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O And G Junior > Introduction To Fetal Monitoring > Flashcards

Introduction To Fetal Monitoring Flashcards

1
Q

Weight gain in pregnancy varies greatly.

Most pregnant women gain between _____ and _____kg (22lb to 28lb), putting on most of the weight after week ____.

Much of the extra weight is due to _____________ , but your body will also be storing fat, ready to make breast milk after your baby is born.

A

10kg and 12.5

20

your baby growing

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2
Q

Fetal ultrasound

At the _____ week scan our sonographer can detect structural defects

A

20

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3
Q

Postterm pregnancy is defined as pregnancy that has extended to or beyond ____ weeks of gestation (294 days), or estimated date of delivery (EDD) + _____ days

A

42

14

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4
Q

___________________________, or IUGR, is when a baby in the womb (a fetus) does not grow as expected.

A

Intrauterine growth restriction

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5
Q

Intermittent auscultation is the technique of listening to and counting the fetal heartbeats for ________ of time during __________. It is usually performed using a _______________ or a _______________ device, with the uterine contractions palpated by hand.

A

short periods

active labour

Pinard stethoscope; hand-held Doppler

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6
Q

This method of measuring amniotic fluid is referred to as the ________________. If the amniotic fluid depth measures less than ___________, the pregnant woman has oligohydramnios (or polyhydramnios).

A

amniotic fluid index (AFI)

5 centimeters

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7
Q

Normal pregnancy is assessed clinically

Maternal _________
Fetal ______
Fetal __________
Fetal ________
____________

A

weight gain

growth

movements

heart rate; Ultrasonically

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8
Q

High risk pregnancies include:
________ pregnancy
___________
__________________
Diabetes mellitus
Cardiac disease
Sickle cell disease etc

A

Postdated; IUGR

PIH/Pre-eclampsia

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9
Q

High risk pregnancies Are assessed clinically by ;

__________________
Daily fetal ______________
Electronically by _______________
Ultrasonically by _____________ and by ______ ultrasound
Assessing _______________

A

Intermittent auscultation
Daily fetal movement counting
Electronically by cardiotocography (CTG)
Ultrasonically by biophysical profile and by doppler ultrasound
Assessing state of liquor

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10
Q

A _______ test result is the usual finding of antepartum tests for fetal wellbeing.

A

normal

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11
Q

Even with persistently reassuring tests, perinatal death may still occur and each patient should be informed.
T/F

A

T

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12
Q

The oldest and most widely used form of fetal assessment is ???

A

Daily fetal movement counting

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13
Q

Fetal demise is preceded by cessation of fetal activity for _________hours.

A

24 - 48

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14
Q

Fetal movement Counting

Is A good screening method from ___ to _____ weeks to select patients who require electronic monitoring.

Can detect up to ____% of fetuses destined to develop fetal distress

A

30 to 42

60

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15
Q

Intermittent Auscultation

Can be done with _______ or _________.

Every _____ minutes in first stage of labour.
Every ____ minutes in second stage of labour.

Count rates at each review.

A

pinard or sonicaid

15;5

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16
Q

Intermittent auscultation of the fetal heart is performed _______ and _________ after contractions

A

during and 30secs

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17
Q

Normal FHR = ____-______ beats/min.

FHR > ____ beats/min = tachycardia.
FHR <_____ beats per/min = bradycardia.
Record on the partograph.

A

120 – 160

160; 120

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18
Q

Intermittent auscultation is inferior to CTG monitoring

T/F

A

F

Has not been found to be inferior to CTG monitoring if properly conducted.

19
Q

The most commonly used antenatal test of fetal wellbeing is ???

A

CARDIOTOCOGRAPHY

20
Q

An (internal or external?) method of monitoring fetal heart rate

A

External

21
Q

CARDIOTOCOGRAPHY

Rationale – the presence of spontaneous fetal heart rate __________ associated with ____________ ( ____________ ) is an indicator of fetal wellbeing.

A

accelerations

fetal movements

fetal reactivity

22
Q

CHARACTERISTICS OF NORMAL FETAL HEART RATE PATTERN

Normal pattern is:
– Associated with a good outcome.
– Baseline rate between _____ and ______ beats/min.
– Variability of at least ____ beats/min.
-_______________ is associated with contractions.
– Presence of ___________.

