Nursing 209

N209: Reproductive Health Study Guide  Variability that is persistently absent or minimal is often the most significant sign of fetal compromise o FHR accelerations: An increase in FHR above baseline  Before 32 weeks: FHR increase of 10 BPM above baseline for more than 10 seconds  After 32 weeks: FHR increase of 15 BPM above baseline for more than 15 seconds o Reactive FHR: An increase in FHR of 15 BPM above baseline for 15 seconds twice in a 20- minute period o FHR decelerations: Can be a gradual or abrupt decrease in FHR from baseline  Early decelerations: Associated with fetal head compression  Variable decelerations: Associated with cord compression; the most common pattern in labor  Late decelerations: Associated with uteroplacental insufficiency • Fetal heart rate categories: o Normal: Category I (FHR baseline wnl, moderate variability, no late or variable decelerations) o Indeterminate: Category II (not clearly normal or abnormal; requires observation) o Abnormal: Category III (associated with fetal metabolic acidosis; absent variability with either recurrent late or variable decelerations or bradycardia; sinusoidal pattern) 4.3 Labor Complications • Preterm labor: Contractions resulting in cervical change prior to 37 weeks gestation • Premature rupture of membranes (PROM): Rupture of membranes before the onset of labor • Umbilical cord prolapse: Umbilical cord is in front of the presenting part • Amniotic fluid embolism: The entrance of amniotic fluid and fetal cells into maternal circulation • Fetal dystocia: Abnormal fetal size or position resulting in difficult delivery • Inverted uterus: The uterus turns inside out and protrudes into the vagina or beyond the introitus • Placenta accrete: Abnormally adherent placenta growing into myometrium • Protracted labor: Abnormally slow cervical dilation or fetal descent during the active phase of labor • Uterine rupture: Occurs when there is a full thickness disruption of the uterine wall that also involves the overlying visceral peritoneum • Placental abruption: Detachment of the placenta from the uterine wall (complete or partial)

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