Miscellanous Obstetrics

Question 1

How is fetal heart rate measured during labour and antenatally?

Answer 1

Pinnard’s stethoscope

Handheld doppler device ie CTG

Question 2

CTG measures contractions and the fetal heart rate. What parameters are measured in the fetal heart rate?

Answer 2

Baseline fetal heart rate N- 110-160
Baseline variability- N >5bmp
Acceleration- present
Deceleration (early, variable, late)

Question 3

Fetal tachycardia on CTG- what would that indicate
Loss of baseline variability <5bmp occurs when
When does late deceleration occur?
When does variable deceleration occur?

Answer 3

• Tachycardia: choriomanionitis, hypoxia, prematurity
• Loss of baseline variability: prematurity, hypoxia
• Late decelerations: fetal distress: fetal hypoxia, placental insufficiency
• variable decelerations: Cord compression

Question 4

What are the ultrasound features of Down’s syndrome?

Answer 4

Thickened nuchal transluceny (11-13+6)
Absent or shortened nasal bone
Tricuspid regurgitation

Question 5

What is the combined test and when is it carried out?

What would down’s markers look like on combined test?

Answer 5

1st trimester
Looks at: 
- maternal age 
- nuchal translucency 
- Serum markers- free bhCG and pregnancy associated plasma protein A (PAPPA)

High free bhCG and low PAPPA

Question 6

What is the quadruple test and when is it carried out?

Answer 6

14th week-22th week, looks only for Down’s

• Maternal age
• free bhCG
• Alpha feto protein
• Oestriol
• Inhibin A