CST PPT MILY.ppt
- 2. DEFINITION • A TEST IN WHICH THE FETUS IS EXPOSED TO THE STRESS OF UTERINE CONTRACTIONS TO DETERMINE WHETHER THERE IS ADEQUATE PLACENTAL PERFUSION UNDER SIMULATED LABOR CONDITIONS.
- 3. METHODS 1. OXYTOCIN CHALLENGE TEST 2. BREAST STIMULATION
- 5. PURPOSE TO ASSESS THE FETAL ABILITY TO COPE WITH THE CONTINUATION OF A HIGH RISK PREGNANCY. TO DETERMINE THE PROJECTED ABILITY OF THE FETUS TO WITHSTAND THE STRESS OF LABOR.
- 6. INDICATIONS IUGR POSTMATURITY. HYPERTENSIVE DISORDER OF PREGNANCY. DIABETES MELLITUS. WOMEN WITH NON REACTIVE NST.
- 7. CONTRAINDICATIONS • THIRD TRIMESTER BLEEDING. • INCOMPETENT CERVIX. • MULTIPLE GESTATION. • PREVIOUS CLASSICAL UTERINE INCISION. • HYDRAMNIOS. • HISTORY OF PRETERM LABOR. • PREMATURE RUPTURE OF MEMBRANE.
- 8. ARTICLES FETAL MONITOR,MONITOR STRIP,TRANSDUCER AND MONITOR BELT. • IV LINE TO ADMINISTER A DILUTE DOSE OF OXYTOCIN. • AN IV INFUSION PUMP TO MONITOR THE FLOW RATE. • INJECTION OXYTOCIN AND IV FLUIDS.
- 9. PROCEDURE • EXPLAIN TO MOTHER THE PROCEDURE AND ITS PURPOSE. • MAKE SURE THAT THE WOMAN HAD EATEN FOOD AND ASK HER TO EMPTY HER URINARY BLADDER. • TURN ON THE MONITOR AND PRESS “TEST” BUTTON TO SEE THAT IS WORKING AND ADJUST THE PAPER SPEED(3CM PER MIN).
- 10. CONT….. • PERFORM AN ABDOMINAL PALPATION. • POSITION THE WOMAN IN SEMI- FOWLERS OR LATERAL TILT POSITION AND PLACE THE MONITOR BELTS UNDER HER BACK SO THAT THEY ARE FLAT AGAINST HER SKIN. • CONNECT THE ULTRATRANDUCER AND TOCOTRANSDUCER TO FETAL MONITOR.
- 11. CONT….. • PLACE THE ULTRASOUND TRANSDUCER ON THE MATERNAL ABDOMEN OVER THE FETAL BACK. • MOVE THE TRANSDUCER UNTIL THE CLEAR AND AUDIBLE FETAL HEART TONES ARE HEARD. SECURE THE DEVICE IN PLACE WITH BELT. • PLACE TOCO TRANSDUCER ON FUNDUS AND SECURE WITH BELT.
- 12. CONT… • RUN THE MONITOR AND EVALUATE THE QUALITY OF TRACING TO DETERMINE IF IT IS ADEQUATE FOR INTERPRETATION. • START THE OXYTOCIN INFUSION AT THE RATE OF 1mu/ MIN. • STEP UP THE OXYTOCIN INFUSION RATE AT EVERY 15 MINUTES AT THE PRESCRIBED RATE UNTIL THE UTERINE CONTRACTIONS ARE ESTABLISHED.
- 13. CONT… • MONITOR THE UTERINE CONTRACTION USING HANDS. • CONTINUE THE INFUSION UNTIL THE CONTRACTIONS ARE OCCURING AT A FREQUENCY OF AT LEAST ONE IN A 10 MINUTE PERIOD AND LASTING AT LEAST 30 SECONDS. • RECORDE STRIP TAKEN OUT AND OXYTOCIN INFUSION DISCONTINUED.
- 14. INTERPRETATION • NEGATIVE: No late decelerations present throughout the test. Indicates fetal well-being and predicts that the fetus will continue to be alright for another week without intervention of delivery.
- 15. Cont.... • POSITIVE: repeated late decelerations of fetal heart patterns occur during the test. HYPERSTIMULATION: contractions are more frequent than two per minutes or for duration of more than 90 sec. The test should be stopped and repeated within 24-48 hours.
- 16. Cont.... • SUSPICIOUS: Occasional late decelerations with continued contractions. The CST should be repeated within 24-48 hours. UNSATISFACTORY: The recording is not of good quality to be interpreted. This may be due to problems inherent with monitoring.
- 17. SPECIAL CONSIDERATIONS • DISCONTINUE INFUSION WHEN: 1. Criteria are met. 2. Hyper stimulation occur. 3. Prolonged deceleration / bradycardia occur.
- 18. THANK YOU