Fetal growth, compromise and surveillance

Description

Obs and Gynae (Obstetrics) Flashcards on Fetal growth, compromise and surveillance, created by Liam Musselbrook on 02/02/2017.
Liam Musselbrook
Flashcards by Liam Musselbrook, updated more than 1 year ago
Liam Musselbrook
Created by Liam Musselbrook almost 8 years ago
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Resource summary

Question Answer
Principal associations of cerebral palsy Preterm IUGR Congenital abnormalities Intrapartum fetal distress Pre-eclampsia Infection
Define small for dates (SFD)/small for gestation (SFG) The weight of the fetus is less than the tenth centile for its gestation
Identification of the high-risk pregnancy: prepregnancy Poor past obstetric history or very small baby Maternal disease Assisted conception Extremes of reproductive age Heavy smoking or drug abuse
Identification of the high-risk pregnancy: during pregnancy Hypertension/ proteinuria Vaginal bleeding Small for dates (SFD) baby Prolonged pregnancy Multiple pregnancy
Identification of the high-risk pregnancy: investigations Cervical scan at 23 weeks Uterine artery Doppler Maternal blood tests, e.g. PAPP-A
Methods of surveillance in the high-risk pregnancy Fortnightly (max.) US - growth Umbilical artery Doppler - identify compromised fetus CTG on a daily basis Methods specific to disorder, e.g. blood pressure in pre-eclampsia
In what three ways can ultrasound scans be used to monitor whether fetal growth is healthy? 1. Comparison to previous scans 2. Compare growth of abdomen to that of the head (abdo growth will slow before head growth if compromised) 3. Compare actual growth against expected growth for individual fetus
Cardiotocography (CTG) Fetal heart is recorded electronically Accelerations and variability >5 bpm should be present Decelerations should be absent Rate should be 110–160 bpm
Constitutional determinants of smaller fetal size and growth Low maternal height and weight Nulliparity Asian ethnic group Female fetal gender
Pathological determinants of fetal growth causing IUGR Pre-existing maternal disease Pre-eclampsia Multiple pregnancy Smoking Drug usage Infection e.g. CMV Extreme malnutrition Congenital abnormalities
What are the risks of prolonged pregnancy? More common: stillbirth, neonatal illness, encephalopathy, meconium passage, fetal distress
Management of prolonged pregnancy From 41 weeks: Examine the patient vaginally and induce unless cervix very unfavourable (not ripe), or patient prefers to wait If no induction: sweep cervix and arrange daily CTG
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