Gestational assessment and morphology

Question 1

How is gestational age calculated?

Answer 1

• Use of LMP to calculate EDD
LMP- Last menstrual period
EDD- Estimated Date of Delivery

Gestational Age by LMP is calculated from the first day of the last menstrual period. EDD by LMP is calculated by adding 280 days (40 weeks) to the first day of the last menstrual period.

Question 2

• Role of ultrasound to confirm EDD

Answer 2

An ultrasound scan at 12 weeks is about 2 +/- 3 days accurate

Question 3

Use of Centile charts

Answer 3

plot weight, length, head circumference against age
Below 2nd centile- we don’t want a baby having a lower weight than the 2nd centile as this could lead to baby having low level of ..
Make sure it is the right chart
Wrong gestation=wrong centile
REMEMBER
Don’t treat scan as if it really accurate
Question when the scan was performed
Optimal neonatal centile: 50th centile

Question 4

Physical examination to confirm gestation

Answer 4

The physical maturity part of the examination is done in the first 2 hours of birth. The neuromuscular maturity examination is completed within 24 hours after delivery.
Neonates are post term at 42 weeks gestation
Neonates are at term at 37 weeks gestation

Question 5

What is Lanugo?

Answer 5

This is the soft downy hair on a baby’s body. It is absent in immature babies, then appears with maturity, and then disappears again with postmaturity.

Question 6

Physical examination of Male and female genitalia?

Answer 6

female: size of the clitoris and the labia are assessed: labia majora is covering labia minora
Male: if the testes have descended and appearance of scrotum, from smooth to wrinkled, are assessed.

Question 7

What are Plantar creases?

Answer 7

Plantar creases. These creases on the soles of the feet range from absent to covering the entire foot, depending on the maturity.
Premature: surfaced are smooth

Question 8

Examination of breast tissue

Answer 8

The thickness and size of breast tissue and areola (the darkened ring around each nipple) are assessed

Question 9

Normal number of bones in the neonatal skull at birth

Answer 9

5

Question 10

Oedema between the neonates skull and skin is called

Answer 10

Caput succedaneum

Question 11

The anterior fontanelle closes by

Answer 11

18 months

Question 12

The metopic suture is also called:

Answer 12

Frontal

Question 13

The posterior fontanelle closes by

Answer 13

6 weeks

Question 14

Which factor is not a marker for Down’s syndrome

Answer 14

Blue sclera

Question 15

An ultrasound to confirm gestation at 12 week has the following accuracy

Answer 15

±2-3 days

Question 16

Gestation can be assessed by examining the neonates

Answer 16

Ears

Question 17

Measurement required to plot a babies centile?

Answer 17

Length

Birth weight

Question 18

Neonates are post term at which gestation

Answer 18

42 weeks

Question 19

Neonates are term at which gestation

Answer 19

37 weeks

Question 20

Which of the following is the optimal neonatal centile?

Answer 20

50th centile