A

120 and 160

5

No deceleration

accelerations

23
Q

INTRAPARTUM FETAL MONITORING

Intrapartum fetal monitoring means
To ___________________________

To detect at the earliest, any evidence of fetal jeopardy and Prompt action to be taken to save the fetus from the adverse effect of anoxia

A

watch the fetal behaviour during labour

24
Q

A normal fetus is well adapted to ____________________________ occurring during labour

A

intermittent hypoxia

25
Q

Intrapartum fetal monitoring

The major danger to the fetus is ____________ due to prolonged periods of ____________

A

asphyxia

oxygen reduction

26
Q

Intrapartum fetal monitoring

The risk of asphyxia is more in cases where the mother has one or more high-risk factors like _______,______,_______. etc

A

anaemia, PIH, DM

27
Q

Oxytocin challenge Test

Popular in USA
Here oxytocin infusion is given to provoke ____________ within _________.

The response of the FHR to the contractions is interpreted as in the __________ test.

A

3 uterine contractions; 10mins

non-stress

28
Q

Disadvantages of oxytocin challenge test

_________ and time consuming.

Risk of ______________

A

Invasive

hyperstimulation

29
Q

Biophysical profile

The original BPP assigned a score of _____ or ______ according to the presence or absence of each of the five variables

________
___________
______________
________________
___________________

A

0 or 2

fetal tone
fetal breathing movement
fetal movement
amniotic fluid volume
Non stress test (done using CTG)

30
Q

Interpretation of biophysical profile score

Score of _____ – normal
Score of _____ – equivocal
Score of _______ - abnormal

A

8 or 10

6

4 or less

31
Q

Modified BPP

Consist of ______ and ______
Used widely
If either of the variable is abnormal, a _________ or ____________ is performed.

A

Non-stress test and Amniotic Fluid index

complete BPP or CST

32
Q

The __________,__________, and ___________ have similar low false-negative mortality rates –

What is low false-negative mortalitity rates ?

A

modified BPP, CST and complete BPP

defined as the number of fetal deaths within one week of a normal test result.

33
Q

Mention 2 pitfalls of modified BPP

A

No clear evidence that the 2 variables used are better predictors than the other variables omitted from the BPP.

Requires 2 modalities for fetal evaluation while normal USS findings in BPP eliminates the need for NST.

34
Q

Examination of Amniotic fluid

A route of access to information about the condition of the fetus in utero.
May involve either __________ or ___________

A

amniocentesis or amnioscopy

35
Q

Examination of Amniotic fluid

Applications:
Diagnostic
Between _____ and ______ weeks
To detect ________ abnormality eg Trisomy 21
To detect some __________ defects by measuring alpha feto protein
To detect _______ genetic disorder
To detect certain _________________

A

15 and 20

chromosomal; open neural tube

sex-linked

inborn errors of metabolism

36
Q

Examination of Amniotic fluid

Applications:

After 20weeks
To estimate bilirubin and antibody in _______________
To estimate phospholipids as a guide to ____________
For chemical and/or cytological analysis, to estimate __________
To perform angiography or fetography

A

rhesus isoimmunisation

pulmonary maturity

maturity

37
Q

Examination of Amniotic fluid

Applications:

Therapeutic
For the temporary relief of _________
For intra-amniotic injection to ________________

A

hydramnios

terminate pregnancy

38
Q

Meconium staining of liquor AMNII

Said to be a sign of __________
Recent studies disregard its importance when considered in isolation

A

fetal distress

39
Q

Meconium staining has been classified according to the stage of labour as early and late.

Early- when it is passed during the ______ stage of labour
Late- when it is passed during the _______ stage after ______________________

The colour may vary from light yellow, light green, dark green to blackish

A

first

second

clear fluid has been noted previously

40
Q

Meconium staining of liquor AMNII

Yellow or light green in the first stage of labour : _____________________

Thick dark green meconium in early labour : ________________________

Thick meconium associated with __________ variation should alert the obstetrician

A

insignificant if the rest of the findings are normal as in 50% of cases

significantly increased incidence of meconium aspiration in the new born

fetal heart

41
Q

Biochemical Monitoring

FETAL SCALP pH
To recognise _______ in cases of altered ______ patterns

A

acidosis

FHR

42
Q

Biochemical monitoring

Normal fetal scalp pH _______

pH _______, 50% of the neonates are normal.

pH ______ the fetus is compromised and 30% of such infants are ________ at birth.

A

> 7.25

> 7.2

<7.2

depressed

43
Q

Biochemical monitoring

Severe acidosis can lead to neonatal ______________ and ______________

A

Seizures and hypotonia

O And G Junior (20 decks)

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