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Gynecology > Fetal Surveillance & Fetal Distress > Flashcards

Fetal Surveillance & Fetal Distress Flashcards

1
Q

Causes of stillbirth

A

Chronic placental insufficiency
Actute placental insufficiency:
Abruptio placenta, placenta previa
Infection
Unexplained

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2
Q

Acute events that occur suddenly may not be identifiable by antepartum testing such as:

A

Cord accident
Abruptio placenta
Hydrops fetalis
Intrauterine infection

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3
Q

Candidates for testing

A

Pts with DM
Chronic HTN
Autoimmune disease
Maternal CHD
Maternal hypothyroidism
(All around 32-34 wks)
Post date pregnancy at 42 wks

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4
Q

Conditions that need urgent testing at the time of diagnosis

A

PET
Suspected IUGR
Discordinate twins

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5
Q

Progressing fetal hypoxia can be detected by changes in :

A

Fetal heart rate
Amniotic fluid volume
Fetal behavior
Fetal umbilical artery blood velocity

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6
Q

Antepartum fetal surveillance techniques :

A

FM count
Non stress test (NST)
Contracting stress test (CST)
Biophysical profiles (BPP)
Amniotic fluid index
Doppler velocimetry

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7
Q

Causes if decrease variability in non stress test:

A

Fetal hypoxia
Drugs (alcohol, opiates, pethidine, diazepam.)
Premature
Fetal sleep (but not longer >30 min)
CNS & Cardiac abnormality

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8
Q

Causes of ++ variability

A

It is called sinusoidal pattern dt:
Severe fetal anemia (e.g in Rh isoimmunization, bleeding from vasaprevia)
Hypoxia of fetal myocardium

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9
Q

Causes of fetal tachycardia

A

Idiopathic
Prematuritry
Infection
Maternal pyrexia
Maternal thyrotoxicosis
Drugs (B sympathomemtics)

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10
Q

Causes of fetal bradycardia

A

Idiopathic
Asphyxia
Fetal cardiac dysarrhythmias and cardiac anomalies
Fetal hge
Drugs (morphine, local anasthesia, digoxin)

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11
Q

Expain CST

A

It evaluates fetal O2 reserves in the present of uterine contraction

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12
Q

Absolute contraindications to CST:

A

Classical C/S and other uterine surgery with exception LSCS
Placenta previa

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13
Q

Types of fetal heart deceleration

A

Early deceleration
Late deceleration
Variable deceleration

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14
Q

Which deceleration associated with UPI:

A

Late deceleration

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15
Q

Deceleration that is dt head compression

A

Early deceleration

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16
Q

Deceleration that has no consistent relationship to uterine contractions and it is usually dt **transient compression of the umbilical cord

A

Variable deceleration

17
Q

If variable deceleration is prolonged and reccurent, may be associated with

A

Fetal acidosis

18
Q

V shaped deceleration:

A

Early

19
Q

It occurs during a contraction and is over by the end of contractuon

A

Early

20
Q

It begins after the beginning of the contraction, and recovery occurs after the contraction is finished

A

Late
Often with slow return to base line

21
Q

Late deceleration is associated with

A

IUGR, PET, DM, Abruptio placenta, and maternal hypotension

22
Q

Which deceleration is normal

A

Early

23
Q

Biophysical profile items:

A

Fetal breathing movement
Fetal gross movement
Fetal tone
Amniotic fluid index
Non stress test

24
Q

In Doppler, blood flow, abesnt, or even reverse flow at the end of diastole are strongly suggestive of

A

Fetal hypoxia

25
Q

Monitor fetal well-being in labor by:

A

Intermittent auscultation by fetostethscope
Continues electronic fetal heart monitoring
Fetal scalp ph

26
Q

Mothod for performing Continues FHR in labor

A

External FHR monitoring
Uses doppler device ro detect movement of fetal cardiac valve or movement of blodd in fetal heart and vessels
Internal
By using small electrode applied to fetal scalp (a fetal ECG is obtained)

27
Q

Causes of acute fetal distress

A

Abruptio placenta and cord prolapse

28
Q

Effects of hypoxia on the fetus

A

• Neurological abnormalities: **cerebral palsy & mental retardation
• Fetal death : can result from severe intrapartum asphyxia

29
Q

The dx of suspected fetal distress in labor by:

A

CTG abnormalities

30
Q

In management of fetal distress
vaginal examination should be performed to exclude:

A

Cord prolapses or rapid progess to full dilatation (PPT labor)

31
Q

Main indication for fetal scalp sampling:

A

Abnormal CTG

32
Q

Factors that may reduce the threshold to carry out a fetal scalp sampling:

A

Meconium staining
Post term
Suspected IUGR

Gynecology (20 decks)

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