. Catecholamine The aim of intrapartum continuous electronic fetal monitoring using a cardiotocograph (CTG) is to identify a fetus exposed to intrapartum hypoxic insults so that timely and appropriate action could be instituted to improve perinatal outcome. Stimulating the vagus nerve typically produces: The vagus nerve begins maturation 26 to 28 weeks. A. B. Sinoatrial node A. pH 7.17, PO2 22, PCO2 70, HCO3 24, BE -5 Within this group, fetal heart rate tracings will show many similarities to the 2426 week gestation cohort. b. Usually, premature birth happens before the beginning of the 37 completed weeks of gestation. A. Decreases during labor A. Acetylcholine C. Polyhydramnios, Which of the following is the most appropriate method of monitoring a patient who is a gestational diabetic? Acceleration HCO3 4.0 Practice PointsBaseline fetal heart rate and variability should be comparable to the term fetus and accelerations with an amplitude of greater than 15 beats from the baseline should be present as an indicator of fetal well-being. C. Mixed acidosis, pH 7.0 A. Administer terbutaline to slow down uterine activity Further research is needed to determine the effects of variable decelerations observed in preterm fetuses on the short-term and long-term outcomes. The oxygen pathway Fetal oxygenation involves - (1) the transfer of oxygen from the environment to the fetus, and - (2) the fetal response to interruption of oxygen transfer 4 5. A. Adrenocortical responsiveness is blunted in twin relative to singleton ovine fetuses. 20 min B. Uterine contractions and/or elevated baseline uterine tone are the most common causes of interruption of fetal oxygenation at this level. B. B. Hypoxia related to neurological damage 1827, 1978. A. Thus, classical features observed on the CTG trace in a well grown term fetus exposed to a hypoxic insult may not be observed with similar amplitude or characteristics in a pre-term fetus. 192202, 2009. A. B. Hence, ST analyser is not recommended prior to 36 weeks of gestation as it may not be reliable due to changes in the myocardial composition described above. B. Betamethasone and terbutaline A. Digoxin B. Dopamine We aim to investigate whether renal tissue oxygen saturation (rSO2) measured with near-infrared . Positive Transient fetal tissue metabolic acidosis during a contraction C. Transient fetal asphyxia during a contraction, B. Does the Blood-Brain Barrier Integrity Change in Regard to the Onset of Fetal Growth Restriction? Base buffers have been used to maintain oxygenation The availability of oxygen to the fetus is limited by the route taken by oxygen from the atmosphere to fetal tissues, aided or diminished by pregnancy-associated changes in maternal physiology and, ultimately, a function of atmospheric pressure and composition of the mother's inspired gas. Therefore, understanding of oxygen transport across the human placenta and the effect of maternal ventilation on fetal oxygenation is tentative, and currently based on a model that is derived from evidence in another species. B. 60, no. B. C. Poor interobserver and intraobserver reliability, C. Poor interobserver and intraobserver reliability, The objective of intrapartum FHR monitoring is to assess for fetal With results such as these, you would expect a _____ resuscitation. Generally, the goal of all 3 categories is fetal oxygenation. Persistence of late decelerations within this cohort is likely to represent ongoing uteroplacental insufficiency. This may also be the case when the normal physiological reserves of the fetus may be impaired (intra-uterine growth restriction, fetal infection). B. A. B. D. 7.41, The nurse notes a pattern of decelerations on the fetal monitor that begins shortly after the contraction and returns to baseline just before the contraction is over. Variable and late decelerations should be classified according to NICE guidelines and appropriate action should be taken. Daily NSTs B. Smoking The most likely etiology for this fetal heart rate change is A. C. Decrease or discontinue oxytocin infusion, C. Decrease or discontinue oxytocin infusion, The most common tachyarrhythmia in fetuses, supraventricular tachycardia, typically occurs at a rate of _____ to _____ bpm with minimal or absent variability. d. Decreased fetal movement, Which of the following does not affect the degree of fetal activity? C. Variable, An appropriate initial treatment for recurrent late decelerations with moderate variability during first stage labor is B. Umbilical vein compression The reex triggering this vagal response has been variably attributed to a . A. Metabolic acidosis C. Maternal and fetal hemoglobin are the same, A. Fetal hemoglobin is higher than maternal hemoglobin, A 36 week gestation patient is brought to triage by squad after an MVA on her back. A. Meconium-stained amniotic fluid Background and Objectives: Prematurity is currently a serious public health issue worldwide, because of its high associated morbidity and mortality. 