Foetal Growth And Development

Question 1

Duration of pregancy dating

Answer 1

Last menstrual period

Uterine size - symphysis fundal height

Developmental criteria- biomarkers, biometrics (head circumference vs abdomen, amniotic volume) ultrasound

Question 2

How to measure fundal height

Answer 2

Consent, Dignity
Not lying flat (supine hypotension)
Locate top if the fundus to pubic symphysis
Share with woman, record and plot

Question 3

Current average birth weight

Answer 3

7.5lb, 3.2kg

Question 4

What are the landmarks of the gravid uterus in each trimester?

Answer 4

End of 1st trimester - lifts out of the pelvis
2nd trimester - umbilicus
3rd trimester - xiphisternum

Question 5

Markers of fundal height

Answer 5

1cm per week of pregnancy

Question 6

Sources of error in fundal height

Answer 6

Bladder
Multiple pregnancy
Incorrect dating
Fibroids

Question 7

Foetal distress

Answer 7

Acute distress in Iabour

Question 8

Foetal compromise

Answer 8

Health of the baby in utero is compromised.

Question 9

Biophysical growth measurements

Answer 9

Ultrasound scan
Cardiotocograph

B - breathing
A - amniotic fluid
T - tone 
H - heart rate
M - movements

Question 10

When are foetal movements felt?

Answer 10

Detected at 8 weeks

Felt at 18-20 weeks

Question 11

Why is monitoring foetal movements is important

Answer 11

Change in foetal movements can indicate development.

Increase with growth
Decrease can indicate compromise

Question 12

Ultrasound scanning in pregnancy

Answer 12

12 weeks, dating or viability scan

20 weeks is an anomaly scan

Question 13

Preterm babies are small and physiologically immature. Which organ needs to be managed and why?

Answer 13

Lung

Question 14

Drugs used to prevent labour

Answer 14

Tocolytics

Allows administration if corticosteroids to accelerate foetal lung maturity
And transfer to a suitable unit

Question 15

IUGR

Answer 15

2 main types:

Asymmetrical - head sparing, most commonly extrinsic factors later in pregnancy. Loss of abdominal fat.

Symmetrical - undernourished, genetic

Question 16

Causes of asymmetrical IUGR

Answer 16

Placental insufficiency
Smoking
Pre-eclampsia

Question 17

Birthweights of a large, small and average baby

Answer 17

Average 3.2kg
Large: over 4.5kg
Small: under 2.5kg

Question 18

When is the period of most foetal growth?

Answer 18

third trimester, between 20-40weeks (300g-3kg)

Question 19

Name 4 factors that have an impact on foetal growth

Answer 19

pre-eclampsia
trauma
maternal nutrition 
multiple pregnancy
smoking
alcohol/drugs