Antenatal And Intrapartum Fetal Surveillance and Resuscitation.

Antenatal and intrapartum fetal surveillance involves monitoring the baby’s well-being before and during labor to detect potential problems and initiate appropriate interventions, including resuscitation if needed. Resuscitation efforts in the intrapartum period may involve strategies to improve fetal oxygenation, such as repositioning the mother, correcting maternal hypotension, or stopping oxytocin. 

Antenatal Fetal Surveillance:

• Goals:To identify fetuses at risk of adverse outcomes like stillbirth and to detect those that will benefit from early intervention. 
• Methods:
  • Nonstress Test (NST): Measures fetal heart rate in response to fetal movement. 
  • Biophysical Profile (BPP): Evaluates fetal heart rate, breathing movements, muscle tone, and amniotic fluid volume. 
  • Contraction Stress Test (CST): Assesses fetal heart rate response to contractions. 
  • Umbilical Artery Doppler Velocimetry: Measures blood flow in the umbilical artery. 
  • Fetal Movement Counts: Mother monitors fetal movements. 

Intrapartum Fetal Surveillance:

• Goals: To detect fetal distress during labor and to plan delivery safely. 
• Methods:
  • Continuous Electronic Fetal Monitoring (CEFM): Records fetal heart rate and uterine contractions continuously. 
  • Intermittent Auscultation: Periodically listening to the fetal heart rate with a stethoscope or Doppler. 
• Interpretation: Fetal heart rate patterns are analyzed to assess fetal well-being and predict potential problems. 

Intrapartum Fetal Resuscitation:

• Goals: To improve fetal oxygenation and prevent or mitigate adverse outcomes. 
• Interventions:
  • Changing Maternal Position: Repositioning the mother to the left lateral or other positions to improve blood flow to the placenta. 
  • Managing Maternal Hypotension: Correcting low blood pressure to improve uterine blood flow. 
  • Hydration: Giving intravenous fluids to increase blood volume and improve blood flow. 
  • Discontinuing Oxytocin: Stopping oxytocin if it is contributing to uterine hyperstimulation. 
  • Tocolysis: Using medications to relax the uterus and reduce contractions. 
  • Consideration of other interventions: Depending on the specific situation, other interventions like amnioinfusion or delivery may be considered. 

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