- 1. Turn patient to left, lateral side.
-
Correct.
This relieves compression on the IVC increasing cardiac output and
therefore uterine perfusion.
Incorrect.
This relieves compression on the IVC increasing cardiac output and
therefore uterine perfusion.
- 2. Change maternal position to various positions until
fetal improvement.
-
Correct.
This is useful with cord compression but the main problem is
hypoperfusion with hyperstimulation.
Incorrect.
This is useful with cord compression but the main problem is
hypoperfusion with hyperstimulation.
- 3. Fluid bolus, lower maternal head.
-
Correct.
These efforts may help improve maternal cardiac output and therefore
uterine perfusion.
Incorrect.
These efforts may help improve maternal cardiac output and
therefore uterine perfusion.
- 4. Vasopressor (e.g. Ephedrine).
-
Correct.
There is no evidence of maternal hypotension.
Incorrect.
There
is no evidence of maternal hypotension.
- 5. Supplemental Oxygen.
-
Correct.
Though controversial, O2 may be of benefit to the fetus in this case.
Incorrect.
Though controversial, O2 may be of benefit to the fetus in this case.
- 6. Start amnioinfusion.
-
Correct.
Amnioinfusion is indicated only for the treatment of severe variables.
Incorrect.
Amnioinfusion is indicated only for the treatment of severe variables.
- 7. Give tocolytic (e.g. Terbutaline).
-
Correct.
If the tachycardia is taken as evidence of fetal distress, then giving
a tocolyic may hasten the resolution of the hyperstimulation.
Incorrect.
If the tachycardia is taken as evidence of fetal distress, then giving
a tocolyic may hasten the resolution of the hyperstimulation.
- 8. Perform vaginal exam.
-
Correct.
Though not contraindicated, this is not likely to be beneficial.
Incorrect.
Though
not contraindicated, this is not likely to be beneficial.
- 9. Perform expeditious (emergent) delivery (operative
vaginal delivery or Cesarean delivery)
-
Correct.
Intrauterine resuscitation should be attempted first.
Incorrect.
Intrauterine rescucitation should be attempted first.
- 10. Perform fetal scalp stimulation.
-
Correct.
Fetal scalp stimulation should never be performed in the presence of
tachycardia.
Incorrect.
Fetal scalp stimulation should never be performed in the presence of
tachycardia.
