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Labor Stage 3: Postpartum Hemorrhage – Therapies and Treatment

by Veronica Gillispie, MD, FACOG
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    Now let's discuss the interpretation of fetal heart rate tracings. So let's go over some terminology and some nomenclature. When we talk about the fetal heart rate tracing, we talk about the baseline, the variability and accelerations. When we talk about contraction, the bottom part of this example we discuss if the contractions are normal and what tachysystole means. Let's start with baseline. So a normal baseline is between 110 beats to a 160 beats per minute. And this is for the fetal heart rate. Tachycardia is considered to be 160 beats per minute sustained for a 10 minute time frame. And bradycardia is considered to be less than 100 beats per minute when it's sustained for a 10 minute time frame. So variability talks about the ability of the fetal heart rate to change above or below baseline. When the variability is absent that means there's no change in the baseline. When it's minimal, it means it's less than 5 beats per minute. Moderate is 6 to 25 beats per minute. And marked is greater than 25 beats per minute. In our example here, we would call this moderate variability. Now when we discuss accelerations, we divide that to before 32 weeks gestation and after 32 gestation. After 32 weeks gestation, we expect to see an increase in the fetal heart rate by 15 beats per minute for 15 seconds over a 2 minute tracing. Before 32 weeks, normal accelerations consist of an increase in the fetal heart rate by 10 beats per minute for 10 seconds over a 2 minute tracing. Now, contractions. A normal amount of contractions are 5 or less contractions in a 10 minute time frame. Uterine tachysystole means greater than 5 contractions in 10 minutes. Now there's something called Montevideo Units. When normally a...

    About the Lecture

    The lecture Labor Stage 3: Postpartum Hemorrhage – Therapies and Treatment by Veronica Gillispie, MD, FACOG is from the course Intrapartum Care. It contains the following chapters:

    • Directed Therapies and other Treatments for Postpartum Hemorrhage
    • Directed Therapy for Thrombin Disorders

    Included Quiz Questions

    1. Methylergonovine (Methergine)
    2. PGF-2 alpha (Hemabate)
    3. Antibiotics only to treat the root cause
    4. Fresh frozen plasma
    5. Cryoprecipitate
    1. Hypertension
    2. Asthma
    3. Diabetes
    4. von Willebrand disorder
    5. Disseminated intravascular coagulation
    1. Empty the bladder
    2. Assure maternal anesthesia
    3. Insertion of foley catheter balloon into the uterus
    4. Use a step stool to obtain the proper angle and leverage
    5. First try at least three uterotonic medications prior to attempting uterine massage.
    1. 2 g/dL
    2. 1g/dL
    3. 5 g/dL
    4. 3 g/dL
    5. 0.5 g/dL

    Author of lecture Labor Stage 3: Postpartum Hemorrhage – Therapies and Treatment

     Veronica Gillispie, MD, FACOG

    Veronica Gillispie, MD, FACOG


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