Assessment of fetal wellbeing

Question 1

Name the four parameters viewed on fetal ultrasound

Answer 1

• fetal biometry
• liquor volume
• Fetal activity
• Doppler

Question 2

Fetal biometry, what are the different parameters of it?

Answer 2

• Head circumference
• Abdominal circumference
• Femur length

Question 3

What is the amniotic fluid index?

Answer 3

The amniotic fluid index is the depth of the amniotic fluid in each of the 4 quadrants, between 7-20 is a the normal range

Question 4

What things do we measure in terms of fetal activity?

Answer 4

Body Movements, Breathing movements, TOne

Question 5

What does the Doppler of ultrasound detect?

Answer 5

Umbilical artery and middle cerebral artery

Question 6

What is cardiotocography?

Answer 6

Measures fetal heart rate over time. Measure of fetal well being, both antenatal and in labortal.

Question 7

Describe the normal ranges for the parameters? For baseline, Variability, Accelerations, Decelerations?

Answer 7

Baseline : 110-160 bom
Reduced: 3-5 bpm - 5 - 25 bpm
Absent: 2 x 15 bpm in 20
Decelerations: No ominous decelerations

Question 8

What are the 4 S’ , the causes for Decelerations

Answer 8

Sickness, sleeping, sedation, sub-mature

Question 9

What are early decelerations?

Answer 9

Slow onset, slow recovery decelerations which are simultaneous with contractions, caused by head compression during labour. It is picked up by pain receptors.

Question 10

What are late decelerations?

Answer 10

Slow onset, slow recovery decelerations where the peak occurs after the peak of contraction, it is caused by fetal hypoxia and is picked up by chemoreceptors

Question 11

What are variable decelerations?

Answer 11

Variable decelerations are rapid onset rapid recovery decelerations. These are simultaneous with contractions and are indicative of cord compression. They are detected by baroreceptors.

Question 12

What are prolonged decelerations?

Answer 12

Sustained bradycardia for more than 2 minutes, chemoreceptors indicating sustained hypoxia.

Question 13

What are the causes of sudden severe fetal hypoxia?

Answer 13

• cord compression
• Maternal hypotension
• Sustained uterine contractions
• Placental abruptions

Question 14

What is reactive CTG and how is it managed?

Answer 14

A reactive CTG entails a normal baseline, normal variability, Accelerations and no adverse decelerations. It is just reassurance which is involved.

Intermittent CTG

Question 15

What is a non reactive CTG? What is the management?

Answer 15

It is no accelerations and reduced variability, needs continuous CTG, not reassured

Question 16

What is a critical CTG? What is the management?

Answer 16

Late decelerations, absent variability and sinusoidal pattern. Requires C/S or vaginal delivery.