1, pp. B. C. 10 A. Repeat in 24 hours True. Study with Quizlet and memorize flashcards containing terms like Which of the following factors can have a negative effect on uterine blood flow? Fetal tachycardia to increase the fetal cardiac output 2. The primary aim of the present study was to evaluate a potential influence of FIRS on cerebral oxygen saturation (crSO2) and fractional tissue oxygen extraction (cFTOE) during . This clinical scenario of decelerations, followed by loss of accelerations, subsequent rise in baseline heart rate and gradual loss of variability is typical of a gradually evolving hypoxia (Figure 1). _______ is defined as the energy-releasing process of metabolism. Provide juice to patient Increased FHR baseline 3. Decrease in variability B. Liver the umbilical arterial cord blood gas values reflect A. Metabolic; lengthy C. Increased variable decelerations, Which of the following is not commonly caused by terbutaline administration? Zizzo AR, Hansen J, Peteren OB, Mlgaard H, Uldbjerg N, Kirkegaard I. Physiol Rep. 2022 Nov;10(22):e15458. Increasing variability A. Atrial Immediately after birth with the initiation of breathing, the lung expands and oxygen availability to tissue rises by twofold, generating a physiologic oxidative stress. They are visually determined as a unit C. Stimulation of the fetal vagus nerve, A. The labor has been uneventful, and the fetal heart tracings have been normal. Term newborns should begin at 21% oxygen (room air oxygen concentration), whereas preterm babies should be started at a higher oxygen concentration, such as 30% (Kattwinkel et al., 2010). Other possible factors that may contribute to onset of labour in this group include multiple gestations maternal risk factors such as increased maternal age, raised body mass index (BMI), or pregnancies conceived through in-vitro fertilization (IVF). R. M. Grivell, Z. Alfirevic, G. M. Gyte, and D. Devane, Antenatal cardiotocography for fetal assessment, Cochrane Database of Systematic Reviews, no. B. Preeclampsia D. Oligohydramnios, All of the following are likely causes of prolonged decelerations except: Angiotensin II and cardiovascular chemoreflex responses to acute hypoxia in late gestation fetal sheep. A. Digoxin Excludes abnormal fetal acid-base status B. C. Increased FHR accelerations, Which of the following would likely be affected by betamethasone administration? In non-reassuring CTG traces, pulse oximetry was initially felt to provide a more sophisticated way of detecting adverse neonatal outcome. Optimizing the management of these pregnancies is of high priority to improve perinatal outcomes. B. However, caution should be exercised in fetuses prior to 28 weeks that demonstrate such features as perinatal outcome is poor in this group. B. Maternal hemoglobin is higher than fetal hemoglobin Less-oxygenated blood enters the ______ ventricle, which supplies the rest of the body. Recent epidural placement These types of decelerations are termed late decelerations and due to the accumulation of carbon dioxide and hydrogen ions are more suggestive of metabolic acidosis [3]. Likely, iatrogenic causes of fetal heart rate abnormalities (as mentioned above) should also be noted and documented. It is important to realize that physiological reserves available to combat hypoxia are less than those available to a term fetus. A. Both signify an intact cerebral cortex T/F: Variable decelerations are a vagal response. Fetal bradycardia may also occur in response to a prolonged hypoxic event. B. Cerebral cortex By the 28th week, 90% of fetuses will survive ex utero with appropriate support. B. mixed acidemia B. This response is mediated through the somatic nervous system and represents fetal wellbeing [3]. D. 3, 2, 4, 1, FHTs with accelerations, no decelerations, and minimal variability would be categorized as C. Oxygen at 10L per nonrebreather face mask. The number of decelerations that occur Late decelerations are one of the precarious decelerations among the three types of fetal heart rate decelerations during labor. Fetal development slows down between the 21st and 24th weeks. B. T/F: Umbilical cord influences that can alter blood flow include true knots, hematomas, and number of umbilical vessels. A. Abnormal what characterizes a preterm fetal response to interruptions in oxygenation. B. T/F: Contractions cause an increase in uterine venous pressure and a decrease in uterine artery perfusion. The preterm infant 1. What information would you give her friend over the phone? CTG of a fetus at 26 weeks of gestation: note higher baseline heart rate, apparent reduction in baseline variability, and shallow variable decelerations. Turn patient on side The nurse reviews the arterial gas results and concludes that the fetus had _____ acidosis. Based on current scientific evidence, a CTG is not recommended in the UK as a method of routine fetal assessment of the preterm fetus (<37 weeks gestation) and currently no clinical practice guidelines on intrapartum monitoring of the preterm fetus exist in the UK The International Federation of Gynaecologists and Obstetricians (FIGO) guidelines for interpretation of intrapartum cardiotocogram distinguish 2 levels of abnormalities, suspicious and pathological, however, the gestation to which such criteria can be applied has not been specified. However, both lung anatomy and function and the antioxidant defense system do not mature until late in gestation, and therefore, very preterm infants often need . camp green lake rules; As the fetus develops beyond 30 weeks, the progressive increase in the parasympathetic influence on fetal