Fetal and Neonate assessment Flashcards

1
Q

The mean duration of a singleton pregnancy (birth of only one child during a single delivery with a gestation of 20 weeks or more) is __________

A

280 days/40 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Term is defined as the period from __________________ (optimal time for delivery)

A

37 weeks to 42 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Early term ______weeks

A

37 to 38

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Full term ______weeks

A

39 to 40

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Late term ______weeks

A

41 to 42

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Determinations of gestational age is most accurate when ultrasonographic measurement of the fetus or embryo is performed in the ___________________.

A

first trimester (up to and including 14 weeks)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Recommended for all pregnancies given its ability to :

A
  1. Viability
  2. Fetal number
  3. Placental location
  4. Screen for fetal structural abnormalities in the second trimester
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

An increased risk for delivering a small-for-gestational age baby and/or having a preterm delivery is associated with _____________________________.

A

low maternal gestational weight gain.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Higher risk for delivering a large-for-gestational age baby and/or cesarean delivery is associated with ____________.

A

excessive gestational weight gain.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Although the _________ examination has several limitations (especially in the setting of a small fetus, maternal obesity, multiple pregnancy, uterine fibroids, or polyhydramnios), it is safe, is well tolerated, and may add valuable information to assist in antepartum management.

A

abdominal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

what is Leopold Maneuver designed to do?

A

identify specific fetal landmarks or to reveal a specific relationship between the fetus and the mother

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

1st maneuver - measurement of fundal (uterus) height, uterus can be palpated above the pelvic brim at approximately 12 weeks’ gestation then should increase 1 cm per week, reaching the umbilicus at ________.

A

20-22 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Fundal height between 20 and 32 weeks gestation (in cm) is __________ ______ to the gestational age ( in weeks) in a healthy women of average weight with an appropriately growing fetus.

A

approximately equal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Maximal fundal height occurs at approximately ___ weeks’ gestation, after which time the fetus drops into the pelvis in preparation for labor

A

36

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Fetal Growth Restriction is associated with a number of significant adverse perinatal outcomes: (5)

A
  1. Intrauterine Demise
  2. Neonatal Morbidity
  3. Neonatal Mortality
  4. Cognitive Delay in
    Childhood
  5. Chronic Diseases (Obesity, Type II Diabetes, CAD, Stroke in Adulthood
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Maternal disorders associated with fetal growth restriction include any condition that can potentially result in vascular disease, such as :

A

pregestational diabetes, hypertension, antiphospholipid antibody syndrome, autoimmune diseases and renal insufficiency, malnutrition, and substance abuse

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Fetal conditions that may result in growth restriction include:

A

teratogen exposure, including certain medications; intrauterine infection; aneuploidy, most often trisomy 13 and trisomy 18; and some structural malformations, such as abdominal wall defects and congenital heart disease.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Fetal growth restriction is associated with an increased risk for ______

A

stillbirth

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

The risk for stillbirth is further increased when fetal growth restriction occurs in the context of ________ or _______.

A

oligohydramnios or abnormal diastolic blood flow in the umbilical artery.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

_____& ______diagnosis of fetal growth restriction coupled with ________________leads to an improvement in perinatal outcome. If fetal growth restriction is suspected clinically and on the basis of ultrasonography, a thorough evaluation of the mother and fetus is indicated.

A

Early and accurate, appropriate intervention

21
Q

Fetal macrosomia, defined as growth beyond an _________________regardless of gestational age

A

absolute birth weight of 4000 g or 4500 g

22
Q

the risk for labor abnormalities, maternal morbidity, and newborn complications increases with birth weights between__________ & _______; newborn and maternal morbidity increases significantly with birth weights between ___________ and perinatal mortality (e.g., stillbirth and neonatal mortality) increase with birthweights _____________ Shoulder dystocia, defined as a failure of delivery of the fetal shoulder(s) after initial attempts at downward traction, is the most serious consequence of fetal macrosomia, and requires additional maneuvers to effect delivery.46 The fetal injuries associated with shoulder dystocia include fracture of the clavicle and damage to the nerves of the brachial plexus, resulting in Erb-Duchenne paralysis, of which the vast majority resolve by 1 year of age. Compared with a prevalence of 0.2% to 3.0% for all vaginal deliveries, the risk for shoulder dystocia at birth weights of 4500 grams or more is 9% to 14%, and increases further in the setting of maternal diabetes to 20% to 50%.47,48

A

4000 and 4499 g; 4500 and 4999 g; greather than 5000 g.

23
Q

Estimated fetal weight measurements are_____________ in macrosomic fetuses than in normally grown fetuses, and factors such as low amniotic fluid volume, advancing gestational age, maternal obesity, and fetal position can compound these inaccuracies

A

less accurate

24
Q

A number of alternative ultrasonographic measurements have therefore been proposed in an attempt to better identify the macrosomic fetus, including fetal abdominal circumference alone,__________cheek-to-cheek diameter and ___________________________________.However, these measurements remain investigational.

