Ch 1a Fetal Lie + CX

Question 1

When scanning a baby do we annotate our images based off of moms anatomy or how the baby is lying?

Answer 1

Moms anatomy - if SAG uterus is showing a TRV baby we still annotate it as SAG

Question 2

What is the cephalic/vertex fetal lie position?

Answer 2

Head by cervix, placenta + bum at fundus

Question 3

What is the TRV lie?

Answer 3

When baby is TRV in the uterus

Question 4

What is frank breech?

Answer 4

When baby’s bum is by cervix with legs up by head at the fundus (think frank is a flexible baby)

Question 5

What is footling breech?

Answer 5

When baby’s bum is by cervix + a foot is going to come out of the cervix first

Question 6

What is complete breech?

Answer 6

When bum is by cervix + bum will come out first

Question 7

Is TRV lie a type of breech?

Answer 7

No

Question 8

What is the normal position for fetal lie?

Answer 8

Facing backwards (prone) head at cervix

(is abnormal if facing forwards head at cervix)

Question 9

On u/s what 4 things are we concerned about regarding fetal lie?

Answer 9

-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

Question 10

Name 3 types of breech positions?

Answer 10

Frank, footling + complete

Question 11

When should we acquire fetal lie images in an exam?

Answer 11

One of the first images of fetal portion of exam

Question 12

We should demonstrate the relationship of the cervix + fetus in what plane?

Answer 12

SAG

Question 13

When should we annotate which maternal side the fetus is on?

Answer 13

In late 3rd trimester when fetus has settled into 1 position

Question 14

Why is knowing fetal lie important?

Answer 14

Helps to understand which side is what when assessing situs (position of organs) + limbs

Question 15

During what trimester can we use the term breech?

Answer 15

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)

Question 16

Length normal cervix should be?

Answer 16

3.0 cm or greater

Question 17

Will the most accurate cervix measurement be with a full or empty bladder?

Answer 17

Empty

Question 18

How many times should we measure the cervix during an exam?

Answer 18

At least twice with different stages of bladder filling

Question 19

What if pt’s cervix measures less than 3cm?

Answer 19

Get pt to empty bladder + do an EV to check if it is still under 3cm

Question 20

What is the term for a shortened cervix?

Answer 20

“Beaking”

Question 21

How do we measure a shortened/beaking cervix?

Answer 21

Measure only the endocervical canal that is still intact and closed

Question 22

What technique can we try that will help get a more accurate cervix measurement?

Answer 22

Apply gentle pressure with hand on pt’s fundus

Question 23

What is a cervical cerclage + when is it done?

Answer 23

A stitch placed in the cervix b/w 12-24 weeks of gestation to keep the cervix closed to prevent preterm birth

Question 24

When is a cerclage removed?

Answer 24

At week 36-37 before labour

Question 25

4 indications for a cervix assessment?

Answer 25

-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)

Question 26

Reasons (contraindications) why a cerclage should not be done?

Answer 26

-bleeding
-infection
-bladder or cervix injury
-ruptured membranes
-cervix too short or too far open

Question 27

What position should fetus be in, late in the 3rd trimester?

Answer 27

Cephalic/vertex position

Question 28

If SAG uterus, where will the fetal head be?

Answer 28

Either right/left

Question 29

If TRV uterus, where will the fetal head be?

Answer 29

Either up/down

Question 30

List the 4 locations the spine can be + how the fetus would lie according to that?

Answer 30

-Superior spine: prone lie
-Inferior spine: supine line
-Right spine: lying on left side
-Left spine: lying on right side