Multifetal gestation

Question 1

Monoamniotic twins are significant because they?

Answer 1

share a placenta, mortality is increased

Question 2

What would change with the induction of monoamniotic twins?

Answer 2

they are induced early

Question 3

What is the most significant cause of mortality with multifetal gestation>?

Answer 3

Preterm delivery

Question 4

What is hydramnios?

Answer 4

too much amniotic fluid?

Question 5

The uterine size is larger than expected for gestational age. What test and suspect would you have?

Answer 5

twins, ultrasound

Question 6

What is the best way to determine the number of fetuses?

Answer 6

Ultrasound

Question 7

You observe a lambda sign what is the significance of this?

Answer 7

twins non monoamniotic

Question 8

What is a normal BMI for a normal wt woman with twins?

Answer 8

37 lbs

Question 9

When do fetal kick counts begin?

Answer 9

30-32 weeks

Question 10

What is a nonstress test?

Answer 10

fetal doppler monitor, that monitors fetal hr in response to fetal movement

Question 11

What is an acceleration for Nonstress test?

Answer 11

15 beats/min above baseline for 15 secs

Question 12

What is reactive NST?

Answer 12

2 or more acceleration over 20 mins

Question 13

What is a nonreactive NST?

Answer 13

The baby could be asleep so no measure, warrants further assessment

no change in hr from baseline over 40 mins

Question 14

Expected or desired fetal hr?

Answer 14

110-115 beats/min

Question 15

What is a good indication of normal autonomic in a NST ?function

Answer 15

Reactivity

Question 16

How long would an NST take before labeling as non-reactive?

Answer 16

40 mins

Question 17

In a biophysical profile BPP what is included?

Answer 17

Fetal breathing movements
fetal movements
fetal tone
amniotic fluid volume
NST

Question 18

When does a symmetric Fetal Growth Classification occur FGC?

Answer 18

early in gestation

Question 19

Asymmetric FGR occurs when ? and what are common causes?

Answer 19

Later in gestation, smoking uteroplacental insufficiency

Question 20

Tx goal of FGR is to maximize fetal growth maturity

Answer 20

True

Question 21

What is macrosomia?

Answer 21

big baby 10lbs or >4500g

Question 22

What are some risks to macrosomia fetus upon delivery

Answer 22

Brachial plexus injury
asphyxia
minor congenital abnormalities
respiratory problems

Question 23

What is the biggest risk for macrosomia?

Answer 23

diabetes (gestation or preexisting)

Question 24

What is the two step glucose test?

Answer 24

50g of oral glucose (fasting not required) measured 1 hr later

100g