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OB CH 50 OBSTETRIC MSMTS & GA > OB - FETAL GROWTH ASSESSMENT > Flashcards

OB - FETAL GROWTH ASSESSMENT Flashcards

0
Q

WHAT IS CONSIDERED TERM?

A

BETWEEN 38 - 42 WEEKS

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1
Q

WHAT IS CONSIDERED PRETERM?

A

BEFORE 38 WEEKS

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2
Q

WHAT IS CONSIDERED POST TERM?

A

MORE THEN 42 WEEKS

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3
Q

WHAT DOES SGA & LGA STAND FOR?

A

SMALL FOR GESTATIONAL AGE
&
LARGE FOR GESTATIONAL AGE

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4
Q

THIS BEST DESCRIBES A DECREASED RATE OF FETAL GROWTH.

A

INTRAUTERINE GROWTH RESTRICITION (IUGR)

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5
Q

WHATS THE % OF PREGNANCIES WITH IUGR?

A

3-7%

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6
Q

IF THE FETAL WEIGHT IS AT OR BELOW ______ FOR A GIVEN GA IT IS CONSIDERED IUGR.

A

10%

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7
Q

WHAT RISKS DOES IUGR POSE FOR THE FETUS?

A

ANTEPARTUM DEATH, PERINATAL ASPHYXIA, NEONATAL MORBIDITY, LATER DEVELOPMENTAL PROBLEMS.

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8
Q

WHAT INCREASES WITH THE SEVERITY OF IUGR?

A

MORTALITY

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9
Q

WHAT ARE SOME OF THE FACTORS THAT CAN CAUSE IUGR?

A

MOTHER HAVING A HX OF PREVIOUS IUGR,

SEVERE HYPERTENSION, TOBACCO USAGE, UT ANOMALIES, PLACENTAL HEMORRHAGE

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10
Q

WHAT ARE OTHER CONSIDERATIONS FOR IUGR?

A

MATERNAL SIZE & RACE & THE GENDER OF NEONATE.

HISPANIC & ASIAN WOMEN TYPICALLY HAVE SMALLER BABIES

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11
Q

WHAT ARE THE CLINICAL FINDINGS FOR IUGR?

A
  • DECREASED FUNDAL HEIGHT
  • DECREASED FETAL MVMT
  • GRADE 3 PLACENTA PRIOR TO 36 WEEKS
  • DECREASED PLACENTAL THICKNESS
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12
Q

THIS RESULTS FROM SEVERE CHROMOSOMAL ABNORMALITIES OR INFECTION IN THE 1ST TRIMESTER?

A

SYMMETRIC IUGR

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13
Q

WHAT CHARACTERISTICS DOES SYMMETRIC IUGR HAVE?

A

PROPORTIONATELY SMALL FETUS

ALL PHYSICAL PARAMETERS (BPD, HC, AC, FL) ARE EQUAL

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14
Q

THIS IS CAUSED BY PLACENTAL INSUFFIECIENCY IN THE LATE 2ND & 3RD TRIMESTER.

A

ASYMMETRIC IUGR

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15
Q

WHICH IS THE MORE COMMON TYPE OF IUGR?

A

ASYMMETRIC IUGR

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16
Q

WHAT ARE THE CHARACTERISTICS OF ASYMMETRICAL IUGR?

A
  • APPROPRIATE BPD & HC AND DISPROPORTIONATELY SMALL AC (BRAIN SPARING EFFECT)
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17
Q

WHAT CAUSES ASYMMETRICAL IUGR?

A

MATERNAL DISEASE (LIKE MATERNAL DIABETES), CHRONIC HYPERTENSION, ETC OR NO HIGH RISK FACTORS.

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18
Q

WHAT IS NOT A RELIABLE DETECTOR OF IUGR?

A

BPD BECAUSE THERE CAN BE THE BRAIN SPARING EFFECT OR OLIGOYDRAMNIOS CAUSES DOLICOCEPHALY OR BRACHYCEPHALY

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19
Q

WHAT IS A MORE EFFECTIVE PARAMETER FOR GA IN RELATION TO IUGR?

