ASSESSMENT OF FETAL GROWTH AND DEVELOPMENT

Question 1

HEALTH HISTORY

Answer 1

Nutritional intake
Personal habits
HISTORY OF ACCIDENTS, INTIMATE PARTNER ABUSE

Question 2

a symphysis-fundal height measurement

Answer 2

McDonald’s Rule

Question 3

the distance from the uterine fundus to the
symphysis pubis in centimeters is equal to the
week of gestation between the _____ and _____
weeks of pregnancy.

Answer 3

20TH
31ST

Question 4

Typical measurements
12 weeks -the _______ ______
20 wks - At the ________
36 wks - At the _________ _______

Answer 4

Typical measurements
12 weeks -the symphysis pubis
20 wks - At the umbilicus
36 wks - At the xiphoid process

Question 5

fetal movement that can be felt
by the mother

Answer 5

quickening

Question 6

– occurs at approximately 18 to 20 weeks of
pregnancy and
– peaks in intensity at 28 to 38 weeks.

Answer 6

Quickening

Question 7

A healthy fetus moves with a degree of
consistency, or at least

Answer 7

10 times a day.

Question 8

The Sandovsky Method

Answer 8

• ask the woman to lie in a left recumbent
position after a meal and
• record how many fetal movements she feels
over the next hour
• a fetus normally moves a minimum of twice
every 10 minutes or an average of 10–12
times an hour.
• If less than 10 movements occur within an
• hour, the woman repeats the test for the next
hour.

Question 9

The Cardiff method (“Count-to-Ten”)

Answer 9

a woman records the time interval it takes for
her to feel 10 fetal movements within 60
minutes.

Question 10

Fetal Heart Rate

Answer 10

120 to 160 beats per minute throughout
pregnancy.

Question 11

Methods of acquiring FHR:

Answer 11

✓Rhythm Strip Testing
✓Nonstress Testing
✓Vibroacoustic Stimulation
✓Contraction Stress Testing

Question 12

assessment of the fetal heart rate for whether a good baseline
rate and a degree of variability are present.

Answer 12

Rhythm Strip Testing

Question 13

refers to the average rate of the
fetal heartbeat per minute.

Answer 13

Baseline reading

Question 14

refers to small changes in rate that occur if
the fetal parasympathetic and sympathetic nervous
systems are receiving adequate oxygen and
nutrients

Answer 14

Variability

Question 15

Rhythm Strip Testing CATEGORY

Answer 15

1) absent (none apparent);
2) minimal (extremely small fluctuations);
3) moderate (amplitude range of 6–25
beats per minute);
4) marked (amplitude range over 25 beats
per minute)

Question 16

measures the response of the fetal heart
rate to fetal movement

Answer 16

Nonstress Testing

Question 17

TEST RESUlTS FOR Nonstress Testing

Answer 17

1. Reactive
   – if two accelerations of fetal heart rate (by 15 beats or
   more) lasting for 15 seconds occur after movement within
   the chosen time period.
2. Nonreactive
   – if no accelerations occur with the fetal movements.
   – The results also can be interpreted as nonreactive if no
   fetal movement occurs
   – or if there is low short-term fetal heart rate variability (less
   than 6 beats per minute) throughout the testing period

Question 18

a specially designed acoustic stimulator is applied to
the mother’s abdomen to produce a sharp sound of
approximately 80 decibels at a frequency of 80 Hz,

Answer 18

Vibroacoustic Stimulation

Question 19

the fetal heart rate is analyzed in conjunction with
contractions.

Answer 19

Contraction Stress Testing

Question 20

Contraction Stress Testing test result

Answer 20

• Negative (normal)
– if no fetal heart rate decelerations are present
with contractions.
• Positive (abnormal)
– if 50% or more of contractions cause a late
deceleration (a dip in fetal heart rate that occurs
toward the end of a contraction and continues
after the contraction)

Question 21

measures the response of sound
waves against solid objects,

Answer 21

Ultrasonography

Question 22

Predict maturity by measurement of the biparietal diameter of
the head

Answer 22

Ultrasonography

Question 23

Woman should have a full bladder at the time of the
procedure.

Answer 23

Ultrasonography

Question 24

Uses of Ultrasound for assessing fetal growth and
development:

Answer 24

1. Biparietal Diameter
2. Doppler Umbilical Velocimetry
3. Placental Grading
4. Amniotic Fluid Volume Assessment

Question 25

used to predict fetal maturity by measuring the __________ _________ (side-to-side measurement) of the fetal head.

