Fetal Age & Measurements Flashcards
Sonographic measurements of the fetus provide info about…
- fetal age
- EFW
- diagnose growth disturbances
This is the true measure of age, the number of days since conception.
conceptual age
This is the number of days since the first day of the last menstrual period.
menstrual age
Accurate knowledge of gestational age is important…
Telling normal from abnormal and timing of …
- CVS
- amnio
- elective induction
- cesarean
Dating by LMP may be inaccurate because of…
- variability of cycle length
- faulty memory
- oral contraceptives
- bleeding during early pregnancy
Determining gestational age from fundal height may be affected by…
- uterine fibroids
- multiple pregnancy
- maternal body habitus
From 5-6 weeks, there are two methods for assigning gestational age. They are?
- MSD
2. contents of the sac
This is the average internal diamter of the sac.
MSD
The sac is _mm at 5 weeks and _mm at 6 weeks.
2, 10
You should only use the MSD for dating if..
you don’t see an embyro.
If the difference between the MSD and the CRL is 5 mm or less there’s a high risk of…
spontaneous abortion.
The heartbeat should always be seen from __ weeks onward.
6.3
The term ‘embryo’ applies until the __ week.
10
CRL correlates closely with GA until around the __ week.
13
What are the main measurements in the 2nd and 3rd trimesters?
- BPD
- HC
- AC
- FL
If the AC is too short, look for signs of…
IUGR.
If the FL is too short, look for signs of…
skeletal dysplasia.
What are the three head measurements?
- BPD
- OFD
- HC
BPD measures from the ___ edge of the near side of the cranium to the ___ edge of the far side of the cranium.
outer, inner
What anatomic landmarks do you need to measure the BPD?
- symmetrically postioned thalami
- cavum septum pellucidum
- falx
Sonographically, this refers to the relationship between the fetal cranial sagittal suture and the central portion of the u/s beam.
angle of asynclitism
For an exact BPD, the angle of asynclitism should be…
90 degrees to the cranial sag suture
This is the length of the outer perimeter of the cranium, made at the same level as the BPD.
HC
T/F? HC should include scalp echoes when using the ellipse method.
FALSE, should not
This is the measure of the long axis of the fetal head, at the same level as the BPD.
OFP
The OFP should be measured from the ___ edge to the ___ edge.
outer, outer
In this condition, the AP length of the fetal head is shortened.
brachycephaly
In this condition, the AP length of the fetal head is lengthened.
dolicocephaly
This is obtained by measuring the widest and longest dimension of the fetal skull.
cephalic index (CI)
This should be used to evaluate the validity of the BPD, if the head is an unusual shape.
CI
What’s the normal range for CI?
75%-81%
This is the length of the outer perimeter of the fetal abdomen.
AC
At what level is the AC measured?
With the stomach and LPV visible
The AC should not be taken if the spine is at what position?
12 (or 6) o’clock
T/F? When taking an AC, the fetal abdomen should be round, not elliptical.
true
T/F? When taking an AC, the ellipse should not contain skin echoes.
FALSE, should
T/F? Gestational diabetes causes the fetal abdomen to enlarge.
true
This is a measurement of the ossified diaphysis of the femur.
FL
T/F? The distal femoral epiphysis (spike) should NOT be included in the FL.
true
T/F? Sonography is an accurate predictor of fetal weight, especially in the 3rd trimester.
FALSE, inaccurate
This measurement is taken of the fetal orbits, to include the bridge of the nose.
binocular distance
This is a condition of the eyes being too close together, frequently present with…
hypotelorism, holoprosencephaly.
This is a condition of the eyes being too far apart, seen in cases of…
hypertelorism, cleft syndromes and frontal cephaloceles.
This may be useful in assessing GA in growth restricted fetuses or if baby’s head in not in a good position.
transcerebellar distance
Transcerebellar distance is equivalent to menstrual age from __ weeks.
14-20
Normal fetal kidneys between week 32 - term usually measure…
4-4.5 cm
An off-axis nasal bone length will produce an ___ measurement.
erroneous
A nasal bone that is not visible or with a length of less then 2.5 mmm is called…
nasal hypoplasia
A baby who is LGA has a weight above the…
90th percentile for gestation age.
Macrosomia is most often defined on the basis of a weight above…
4000 g.
Name some risk factors for LGA and macrosoma.
- maternal obesity
- diabetes
- previous LGA infant
- prolonged pregnancy
- excess pregnancy weight
- multiparity
- advanced maternal age
This is a fetal growth disorder most commonly defined on the basis of weight below the 10th percentile for gestational age.
IUGR aka SGA
Most cases of growth restriction are caused by…
- placental insufficiency
- maternal HTN
- collagen vascular disease
- poor nutrition or substance abuse
Less common causes of growth restriction are…
trisomy 18 or intrauterine infection
This fetal condition can be categorized as symmetrical or asymmetrical.
IUGR
This is a system designed to detect fetal asphyxia.
BPP
What are the BPP parameters?
- fetal breathing
- gross body movements
- fetal tone
- AFI
- NST
In a BPP, fetal breathing should last at least…
30 seconds in a 30 minute period.
In a BPP, how many gross body movements should be identified?
3 episodes
In a BPP, how many fetal tone events should be identified?
1 episode
In a BPP, the AFI should exceed…
5 cm
In a BPP, the NST should show how many episodes of acceleration?
2 episodes
What’s an equivocal BPP score?
6
What’s a normal BPP score?
8-10