heart rate results in a gradual lowering of baseline rate. Fetal monitoring: is it worth it? Increase BP and decrease HR A. One tool frequently used to determine the degree of fetal wellbeing is cardiotocography (CTG). It is vital to counsel women prior to instituting continuous electronic fetal monitoring, especially in extreme preterm fetuses (2426 weeks) as survival in this group is largely determined by fetal maturity than the mode of delivery. Right ventricular pressure, 70/4 mmHg, is slightly greater (1 to 2 mmHg) than left ventricular pressure. Uterine tachysystole Xanthine oxidase and the fetal cardiovascular defence to hypoxia in late gestation ovine pregnancy. Physiological control of fetal heart rate and the resultant features observed on the CTG trace differs in the preterm fetus as compared to a fetus at term making interpretation difficult. We have proposed an algorithm ACUTE to aid management. Reducing lactic acid production B. Lowers A. Abruptio placenta Inability of a preterm or growth restricted fetus to mount a required stress response may lead to maladaptive responses resulting in permanent hypoxic insult on the fetal brain occurring at a lower threshold than in the term fetus. This refers to alternative periods of activity and quiescence characterized by segments of increased variability (with or without accelerations) interspersed with apparent reduction in variability. Preterm, immature neonates (sometimes born as early as 4 months preterm) respond to severe oxygen deficiency differently from the term neonates. Increased variables As the neonatal outcome is largely determined by the gestational maturity and fetal weight, operative intervention is likely to increase maternal morbidity and mortality without significantly improving perinatal survival. B. Pulmonary arterial pressure is the same as systemic arterial pressure. PCO2 54 B. Biophysical profile (BPP) score In the normal fetus (left panel), the . A. Bradycardia The initial neonatal hemocrit was 20% and the hemoglobin was 8. Provide oxygen via face mask what characterizes a preterm fetal response to interruptions in oxygenation. Kane AD, Hansell JA, Herrera EA, Allison BJ, Niu Y, Brain KL, Kaandorp JJ, Derks JB, Giussani DA. 5, pp. C. Weekly contraction stress tests, Which of the following is not commonly caused by magnesium sulfate? B. Deposition These are believed to reflect Rapid Eye Movement (REM) and non-REM sleep. Increase FHR C. Atrioventricular node B. Some triggering circumstances include low maternal blood . T. Wheeler and A. Murrills, Patterns of fetal heart rate during normal pregnancy, British Journal of Obstetrics and Gynaecology, vol. B. Oxygenation B. Fluctuates during labor B. D. Respiratory acidosis; metabolic acidosis, B. This review describes the features of normal fetal heart rate patterns at different gestations and the physiological responses of a preterm fetus compared to a fetus at term. A review of the available literature on fetal heart . C. Category III, Maternal oxygen administration is appropriate in the context of B. B. Gestational age, meconium, arrhythmia Oxygen, carbon dioxide, water, electrolytes, urea, uric acid, fatty acids, fat-soluble vitamins, narcotics barbiturates, anesthetics, and antibiotics are transferred across the placenta via _____ _____. By is gamvar toxic; 0 comment; Notably, fetal baseline heart rate is higher, averaging at 155 between 2024 weeks (compared to a term fetus where average baseline fetal heart rate is 140). (T/F) Vibroacoustic stimulation may be less effective for preterm fetuses or when membranes have been ruptured. B. Labetolol Assist the patient to lateral position There are sub-categories of preterm birth, based on gestational age: moderate to late preterm (32 to 37 weeks). In addition, with ongoing development of the autonomic nervous system, variability should often be within the normal range. B. Which of the following is the least likely explanation? Patients 68 (41 males) small for gestational age (SGA) (birth weight <10th percentile) and 136 (82 males) appropriate for . B. A. A. Premature ventricular contraction (PVC) C. Medulla oblongata, When the umbilical vessels traverse the membranes to the placenta without any cord protection, this is called C. Respiratory acidosis, As a contraction beings, partial umbilical cord compression causes occlusion of the low-pressure vein and decreased return of blood to the fetal heart, resulting in decreased CO, hypotension, and a compensatory FHR _____. Oxygen saturation and heart rate during delivery room resuscitation of infants h30 weeks' gestation with air or 100% oxygen. C. E. East, S. P. Brennecke, J. F. King, F. Y. Chan, and P. B. Colditz, The effect of intrapartum fetal pulse oximetry, in the presence of a nonreassuring fetal heart rate pattern, on operative delivery rates: a multicenter, randomized, controlled trial (the FOREMOST trial), American Journal of Obstetrics and Gynecology, vol. C. Triple screen positive for Trisomy 21 Shape and regularity of the spikes The main purpose of this model is to illustrate the kind of information that is needed to make further progress in this . B. C. Vagal reflex. B. J Physiol. C. Possible cord compression, A woman has 10 fetal movements in one hour.
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