What periodic change in the FHR baseline is associated with fetal hypoxia?

Correct Answer: B

Rationale: Late decelerations are associated with fetal hypoxia. Late decelerations occur after the peak of the uterine contraction and can indicate decreased oxygen supply to the fetus. This is because late decelerations are caused by uteroplacental insufficiency, where there is a decrease in blood flow and oxygen to the placenta. This results in a delayed response from the fetus in reducing its heart rate, hence the term "late" deceleration. Early decelerations (choice A) are caused by head compression during contractions and are considered benign and not associated with fetal hypoxia. These decelerations mirror the contraction pattern and are typically reassuring. Variable decelerations (choice C) are caused by umbilical cord compression and can indicate fetal hypoxia if they are persistent, severe, or associated with other abnormal patterns. However, they are not specifically associated with fetal hypoxia like late decelerations. Accelerations (choice D) are an increase in the FHR above the baseline and are considered a reassuring sign of fetal well-being. They are typically seen with fetal movement and are not associated with fetal hypoxia. In summary, late decelerations are the only type of deceleration specifically associated with fetal hypoxia due to uteroplacental insufficiency, making them the correct answer. Early decelerations are benign, variable decelerations are caused by cord compression, and accelerations are reassuring signs of fetal well-being.

Correct Answer: A

Rationale: Intermittent auscultation is the correct choice because it is a non-invasive method of monitoring fetal heart rate during labor. This involves using a handheld Doppler device or a fetoscope to listen to the baby's heart rate at regular intervals. It is a safe and effective way to monitor the baby's well-being without continuous electronic monitoring. External monitoring, on the other hand, involves using belts placed on the mother's abdomen to monitor fetal heart rate and contractions. While external monitoring can provide continuous data, it is not always necessary and can sometimes be less accurate than intermittent auscultation. Internal monitoring involves placing a fetal scalp electrode on the baby's head to directly monitor the heart rate. This method is more invasive than both intermittent auscultation and external monitoring, and carries a higher risk of infection and other complications. Intrauterine pressure monitoring is a method used to measure the strength and duration of contractions during labor. This involves placing a catheter inside the uterus to monitor the pressure changes. While this can provide useful information about the progress of labor, it is not a type of monitoring that can offer information specifically about the baby's well-being, making it less relevant to the question at hand. Overall, intermittent auscultation is the preferred method of monitoring in many cases because it is non-invasive, safe, and effective at assessing fetal well-being during labor.

Correct Answer: C

Rationale: When a pregnant person lies flat on their back, it can compress the vena cava, a major blood vessel that returns blood to the heart. This compression can lead to decreased blood flow to the uterus and placenta, resulting in uteroplacental insufficiency. This condition can compromise the health of the fetus as it may not receive an adequate oxygen and nutrient supply. Choice A, increased risk of early decelerations, is not directly related to lying on the back. Early decelerations are a common finding during labor and are often caused by head compression during contractions. Choice B, increased risk of back pain, may occur when lying on the back for an extended period of time due to the added pressure on the lower back. However, it is not the primary reason pregnant individuals should avoid this position. Choice D, increased risk of uterine labor dystocia, is not directly related to lying on the back. Uterine labor dystocia refers to abnormal or difficult labor due to ineffective uterine contractions or pelvic abnormalities, and it is not typically caused by a specific maternal position. In conclusion, the correct answer is C because lying on the back can lead to uteroplacental insufficiency, which can negatively impact the health of the fetus.

Correct Answer: D

Rationale: Starting an IV fluid bolus is the correct intervention in this scenario. When a pregnant woman presents with decreased fetal movement, it may indicate fetal distress, which could be due to poor oxygenation. Administering IV fluids can help increase blood flow to the fetus, improving oxygenation and potentially increasing fetal movement. Administering antibiotics (choice A) would not be the correct intervention in this situation because decreased fetal movement is not typically an indication for antibiotics. Antibiotics are typically used to treat infections, not fetal distress. Increasing oxytocin (choice B) would also not be the correct intervention. Oxytocin is a hormone that is typically used to induce or augment labor, not to address decreased fetal movement. In fact, increasing oxytocin could potentially exacerbate fetal distress. Performing fetal scalp stimulation (choice C) involves applying pressure to the fetal scalp to elicit a response in the fetus. While this can be a useful technique to assess fetal well-being, it is not the most appropriate initial intervention when decreased fetal movement is noted. Starting with IV fluids to improve oxygenation is more essential in this situation. In conclusion, starting an IV fluid bolus is the most appropriate intervention when a pregnant woman presents with decreased fetal movement. This intervention aims to improve oxygenation to the fetus, potentially addressing the underlying cause of fetal distress. Administering antibiotics, increasing oxytocin, and performing fetal scalp stimulation are not the most appropriate initial interventions in this scenario.

Correct Answer: C

Rationale: Terbutaline is a medication commonly used in obstetrics to relax the uterus and prevent or treat tachysystole, which is defined as excessive uterine contractions. Choice C, tachysystole with decelerations in FHR, is the correct indication for administering terbutaline because it helps to slow down the contractions and improve fetal heart rate patterns. Choice A, early decelerations, is not an indication for terbutaline because early decelerations are typically a normal response to head compression during labor and do not require intervention with terbutaline. Choice B, insufficient labor pattern, is not an indication for terbutaline either. Insufficient labor pattern refers to slow progress in labor, which may require artificial oxytocin (Pitocin) to stimulate contractions, not terbutaline to slow them down. Choice D, fetal tachycardia, is also not an indication for terbutaline. Fetal tachycardia is an increased fetal heart rate above 160 bpm and can be caused by various factors such as maternal fever or fetal distress, but terbutaline is not used to treat this condition. Terbutaline is specifically used for uterine relaxation in cases of tachysystole to improve fetal heart rate patterns.