Ante Partal Fetal Monitoring

Question 1

AFM

Answer 1

From 28 weeks of pregnancy to 1 month after delivery

Question 2

Clinical assessment of AFM

Answer 2

Gestational age best corresponds with SFH in cm at 18-30 weeks.
•Discrepancy of 2-3cm consider abnormal and lead to further investigation
•Exceptions: maternal obesity, multiple gestation, polyhydramnios, abnormal fetal lie, oligohydramnios, low fetal station,

Question 3

U/s in AFM is best at

Answer 3

•Gestational age assessment.
•Diagnosis of multiple pregnancy.
•Diagnosis of congenital malformations(best at 16-18 weeks)

Question 4

Fetal movement count

Answer 4

Count to ten method (Cardiff 10 count)
-Mother instructed to count fetal movement and report if less than 10 counts in a 12 hour period
-Movement alarm signal(MAS)- less than 10 in a 12 hour period
2.Count for 30 minutes, three times per day

Question 5

What is non stress test

Answer 5

Fetal heart rate acceleration in response to contraction

Question 6

Non stress test is absent in?

Answer 6

Hypoxia
Cns depression
Drugs
Congenital anomalies

Question 7

Which should not be present in non stress test

Answer 7

Deceleration

Question 8

Non stress test is considered positive if?

Answer 8

2ormore contraction with in 20 min lasting
15 seconds

Question 9

Base line fetal heart rate variability is

Answer 9

5bpm

Question 10

Indications and contradictions for contraction stress test

Answer 10

Indication
nonreactivenon stress test
Contraindications
Patient with risk of preterm labour
¨ PROM
¨ Previous uterine surgery, classicalcaesarean section
¨ Known placenta previa, multiplegestation, cervical incompetence, vasa previa
¨

Question 11

Contraction stress test methods

Answer 11

Oxytocin challenge test (OCT)-Oxytocin infusion is given till there are 3 contractions in 10 minutes, 35seconds

Breast (nipple) stimulation test same as oxytocin stress test and interpretation is same

Question 12

Biophysical profile

Answer 12

Fetal movement (FM)
Fetal tone (FT)
Fetal breathing movements (FB)
Amniotic fluid volume (AFV) and
A NST is also conducted at the same time and taken as the fifth parameter of the fetal biophysical profile score
Assess acute and chronic fetal compromise

Question 13

Acute markers of biophysical profile

Answer 13

Fm
Ft
Nst
FBM

Question 14

Chronic markers of biophysical profile

Answer 14

AFV

Question 15

Which appear first and disappear last

Answer 15

Activities that become active first in fetal development (FT, FM) are the last to disappear when asphyxia arrests all activities.
Activities that become active later in gestation (NST,FBM) will be abolished 1st in cases of hypoxia and acidosis.

Question 16

Modified biophysical profile

Answer 16

¨ Combines NST and Amniotic fluid index
; Takes only 10 minutes to perform
; It’s reactive if the NST is reactive and AFI is more than 5
¤ repeat test once a week or earlier if clinically required
; It’s abnormal if AFI is less than;5 or NST is non reactive, then BPP is done.