Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

OB > 9.2b Biophysical Assessment, Daily Fetal Movement Count, Ultrasonography, MRI > Flashcards

9.2b Biophysical Assessment, Daily Fetal Movement Count, Ultrasonography, MRI Flashcards

1
Q

Daily Fetal Movement Count (DFMC)

A
  • Kick count
  • Noninvasive way to monitor fetal oxygenation
  • Fetal movement is a good sign
  • If fetal movements cease for 12 hours, this is a cause for alarm
  • Fewer than 3 fetal movements in an hour needs evaluation via Non-Stress Test (NST) or Contraction Stress Test (CST) and a biophysical Profile (BPP)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Polyhydramnios Risk Factors

A
  • Poorly controlled DM
  • Fetomaternal hemorrhage
  • Fetal Congenital anomalies (GI obstruction, CNS abnormalities)
  • Genetic Disorders
  • Twin-to-Twin Transfusion syndrome
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Intrauterine Growth Restriction

A

MATERNAL CAUSES

  • Hypertensive Disorders
  • Pregestational Diabetes
  • Cyanotic Heart Disease
  • Autoimmune Disease
  • Restrictive Pulmonary Disease
  • Multifetal Gestation
  • Malabsorptive Disease
  • Living in High Altitude
  • Tobacco/substance abuse

FETAL CAUSES

  • Genetic Disorders
  • Teratogenic Exposures
  • Fetal Injection
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Oligohydramnios

A
  • Renal agenesis (Potter Syndrome)
  • PROM
  • Prolonged Pregnancy
  • Uteroplacental Insufficiency
  • IUGR
  • Hypertensive Disorders
  • Dehydration/hypovolemia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Chromosomal Abnormailities

A
  • Advanced maternal age
  • Parental chromosomal rearrangements
  • ## Previous pregnancy with autosomal trisomy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Common Maternal/Fetal indications for Antepartum Testing

A
  • Chronic Hypertension
  • Preeclampsia
  • IUGR
  • Multiple Gestation
  • Oligohydramnios
  • PROM
  • Late or Post term gestation
  • Previous still birth
  • Decreased fetal movement
  • Systemic Lupus Erythematosus
  • Renal Disease
  • Cholestasis of pregnancy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Ultrasound

A
  • Transvaginal or abdominal during pregnancy
  • Transvaginal allows evaluation of pelvic anatomies and intrauterine pregnancies to be diagnosed earlier
  • Very useful in obese women where abdominal ultrasound may be harder
  • Does not require full bladder
  • Abdominal ultrasound is more useful in 1st trimester
  • Requires full bladder to displace uterus up for a better picture
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

2D Ultrasound

A
  • Image is black/white/shades of grey
  • Standard medical scan used in pregnancy
  • Soundwaves sent straight down
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

3D Ultrasound

A
  • Soundwaves sent at different angles
  • Computer creates a 3D image
  • Used to find certain anomalies in fetuses,
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

4D Ultrasound

A
  • Standard (Basic) - Used to evaluate fetal presentation, amniotic fluid volume (AFV), cardiac activity, placental position, fetal growth parameters, and number of fetuses
  • Limited - Used to determine specific information about pregnancy (identifying fetal position during labor). Done by OB doctor
  • Specialized - Preformed when women are suspected of a anatomically/physiologically abnormal fetus.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

ULTRASOUND PURPOSE IN 1st TRIMESTER

A
  • Confirm pregnancy/viability
  • Determine gestational age
  • Rule out ectopic pregnancies
  • Detect multiple gestation
  • Determine cause of vaginal bleeding
  • Visualize chorionic villlus
  • Detect maternal abnormalities (Bicornuate Uterus, Ovarian Cysts, Fibroids)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Primary Purpose of Ultrasound

A
  • Confirm Viability
  • Establish/confirm dates
  • Detect Poly/Oligohydramnios
  • Detect congenital anomalies
  • Detect IUGR
  • Assess placental location
  • Visualize amniocentesis
  • Evaluate pre-term labor
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Ultra Sound Third Trimester

A
  • Confirm gestational age
  • Confirm viability
  • Detect macrosomia
  • Detect Congenital Anomalies
  • Detect IUGR
  • Determine fetal position
  • Detect placental previa/abruption
  • Amniotic fluid assessment
  • Evaluation of preterm labor
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Fetal Heart Rate Activity

A
  • Seen at 6 weeks of gestation via transvaginal ultrasound
  • Cardiac anatomy can be seen at 13 weeks of gestation
  • Fetal death is confirmed via lack of heart motion, presence of fetal scalp edema, and maceration/overlap of cranial bones
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Gestational Age Ultrasound

A

USED IF

  • Date is unknown of last menstrual period
  • Recently discontinued oral contraceptives
  • Bleeding during 1st trimester
  • Other high risk conditions
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Most Useful Gestational Age Measurements

A
  • Crown rump length in first trimester
  • Biparietal Diameter
  • Head circumference
  • Abdominal Circumference
  • Femur length after first trimester
17
Q

Ultrasound for Fetal Growth

A

Used If..

