- 1. Turn patient to left, lateral side.
-
Correct.
If the tachycardia is due to maternal fever, then there is no evidence of uteroplacental insufficiency.
Incorrect.
If the tachycardia is due to maternal fever, then there is no evidence of uteroplacental insufficiency.
- 2. Change maternal position to various positions until
fetal improvement.
-
Correct.
This only useful with cord compression of which there is significant evidence.
Incorrect.
There is no significant evidence of cord compression, so this maneuver is not likely to
be beneficial.
- 3. Fluid bolus, lower maternal head.
-
Correct.
Again, we are not treating hypoperfusion or uteroplacental insufficiency.
Incorrect.
Again, we are not treating hypoperfusion or uteroplacental insufficiency.
- 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.
O2 is likely of no benefit to the fetus in this case.
Incorrect.
O2 is likely of no benefit to the fetus in this case.
- 6. Start antibiotic coverage for chorioamnionitis.
-
Correct.
Penicillin alone is not adequate for chorioamnionitis. She should also be given acetominophen.
Incorrect.
Penicillin alone is not adequate for chorioamnionitis. She should also be given acetominophen.
- 7. Give tocolytic (e.g. Terbutaline).
-
Correct.
There are rarely times when this will prove beneficial and there is no
evidence of hypertonus.
Incorrect.
There are rarely times when this will prove beneficial.
- 8. Perform vaginal exam.
-
Correct.
Though not contraindicated, this is not likely to be beneficial and frequent exams may cause or exacerbate infection.
Incorrect.
Though
not contraindicated, this is not likely to be beneficial and frequent exams may cause or exacerbate infection.
- 9. Perform expeditious (emergent) delivery (operative
vaginal delivery or Cesarean delivery)
-
Correct.
Intrauterine resuscitation and treatment of the fever should be attempted first.
Incorrect.
Intrauterine rescucitation and treatment of the fever 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.
