Assessment Foetal Wellbeing

Question 1

History?

Answer 1

Foetal movements

Question 2

Exam?

Answer 2

Fundal height

Question 3

Ix?

Answer 3

US
CTG
Biochemical

Question 4

What do you look at on US for assess wellbeing?

Answer 4

Foetal biometry
Liquor volume
Foetal activity
Doppler

Question 5

What are the foetal biometry factors?

Answer 5

Absolute measurements
Serial measurements
Head abdominal ratio

Question 6

What foetal activity factors are examined?

Answer 6

Body movements
Breathing movements
Tone - extended baby may be hypnoxic

Question 7

What is measured in doppler US?

Answer 7

Blood flow in umbilical artery and MCA

Question 8

How do you measure the flow in curved umbilical artery?

Answer 8

Ratio of systolic to diastolic blood flow

Question 9

What happens to umbilical arterioles in the presence of placental insufficiency?

Answer 9

Constriction

Question 10

What do you look at with CTG?

Answer 10

Baseline
Variability - normally present
Acceleration - occurs with foetal euphoria
Deceleration

Question 11

What is the HR of a foetal

Answer 11

110-160

Question 12

What causes reduced variability, nonreactivity in GTG

Answer 12

Sick
Sleeping
Sedated
Submature

Question 13

What is the normal foetal Hb?

Answer 13

16

Question 14

What are early decelerations?

Answer 14

Normal
Due to head compression
Simultaneous with contractions

Question 15

What are late decelerations?

Answer 15

Adaptive response to hypoxia

Deceleration delayed after contractions

Question 16

What are variable decelerations?

Answer 16

Rapid onset and offset due to cord compression

Bad features

• Deep and wide
• Rebound tachy

Question 17

What are the causes of hypoxia?

Answer 17

Cord compression
Maternal hypotension
Placental abruption
Sustained uterine contraction

Question 18

What do you do if there is an ambiguous CTG?

Answer 18

Doppler US

Question 19

How do you determine whether to do a c-section vs vagina with forceps and suction?

Answer 19

If cervix is dilated and head engaged

Question 20

What do ectopics mean?

Answer 20

Normal

Terminal hypoxia

Question 21

What does bradycardia mean?

Answer 21

Heart block, due to Sjogren’s

Question 22

What does a flat line mean?

Answer 22

Foetal brain death > loss of autonomic innervation