FETAL MONITORING

Question 1

Define fetal monitoring and its primary goal.

Answer 1

Fetal monitoring includes measures to assess fetal well-being throughout pregnancy to ensure delivery of a healthy baby, aiming to prevent fetal demise and unnecessary interventions.

Question 2

Fill in the blank: Fetal assessment begins in the ___ trimester with confirmation of viability.

Answer 2

First.

Question 3

List the three phases of fetal assessment during pregnancy and their focus.

Answer 3

First trimester: confirmation of viability; second trimester: genetic and structural development; third trimester: growth and well-being for safe delivery.

Question 4

What are the two main challenges in combating fetal loss or damage?

Answer 4

Congenital anomalies and preterm birth.

Question 5

Fill in the blank: Preterm birth accounts for about ___% of neonatal deaths.

Answer 5

0.4

Question 6

Name three major indications for fetal assessment in utero.

Answer 6

Poor fetal growth, antepartum hemorrhage, hypertensive disorders in pregnancy, diabetes, and prolonged pregnancy.

Question 7

What maternal factors should be considered in clinical fetal monitoring?

Answer 7

Medical history, family history, past obstetric history, and high-risk factors (e.g., age extremes, substance abuse).

Question 8

Fill in the blank: Average maternal weight gain in a singleton pregnancy is ___ to ___ kg.

Answer 8

10 to 12 kg.

Question 9

What is the purpose of measuring symphysiofundal height, and how is it performed?

Answer 9

It assesses fetal growth; from 20 weeks, the symphysiofundal height corresponds to gestational weeks in centimeters (卤2 cm).

Question 10

Creative question: Design a clinical protocol for monitoring a high-risk pregnancy.

Answer 10

(Answers will vary; must include history taking, ultrasound, CTG, and biophysical profile.)

Question 11

What parameters are measured during an obstetric ultrasound in the second trimester?

Answer 11

Biparietal diameter, femur length, abdominal circumference, and head circumference.

Question 12

Explain the difference between symmetrical and asymmetrical intrauterine growth restriction (IUGR).

Answer 12

Symmetrical: both HC and AC are small (intrinsic factors). Asymmetrical: AC small, HC appropriate (extrinsic factors).

Question 13

At what gestational age is congenital anomaly screening most effective, and why?

Answer 13

18-20 weeks for congenital anomalies; cardiovascular anomalies are best seen at 22 weeks.

Question 14

What is a fetal kick chart, and what is the expected result?

Answer 14

A fetal kick chart records movements, expecting 10 kicks in 12 hours (Cardiff count).

Question 15

Fill in the blank: A reactive cardiotocography (CTG) implies that the fetal neural mechanism controlling the ___ is functioning.

Answer 15

Fetal heart rate.

Question 16

What are the four features of a reactive CTG?

Answer 16

Normal baseline rate (120-160 bpm), baseline variability (5-25 bpm), two accelerations (15 bpm/15 seconds), and no decelerations.

Question 17

Describe the purpose of the contraction stress test (CST) and its interpretation criteria.

Answer 17

Monitors uterine contractions and fetal heart rate to assess fetal response to stress; positive, negative, or equivocal outcomes.

Question 18

Fill in the blank: At least ___% of patients with a positive CST can deliver vaginally.

Answer 18

0.5

Question 19

What is fetal vibroacoustic stimulation, and how does it work?

Answer 19

It uses sound to stimulate fetal activity, aiding in non-reactive non-stress test evaluation.

Question 20

What are the five components of a biophysical profile?

Answer 20

Non-stress test, fetal breathing, body/extremity movement, fetal tone, amniotic fluid volume.

Question 21

Describe the significance of an abnormal Doppler flow study in the umbilical artery.

Answer 21

Indicates placental or vascular abnormalities linked to IUGR or pre-eclampsia.

Question 22

What is the recommended auscultation frequency for fetal heart rate during labor stages?

Answer 22

Every 15 minutes during the first stage, every 5 minutes in the second stage, before, during, and after contractions.

Question 23

Fill in the blank: Green liquor during labor suggests ___ and increases the risk of ___.

Answer 23

Fetal distress; meconium aspiration.

Question 24

What are the key differences between tachycardia and bradycardia in fetal heart rate patterns?

Answer 24

Tachycardia: >160 bpm (e.g., infection, drug use); Bradycardia: <120 bpm (e.g., cord compression).

Question 25

Explain the management of early (Type I) decelerations.

Answer 25

Lateral maternal positioning and supplemental oxygen.

Question 26

What is the clinical significance of late (Type II) decelerations?

Answer 26

Indicates uteroplacental insufficiency; immediate delivery may be necessary.

Question 27

Creative question: Create a flowchart summarizing fetal monitoring during labor.

Answer 27

(Answers will vary; should outline monitoring tools and steps.)

Question 28

Fill in the blank: A fetal scalp pH of less than ___ indicates the need for immediate delivery.

Answer 28

7.20.

Question 29

What is the primary advantage of fetal scalp sampling during labor?

Answer 29

Provides accurate assessment of fetal metabolic status, reducing unnecessary interventions.

Question 30

Describe three interventions to improve outcomes in cases of fetal distress.

Answer 30

Lateral positioning, supplemental oxygen, and expedited delivery if indicated.