Answer 25

Biparietal Diameter.

Question 26

measures the velocity at which red blood cells in the uterine and fetal vessels travel.

Answer 26

Doppler Umbilical Velocimetry.

Question 27

Based particularly on the amount of calcium deposits in the base of the placenta, placentas can be graded by ultrasound as

Answer 27

• 0 (a placenta 12–24 weeks), • 1 (30–32 weeks), • 2 (36 weeks), • 3 (38 weeks)

Question 28

ased particularly on the amount of calcium deposits in the base of the placenta

Answer 28

Placental Grading

Question 29

Amniotic Volume Index (AFI) or total is the sum of the two measurements.

Answer 29

– For gestations of less than 20 weeks, the uterus is hypothetically divided along the midpoint (the linea nigra on the woman’s abdomen) into two vertical halves. – The vertical diameter of the largest pocket of amniotic fluid present on each side is measured in centimeters. • For gestations of 20 weeks or more, the uterus is dividedinto four quadrants, using the linea nigra again as the vertical dividing line and the level of the umbilicus as the horizontal dividing line. • The vertical diameter of the largest pocket of fluid in each quadrant is obtained, and the four values are then added to produce the amniotic fluid index.

Question 30

The average Amniotic Fluid index is approximately

Answer 30

12–15 cm between 28 and 40 weeks.

Question 31

An index greater than 20–24 cm indicates

Answer 31

hydramnios

Question 32

An index less than 5–6 cm indicates

Answer 32

oligohydramnios

Question 33

may be recorded as early as the 11th week of pregnancy. • inaccurate before the 20th week, • however, because until this time fetal electrical conduction is so weak that it is easily masked by the mother’s

Answer 33

Electrocardiography

Question 34

t may be most helpful in diagnosing complications such as ectopic pregnancy or trophoblastic.

Answer 34

Magnetic resonance imaging (MRI)

Question 35

– substance produced by the fetal liver – present in both amniotic fluid and maternal serum.

Answer 35

Alpha-Fetoprotein (AFP)

Question 36

f the level is abnormally high, it indicates fetal defects

Answer 36

Maternal Serum (MSAFP)

Question 37

80% of Down syndrome babies can be detected by this method

Answer 37

Maternal Serum (MSAFP)

Question 38

• may be performed in place of simple AFP testing to yield even more reliable results. • it requires only a simple venipuncture of the mother.

Answer 38

Triple screening, or analysis of three indicators (MSAFP, unconjugated estriol, and hCG)

Question 39

is a biopsy and chromosomal analysis of chorionic villi that is done at 10–12 weeks of pregnancy.

Answer 39

Chorionic villi sampling (CVS)

Question 40

an alternative method to remove cells for fetal analysis.

Answer 40

Coelocentesis (transvaginal aspiration of fluid from the extraembryonic cavity)

Question 41

is the aspiration of amniotic fluid from the pregnant uterus for examination.

Answer 41

Amniocentesis

Question 42

Amniocentesis Fetal complications

Answer 42

• hemorrhage from penetration of the placenta, • infection of the amniotic fluid • puncture of the fetus.

Question 43

ormal amniotic fluid is the color of

Answer 43

water

Question 44

lso called cordocentesis or funicentesis

Answer 44

Percutaneous Umbilical Blood Sampling (PUBS )

Question 45

s the aspiration of blood from the umbilical vein for analysis.

Answer 45

Percutaneous Umbilical Blood Sampling (PUBS )

Question 46

is the visual inspection of the amniotic fluid through the cervix and membranes with an amnioscope (a small fetoscope).

Answer 46

Amnioscopy

Question 47

The main use of the technique is to detect meconium staining.

Answer 47

Amnioscopy

Question 48

in which the fetus is visualized by inspection through a fetoscope (an extremely narrow, hollow tube inserted by amniocentesis technique)

Answer 48

Fetoscopy

Question 49

infection of the amniotic fluid) may occur.

Answer 49

Amnionitis

Question 50

Biophysical Profile Combines five parameters into one assessment

Answer 50

1. fetal reactivity, 2. fetal breathing movements, 3. fetal body movement, 4. fetal tone, and 5. amniotic fluid volume

Question 51

Biophysical Profile fetus score on a complete profile

Answer 51

❑ 8–10, the fetus is considered to be doing well ❑ 6 is considered suspicious ❑ 4 denotes a fetus probably in jeopardy

Question 52

Modified biophysical profile A healthy fetus should

Answer 52

• show a reactive nonstress test • AFI range between 5 and 25 cm