Assessment Foetal Wellbeing Flashcards
History?
Foetal movements
Exam?
Fundal height
Ix?
US
CTG
Biochemical
What do you look at on US for assess wellbeing?
Foetal biometry
Liquor volume
Foetal activity
Doppler
What are the foetal biometry factors?
Absolute measurements
Serial measurements
Head abdominal ratio
What foetal activity factors are examined?
Body movements
Breathing movements
Tone - extended baby may be hypnoxic
What is measured in doppler US?
Blood flow in umbilical artery and MCA
How do you measure the flow in curved umbilical artery?
Ratio of systolic to diastolic blood flow
What happens to umbilical arterioles in the presence of placental insufficiency?
Constriction
What do you look at with CTG?
Baseline
Variability - normally present
Acceleration - occurs with foetal euphoria
Deceleration
What is the HR of a foetal
110-160
What causes reduced variability, nonreactivity in GTG
Sick
Sleeping
Sedated
Submature
What is the normal foetal Hb?
16
What are early decelerations?
Normal
Due to head compression
Simultaneous with contractions
What are late decelerations?
Adaptive response to hypoxia
Deceleration delayed after contractions
What are variable decelerations?
Rapid onset and offset due to cord compression
Bad features
- Deep and wide
- Rebound tachy
What are the causes of hypoxia?
Cord compression
Maternal hypotension
Placental abruption
Sustained uterine contraction
What do you do if there is an ambiguous CTG?
Doppler US
How do you determine whether to do a c-section vs vagina with forceps and suction?
If cervix is dilated and head engaged
What do ectopics mean?
Normal
Terminal hypoxia
What does bradycardia mean?
Heart block, due to Sjogren’s
What does a flat line mean?
Foetal brain death > loss of autonomic innervation