What is considered a reactive nonstress test (NST)?
A decrease in fetal heart rate during monitoring
The presence of at least two fetal heart rate accelerations during 20 minutes of monitoring
A rise in fetal heart rate of at least 15/min from baseline lasting for at least 15 seconds
The absence of fetal heart rate accelerations during monitoring
The Correct Answer is B
A. A decrease in fetal heart rate during monitoring: A decrease in fetal heart rate (deceleration) is not a reassuring sign and suggests fetal distress, which is not considered reactive.
B. The presence of at least two fetal heart rate accelerations during 20 minutes of monitoring: A reactive NST is defined as at least two fetal heart rate accelerations of 15 beats per minute lasting at least 15 seconds within a 20-minute period, indicating fetal well-being.
C. A rise in fetal heart rate of at least 15/min from baseline lasting for at least 15 seconds: While this is part of the criteria for determining accelerations, the key aspect of a reactive NST is the presence of at least two such accelerations within a 20-minute period.
D. The absence of fetal heart rate accelerations during monitoring: The absence of accelerations in a 40-minute period is classified as a nonreactive NST, which may indicate fetal hypoxia or other concerns requiring further evaluation.
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Related Questions
Correct Answer is C
Explanation
A. Maternal heart rate: While the maternal heart rate is important, it is not directly related to interpreting FHR patterns. However, it is necessary to differentiate between the maternal and fetal heart rate on the monitor.
B. Gestational age: While gestational age affects fetal heart rate (younger fetuses tend to have higher baseline rates), it is not a direct component of FHR interpretation.
C. Uterine contractions: Uterine contractions are crucial in FHR interpretation because they influence perfusion to the fetus. Decelerations occurring with contractions may indicate fetal distress (e.g., late decelerations suggest uteroplacental insufficiency).
D. Presence of accelerations and decelerations: Accelerations and decelerations provide key information about fetal well-being. Accelerations indicate fetal well-being, while decelerations may signal hypoxia, cord compression, or uteroplacental insufficiency.
Correct Answer is B
Explanation
A. Repaglinide: Repaglinide is an oral hypoglycemic agent, but it is not recommended in pregnancy due to limited safety data.
B. Insulin: Insulin is the preferred treatment for gestational diabetes mellitus (GDM) when diet and exercise are insufficient. It does not cross the placenta and is safe for both the mother and fetus.
C. Glipizide: Glipizide is an oral sulfonylurea that crosses the placenta and may cause neonatal hypoglycemia. It is not recommended for GDM.
D. Acarbose: Acarbose is not commonly used in pregnancy due to limited safety data and concerns about gastrointestinal side effects.
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