A

HC IS MORE CONSISTENT

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20
Q

THE HC TO AC RATIO IS ESPECIALLY USEFUL FOR DETECTING?

A

ASYMMETRIC IUGR. RATIO WILL INCREASE AS DIFFERENCE BETWEEN GA AND FETUS SIZE INCREASES

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21
Q

IS THE HC AC USEFUL IN PREDICTING SYMMETRIC IUGR?

A

NO BECAUSE THEY WILL BE EQUALLY SMALL

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22
Q

WHAT IS THE MOST RELIABLE TO OBTAIN ESTIMATED FETAL WEIGHT?

A

ALL FETAL PARAMETERS (BPD, HC, AC, FL)

23
Q

WHAT IS USED FOR EFW WITH HADLOCK?

A

HC, AC, AND FL (NO BPD)

24
Q

WHAT ZONE IS IT WHEN THE BABY SHOULD BE DLVD AS SOON AS THE LUNGS HAVE MATURED?

A

ZONE 3

25
Q

WHAT ZONE SHOULD HAVE SERIAL SONOGRAMS AND FETAL HEART RATE MONITORING?

A

ZONE 2

26
Q

THIS ZONE RULES OUT IUGR?

A

ZONE 1

27
Q

HOW IS THE AMNIOTIC FLUID EVALUATED?

A

UT CAVITY IS DIVIDED INTO 4 EQUAL QUADRANTS & THE LARGEST POCKETS ARE MEASURED. THE SUM OF ALL 4 QUADRANTS IS THE AFI AMNIIOTIC FLUID INDEX.

28
Q

WHAT IS THE NML AFI LEVELS?

A

BETWEEN 8-22 CM

29
Q

WHAT AFI IS CONSIDERED OLIGOHYDRAMINIOS & POLYHYDRAMNIOS?

A

OLIGOHYD. IS < 5CM & POLY IS > 22CM

30
Q

DURING THE BPP (BIOPHYSICAL PROFILE) WHAT SHOULD THE FETAL BREATHING MVMT BE?

A

EPISODES FOR 30S CONTINUOUS DURING A 30 MINUTE OBSERVATION

31
Q

WHAT IS THE GROSS BODY MVMT?

A

3 SEPERATE UNPROVOKED BODY/LIMB MVMTS IN 30 MINS, CONTINUOUS MOVEMENT FOR 30 MINS IS COUNTED AS 1

32
Q

WHAT IS THE FETAL TONE TEST?

A

1 EXTENSION & FLEXION OF LIMBS OR TRUNK

33
Q

FETAL HEART RATE TEST aka NON STRESS TEST

A

2 EPISODES OF FHR ACCELERATIONS OF 15 BPM & IN 15 SEC DURATION IN A 20 MIN PERIOD

34
Q

HOW MANY MINS ARE IN A FETAL SLEEP-WAKE CYCLE?

A

40 MINS

35
Q

WHAT IS AN NML AFI IN 1 POCKET?

A

FLUID MEASURES AT LEAST 2CM OR MORE IN 2 PLANES.

36
Q

WHAT IS A NML BPP SCORE?

A

8-10

37
Q

WHAT BPP SCORE INDICATES AN IMMEDIATE DLVRY IS NECESSARY?

A

0-2

38
Q

WHAT IS CONSIDERED A TRUE BREATHING MVMT?

A

SIMULTANEOUS INWARD MVMT OF THE CHX WALL WITH OUTWARD MVMT OF THE ANT ABD WALL DURING INSPIRATION.

39
Q

THIS IS ALSO A SIGN OF FETAL BREATHING MVMTS.

A

FETAL KIDNEY MVMT IN LONG PLANE

40
Q

HOW MANY BODY & TRUNK GROSS MVMTS NEED TO BE OBSERVED TO RECEIVE 2 POINTS?