  • There is poor maternal weight gain
  • History of IUGR
  • Chronic infections or substance abuse
  • Maternal diabetes
  • HTN
  • Multifetal pregnancy
18
Q

Macrosomia

A
  • Larger than 4000g

- Increased risk for traumatic injury and asphyxia

19
Q

Symmetric IUGR

A 
- Fetus is small in all parameters
CAUSES
- Low genetic growth potential
- Intrauterine Infection
- Chromosomal Anomalies
- Maternal undernutrition
- Heavy smoking
20
Q

Asymmetric IUGR

A
  • Head and body do not match
  • Caused by placental insufficiency due to hypertension, renal disease, cardiovascular disease
  • Reduced fetal growth is one of the most frequent reasons of stillbirth
21
Q

Nuchal Translucency (NT) Screening

A
  • Helps identify fetal anomalies in the 10-14th week via ultrasound of fluid in fetal neck
  • Elevated levels indicate increased risk of congenital heart defects
  • Elevated levels with abnormal serum marker levels shows risk of chromosomal abnormalities
  • Diagnostic genetic testing recommended for abnormal NT levels
22
Q

Trisomy 21 (Down Syndrome) Ultrasound Findings

A
  • Absent nasal bone
  • Short femur/humerus
  • Echogenic intracardiac focus
  • Enlarged pelvis where kidneys collect urine
  • Fast/Slow HR
23
Q

Globular Placenta

A
  • Globular placenta with narrow base is associated with increased risk of IUGR, fetal death, and other complications
24
Q

Amniocentesis

A
  • Safer when position of fetus, placenta, umbilical cord, and pockets of amniotic fluid are known.
  • Ultrasound is used to detect these locations
  • Percutaneous umbilical cord sampling (PUBS)
  • Chorionic Villus Sampling (CVS)
  • Both guided by ultrasound
25
Q

What can ultrasound Measure

A
  • Amniotic Fluid Volume
  • Heart motion
  • Fetal breathing
  • Fetal urine production
  • Fetal limb/head movements
26
Q

Doppler Blood Flow Analysis

A
  • Estimates blood flow in arteries by measuring systolic/diastolic flow ratios
  • Reverse flow during diastole could be caused by restricted umbilical artery blood flow
  • Associated with IUGR
  • Increased systolic peak velocity is associated with fetal anemia
  • Abnormal maternal uterine artery wave forms are associated with fetal growth restriction
27
Q

Oligohydramnios

A
  • Decreased amniotic fluid
  • Subjectively determined via small fundal height and easily palpable fetus
  • Objectively determined if maximum vertical pocket of amniotic fluid is less than 1-2 cm
28
Q

Polyhydramnios

A
  • Increased amniotic fluid
  • Subjective includes large fundal height and fetus that is difficult to palpate and also ballotable (ballottement)
  • Objectively defined as amniotic fluid pockets measuring 8+ cm
29
Q

AFV Calcuation

A
  • Measure vertical depths of the largest pocket of amniotic fluid in all 4 quadrants and adding them together. This provides amniotic fluid index (AFI)
  • AFI less than 5 cm is oligohydramnios
  • AFI more than 25 cm is polyhydramnios
30
Q

Oligohydramnios/Polyhydramnios Risks

A
  • Oligo (Potter Syndrome or renal failure, PROM)

- Poly (GI and CNS abnormalities, multiple fetuses, fetal hydrops (fluid buildup in fetus))

31
Q

Biophysical Profile

A 
- Assessment of fetus based on markers of fetal disease
INCLUDES
- AFV (Amniotic fluid volume) 
- FBM (Fetal breathing movements) 
- Fetal movements
- Fetal tone (via ultrasound) 
- FHR based off NST (Non-stress test)
  • Used in second and third trimester to predict fetal well being
  • A level of 8-10 is normal
  • Test may require longer time if fetus is asleep
32
Q

Modified BPP

A
  • Used for shorter test times
  • Combines NST (assesses fetal condition) with AFV (indicates placental function)
  • Recommended to measure AFV via single deepest pocket instead of AFI
  • Desired results are reactive NST and Deepest vertical pocket of amniotic fluid greater than 2 cm
33
Q

BPP

A

Fetal Breathing
2 - At least 1 episode of FBM of at least 30 seconds within 30 minutes
0 - Absent or less than 30 seconds of sustained FBM in 30 minutes

Fetal Movements
2 - At least 3 movements within 30 minutes
0 - Fewer than 3 movements within 30 minutes

Fetal Tone
2 - At least 1 extension and flexion of limb. Opening and closing of hand
0 - No movement or slow extension/flexion

Amniotic Fluid (AFI)
2 - Deepest pocket >2cm
0 - Deepest pocket <2cm

Nonstress Test
2 - Reactive
0 - Nonreactive

34
Q

BPP Scores

A

10 - Low risk for asphyxia (repeat test 1-2 times a week)
8 - Low risk (repeat test 1-2 times a week)
6 - Suspected asphyxia
(If greater than 36 weeks or less than 36 weeks with positive fetal maturity, consider delivery)
(If less than 36 weeks and negative fetal maturity repeat test every 4-6 hours. Deliver is oligohydramnios is also present)
4 - Suspected asphyxia
(If greater than 36 weeks deliver)
(If less than 32 weeks, repeat score)
0-2 - High risk for asphyxia
(Extend the test to 120 min and if the score is still under 4, deliver baby immediately)

35
Q

Non-medical Ultrasound

A
  • Ultrasounds are generally safe but repeated high frequency sound waves to the baby for non-medical purposes should be avoided
36
Q

MRI

A
  • Similar to CT scans
  • Can detect soft tissue, and vascular structures without using radiation or contrast which eliminates biological risk
  • There are no interferences in picture from bones, fat, or gas and bladder does not need to be filled to view pelvic structures
  • Able to see CNS, thorax, abdomen, GU, musculoskeletal, placenta, amniotic fluid, uterus, cervix, pelvis, pH of tissues and organs, soft tissue, metabolic/functional anomalies

OB (96 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions