Ch 1a Fetal Lie + CX Flashcards
When scanning a baby do we annotate our images based off of moms anatomy or how the baby is lying?
Moms anatomy - if SAG uterus is showing a TRV baby we still annotate it as SAG
What is the cephalic/vertex fetal lie position?
Head by cervix, placenta + bum at fundus
What is the TRV lie?
When baby is TRV in the uterus
What is frank breech?
When baby’s bum is by cervix with legs up by head at the fundus (think frank is a flexible baby)
What is footling breech?
When baby’s bum is by cervix + a foot is going to come out of the cervix first
What is complete breech?
When bum is by cervix + bum will come out first
Is TRV lie a type of breech?
No
What is the normal position for fetal lie?
Facing backwards (prone) head at cervix
(is abnormal if facing forwards head at cervix)
On u/s what 4 things are we concerned about regarding fetal lie?
-Which part is presenting to the cervix
-Which maternal side the spine is on
-If breech, what type
-If TRV lie, where is head + spine
Name 3 types of breech positions?
Frank, footling + complete
When should we acquire fetal lie images in an exam?
One of the first images of fetal portion of exam
We should demonstrate the relationship of the cervix + fetus in what plane?
SAG
When should we annotate which maternal side the fetus is on?
In late 3rd trimester when fetus has settled into 1 position
Why is knowing fetal lie important?
Helps to understand which side is what when assessing situs (position of organs) + limbs
During what trimester can we use the term breech?
Not until 3rd trimester - when we know this is how the baby is going to be born
(say baby is mobile in 1st + 2nd trimester)
Length normal cervix should be?
3.0 cm or greater
Will the most accurate cervix measurement be with a full or empty bladder?
Empty
How many times should we measure the cervix during an exam?
At least twice with different stages of bladder filling
What if pt’s cervix measures less than 3cm?
Get pt to empty bladder + do an EV to check if it is still under 3cm
What is the term for a shortened cervix?
“Beaking”
How do we measure a shortened/beaking cervix?
Measure only the endocervical canal that is still intact and closed
What technique can we try that will help get a more accurate cervix measurement?
Apply gentle pressure with hand on pt’s fundus
What is a cervical cerclage + when is it done?
A stitch placed in the cervix b/w 12-24 weeks of gestation to keep the cervix closed to prevent preterm birth
When is a cerclage removed?
At week 36-37 before labour
4 indications for a cervix assessment?
-Previous miscarriage after 16 weeks
-Previous birth before 34 weeks
-Ruptured membranes before 37 weeks
-Previous cervix treatment (ex cone biopsy due to abnormal PAP smear)
Reasons (contraindications) why a cerclage should not be done?
-bleeding
-infection
-bladder or cervix injury
-ruptured membranes
-cervix too short or too far open
What position should fetus be in, late in the 3rd trimester?
Cephalic/vertex position
If SAG uterus, where will the fetal head be?
Either right/left
If TRV uterus, where will the fetal head be?
Either up/down
List the 4 locations the spine can be + how the fetus would lie according to that?
-Superior spine: prone lie
-Inferior spine: supine line
-Right spine: lying on left side
-Left spine: lying on right side
