Foetal surveillance

Question 1

What should be done if symphysis fundal height is found to be small or large after the first trimester?

Answer 1

USS assessment for foetal growth and liquor volume + uterine doppler

Question 2

What is measured for foetal growth during a USS?

Answer 2

1. Bi-parietal diameter (BPD) and head circumference
2. Abdominal circumference (AC)
3. Femur length

Question 3

The relationship of which USS measurements is improtant in assessing IUGR?

Answer 3

BPD and AC (brain sparing)

Question 4

Reasons for small measurements?

Answer 4

Wrong dates
IUGR
Oligohydramnios
Abnormal lie

Question 5

Reasons for large measurements?

Answer 5

Macrosomia - DM
Polyhydramnios
wrong dates
multiple pregnancy
fibroids

Question 6

Doppler umbilical artery waveforms

Answer 6

Doppler used to measure velocity waveforms in uterine arteries
Increased resistance –> decreased foetal diastole = placental insufficiency

Informs which foetuses are genuinely growth restricted and compromised

Question 7

Ultrasound assessment of biophysical profile / amniotic fluid volume

Answer 7

4 variables:
Limb movement
Tone
Breathing movements
Liquor volume 

Scored 0-2, total = 8

Question 8

Kick chart

Answer 8

Mother records foetal movements

Reduced foetal movements often proceeds demise by hrs/days

Not used routinely due to anxiety inducing effect on mother