A

3 IN 30 MINS

41
Q

THIS TEST IS DONE USING DOPPLER TO RECORD FETAL HEART RATE AND ITS REACTIVITY TO STRESS OF UT CONTRACTIONS.

A

NONSTRESS TEST

42
Q

WHAT ARE THE STAGES OF BRAIN DEVELOPMENT?

A
  • FETAL TONE = 7.5 - 8.5 WEEKS
  • FETAL MVMT = 9 WEEKS; DIAPHRAGMTATIC MVMT = 20 WKS
  • HEART RATE REACTIVITY - LATE 2ND- EARLY 3RD
43
Q

where should a doppler blood flow sample be taken from in a baby with IUGR?

A

umbilical vessels. if it shows decreased blood low the fetus will not recv enough blood, nutrients and oxygen from the placenta

44
Q

THIS FORM OF DOPPLER LOOKS AT BLOOD FLOW AND VELOCITY?

A

QUANTITATIVE

45
Q

THIS DOPPLER LOOKS AT CHARACTERISTICS OF THE WAVE FORM.

A

QUALATATIVE

46
Q

THIS MEASURES PEAK SYSTOLE TO END DIASTOLIC BLOOD FLOW.

A

S/D RATIO (SYSTOLIC TO DIASTOLIC)

47
Q

THE RESISTIVE INDED (RI) = ?

A

MAX SYSTOLIC VELOCITY - DIASTOLIC VELOCITY/SYSTOLIC VELOCITY

48
Q

DOPPLER SONO SHOWS FETUSES WITH ASYMMETRIC IUGR VASCULAR RESISTANCE _____ IN THE AORTA & UMBILICAL AND ______ IN THE FETAL MIDDLE CEREBRAL ARTERY.

A

INCREASES & DECREASES

49
Q

AN S/D RATIO OVER ____ IN THE UMBILICAL ARTERY AFTER ____ WEEKS IS CONSIDERED ABNML & SHOWS INCREASED RESISTANCE.

A

3.0 AFTER 30 WEEKS

50
Q

A RATIO ABOVE ____ SUGGEST INCREASED VASCULAR RESISTANCE & INDICATES A ______ MATERNAL BLOOD SUPPLY TO THE UT.

A

2.6; DECREASED

51
Q

WHAT IS CONSIDERED MACROSOMIA?

A

BIRTH WEIGHT OF 4000G (8.8LBS) OR > THEN 90TH %.

OR
TOO BIG TO PASS THROUGH THE PELVIS

52
Q

WHEN IS MACROSOMIA FRQ SEEN WITH?

A 
MULTIPARITY
> 35 YRS OLD
-PREPREGNANCY WEIGHT OF > 70K OR GAIN OF 20 KGS
- POSTDATE PREGNANCY
- HX OF LGA FETUSES
53
Q

WHAT IS MACROSOMIA COMMONLY A RESULT OF?

A

POORLY CONTROLLED MATERNAL DIABETES MELLITUS

54
Q

WHAT SYNDROMES ARE COMMON WITH MACROSOMIA?

A

BECKWITH-WIEDMANN SYNDROME
SOTO’S SYNDROME
WEAVER SYNDROME
MARSHALL-SMITH SYNDROME

55
Q

THERE IS AN INCREASED INCIDENCE OF WHAT WITH MACROSOMIA?

A

HEAD AND SHOULDER INJURIES AND CORD COMPRESSION.

56
Q

WHAT ARE THE 3 TYPES OF MECHANICAL MACROSOMIA?

A
  • FETUSES THAT ARE GENERALLY LG
  • FETUSES THAT “ “ BUT WITH LG SHOULDERS (DIABETIC PREGNANCIES)
  • FETUSES THAT HAVE NML TRUNK BUT LG HEAD (GENETIC OR PATHOLOGIC)

OB CH 50 OBSTETRIC MSMTS & GA (6 decks)

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