A

umbilical cord circumference

subcutaneous fat in the mid humerus, thigh, abdominal wall, and shoulder

25
Q

Is fetal macrosomia an indication for induction of labor?

A

No may increase risk for c-section and no does not improve outcomes

26
Q

At what weight is it recommended to due an elective c-section for macrosomic fetus?

A

exceeds 4500g in diabetic women

or 5000g in non diabectic woman

27
Q

A low FHR ______is associated with an increased risk for pregnancy loss, although congenital complete heart block should be excluded

A

(< 100 bpm)

28
Q

Fetal movements (“quickening”) are typically reported at ________ weeks’ gestation by nulliparous women and at ________weeks’ gestation by parous women; the presence of fetal movements is strongly correlated with fetal health.

A

18 to 20, 16 to 18

29
Q

The normal fetus exhibits an average of ________(range of 0 to 130) gross body movements per hour, with fewer movements during the day and increased activity between 9:00 PM and 1:00 AM

A

20 to 50

30
Q

Biophysical Profile

The five variables described in the original BPP were

A

(1) gross fetal body movements, (2) fetal tone (i.e., flexion and extension of limbs), (3) amniotic fluid volume, (4) fetal breathing movements, and (5) the NST (Table 6.4).75 More recently, the BPP has been interpreted without the NST.

31
Q

Contraction Stress Test the response of the FHR to uterine contractions induced by either _____ or ____.

A

intravenous oxytocin administration or nipple stimulation

32
Q

A minimum of ____contractions for at least ___seconds in a __-minute period is required to interpret the test. A negative CST (no late or severe late decelerations with contractions) is reassuring and suggestive of a healthy, well-oxygenated fetus.

A

3, 40, 10

33
Q

_____ ______can be used for the noninvasive measurement of fetal circulation,

A

Doppler velocimetry

34
Q

As one of the few arteries that normally has diastolic flow, the ______ _____ is frequently evaluated during pregnancy

A

umbilical artery

35
Q

Factors that affect placental vascular ______, ______, and ____.

A
  1. resistance include gestational age, 2.placental location, 3.pregnancy complications
36
Q

Women of advanced maternal age (____ years or older at EDD) are at higher risk for having a pregnancy complicated by fetal aneuploidy and are routinely offered noninvasive prenatal screening and an invasive diagnostic procedure (either amniocentesis or chorionic villus sampling

A

> 35

37
Q

Amniotic fluid is composed of ______, _____,______, and ________.

A

fetal urine, lung fluid, skin transudate, and water

38
Q

Amniotic fluids contains ______, ________, and ________.

A

electrolytes, proteins, and desquamated fetal cells (amniocytes).

39
Q

Amniocentesis can be used to measure various substances such as _______ and ______for assessing fetal lung maturity, to look for pathogenic bacteria for confirmation of an intra-amniotic infection, and to obtain fetal cells for determination of fetal karyotype or performance of specific genetic analyses.

A

lecithin and sphingomyelin

40
Q

The most common indication for second-trimester amniocentesis is ___________

A

cytogenetic analysis of fetal cells

41
Q

As with amniocentesis, the most serious complication of CVS is ______ ____.

A

spontaneous abortion.

42
Q

______ appears to be associated with a higher risk for pregnancy loss than late amniocentesis

A

CHORIONIC VILLUS SAMPLING

43
Q

One complication unique to CVS involves the _____________.

A

interpretation of the genetic test results

44
Q

Hydrops Fetalis is

A

abnormal accumulation of fluid in more than one fetal extravascular compartment, including ascites, pericardial effusion, pleural effusion, subcutaneous edema, and/or placental edema

45
Q

Risk factors for stillbirth include extremes of

A

maternal age, chromosomal disorders, congenital malformations, antenatal infection, multiple pregnancy, prior unexplained IUFD, postterm pregnancy, fetal macrosomia, male fetus, umbilical cord and placental abnormalities, and underlying maternal medical conditions (e.g., chronic hypertension, pregestational or gestational diabetes mellitus, autoimmune disorders, inherited or acquired thrombophilia).

46
Q

The ideal case for fetal surgery consists of a _________ pregnancy before ____ _____. (i.e., before 23 to 24 weeks’ gestation

A

singleton, fetal viability

47
Q

Before in utero surgery can be recommended,

A

a thorough evaluation must be performed

48
Q

The only two randomized controlled trials published to date in fetal surgery—one on tracheal occlusion for the management of congenital diaphragmatic hernia226 and the other on prenatal versus postnatal repair of myelomeningocele229—found _______________________ Moreover, although pediatric benefit with open maternal-fetal surgery for myelomeningocele repair has been observed, there are significant maternal risks, including the need for cesarean delivery with all future pregnancies (similar to that for women with a history of a classical cesarean delivery

A

little significant benefit to in utero surgery.