Fetal Surveillence

Question 1

How to survey fetus?

Answer 1

Measurements
Fetal movements
Biochem: oestriol(not anymore)
U/S
CTG

Question 2

U/S fetal well being? 4 things

Answer 2

Fetal biometry
Liquor Volume amniotic fluid level
Fetal Activity
Doppler

Question 3

Fetal biome try

Answer 3

Head circ
Femur length
Abdo circumference

Question 4

Fetal activity

Answer 4

Body movements
Breathing movements(if well oxygenated)
Tone (flexion=good, extension = bad

Question 5

Doppler U/S: 2 arteries?

Answer 5

Flow:
Umbilical artery
MCA

Question 6

U/S on umbilical artery, how to measure?

Answer 6

Peak systolic and end diastolic flow ratio

Question 7

Total white out of both lungs in neonates?

Answer 7

Hyaline membrane disease

pulmonary HTN - sildenafil, NO

Question 8

Placenta hypoxia, where does blood go?

Answer 8

Want it to go to good area but like lungs:

Umbilical arteriolar vasoconstriction

Question 9

4 things to look for in CTG?

Answer 9

Baseline (110-160)
Acceleration - fetal excitement (2 in 20 minutes)
Deceleration - no bad
Variability - good: sinus arrythmias (5-25)

Question 10

4 types of variability

Answer 10

Increased
Reduced
Absent
Sinusoid all

Question 11

4 Ss for reason of decreased variability

Answer 11

Sick
Sleeping
Sedated
Sub mature

Question 12

Sinusoidal CTG why?

Answer 12

Severe fetal Anaemia

Question 13

Early deceleration from what?

Answer 13

Head compression from contractions: simultaneous from contractions

Question 14

Late deceleration S?

Answer 14

After peak contraction
Fetal hypoxia
Adaptive response to hypoxia, don’t just treat
Need early delivery

Question 15

Variable deceleration S cause?

Answer 15

Cord compression

Rapid decal and rapid recovery

Question 16

Variable deceleration bad waves?

Answer 16

Deep and wide with rebound tachy

Delayed recovery

Question 17

Sudden crash deceleration?

Answer 17

Profound hypoxia, need immediate delivery

Question 18

4 causes of sudden severe fetal hypoxia

Answer 18

Maternal hypotension
Cord compression
Abruption
Sustained uterine contraction

Question 19

Ectopic beats 3 reasons

Answer 19

Normal
Caffeine
Terminal hypoxia (lots of spikes in CTG)

Question 20

If fetus severe Bradycardia, cause?

Answer 20

Heart block - sjorjen’s

Question 21

What causes a straight line on CTG?

Answer 21

Fetal brain death

Question 22

Worst encephalitis in adolescent

Answer 22

Herpes simplex, can happen in utero