Flashcards in Week 2 Fetal & Neonatal Assessment (everything) Deck (151)
Fetal growth restriction results from suboptimal uteroplacental perfusion and fetal nutrition caused by different conditions that can be divided into:
(bold in PPT)
Fetal growth restriction results from? (two answers)
suboptimal uteroplacental perfusion and fetal nutrition.
Maternal disorders associated with fetal growth restriction include any condition that can potentially result in vascular disease, such as ? (multiple answers)
pregestational diabetes, hypertension, antiphospholipid antibody syndrome, autoimmune diseases and renal insufficiency, malnutrition, and substance abuse.
Fetal conditions that may result in growth restriction include?
teratogen exposure, including certain medications; intrauterine infection; aneuploidy, most often trisomy 13 and trisomy 18; and some structural malformations, such as abdominal wall defects and congenital heart disease.
Placental pathology resulting in poor WHAT can lead to fetal growth restriction.
Umbilical cord abnormalities, such as what and what have also been implicated in cases of fetal growth restriction.
velamentous or marginal cord insertion.
In more than HOW MANY of cases of growth restriction, the etiology may be unclear even after a thorough investigation
In more than HALF
Fetal growth restriction is associated with an increased risk for WHAT? (Bold in the PPT)
The risk for stillbirth is further increased when WHAT occurs in the context of oligohydramnios or abnormal diastolic blood flow in the umbilical artery. (bold in the ppt)
fetal growth restrictions
What two issues further increases risk for stillbirth when fetal growth restrictions are also present? (bold in ppt)
oligohydramnios or abnormal diastolic blood flow in the umbilical artery.
If EFW measures less than the 10th percentile, the risk for stillbirth is what percentage? (the percentage is twice the risk for appropriately grown fetuses)
The risk for stillbirth increases to what percentage when the EFW is less than the 5th percentile?
What two things can occur which will lead to an improvement in perinatal outcomes? (think in relation to fetal growth restrictions) (bold in ppt)
Early and accurate diagnosis of fetal growth restriction coupled with appropriate intervention leads to an improvement in perinatal outcome.
If fetal growth restriction is suspected clinically and on the basis of ultrasonography, then what should follow in relation to mother and fetus? (bold in ppt)
a thorough evaluation of the mother and fetus is indicated.
True or false
Every effort should be made to identify the cause of the fetal growth restriction and to modify or eliminate contributing factors.
Monitoring of a fetus who may have fetal growth restrictions should include what all? (multiple answers) (bold in ppt)
Monitoring should include serial ultrasonographic examinations for growth and amniotic fluid volume, and antenatal surveillance with umbilical artery velocimetry and antepartum testing (nonstress tests or biophysical profiles).
What do you base timing of delivery on? (multiple factors) (bold in ppt)
based on gestational age,
the underlying etiology if known, results of antepartum testing and interval growth scans, and any additional risk factors for an adverse outcome, including maternal co-morbidities.
What is the definition of Fetal macrosomia?
growth beyond an absolute birth weight of 4000 g or 4500 g regardless of gestational age. (bold in ppt)
Tell me the difference between fetal macrosomia and large for gestational age?
Fetal macrosomia, defined as growth beyond an absolute birth weight of 4000 g or 4500 g regardless of gestational age,
should be differentiated from the term large for gestational age (LGA), which implies a birth weight greater than or equal to the 90th percentile for a given gestational age.
what percentage of fetuses born in the US are LGA?
(8% of all live-born infants weigh 4000 g or more, and 1.1% weigh more than 4500 g)
Vibroacoustic Stimulation- how is this done
Fetal vibroacoustic stimulation (VAS) refers to the response of the FHR to a vibroacoustic stimulus (82 to 95 dB) applied to the maternal abdomen for 1 to 2 seconds in the region of the fetal head (BOLD)
positive result of fetal vibroacoustic stimulation
An FHR acceleration in response to VAS represents a positive result and is suggestive of fetal health. (BOLD)
What injuries are associated with shoulder dystocia?
The fetal injuries associated with shoulder dystocia include fracture of the clavicle and damage to the nerves of the brachial plexus, resulting in Erb-Duchenne paralysis, of which the vast majority resolve by 1 year of age.
An NST alone may not be sufficient to confirm fetal well-being. In such cases, a biophysical profile (BPP) may be performed.
The BPP combines an NST with an ultrasonographic scoring system performed over a 30-minute period
the Biophysical profile is used in what two situations?
what situation is it not used in?
term and preterm fetuses
not during active labor
what are the 5 variables described in the original BPP
The five variables described in the original BPP were
(1) gross fetal body movements,
(2) fetal tone (i.e., flexion and extension of limbs),
(3) amniotic fluid volume,
(4) fetal breathing movements, and
(5) the NST (Table 6.4).75 More recently, the BPP has been interpreted without the NST.
contraction stress test, also known as the oxytocin challenge test (OCT) how and why is it done
assesses the response of the FHR to uterine contractions induced by either intravenous oxytocin administration or nipple stimulation (which causes release of endogenous oxytocin from the maternal neurohypophysis). (BOLD)
what are the results of a contraction stress test
A minimum of three contractions for at least 40 seconds in a 10-minute period is required to interpret the test. A negative CST (no late or severe late decelerations with contractions) is reassuring and suggestive of a healthy, well-oxygenated fetus
min of 3 ctx for at least 40s in a 10min period is req to interpret the test. a negative CST (no late or severe late decels) is reassuring and suggestive of a healthy well oxygenated fetus.
Doppler Velocimetry what does it measure? where does it measure it?
Doppler velocimetry can be used for the noninvasive measurement of fetal circulation,
including the umbilical artery (UA), middle cerebral artery (MCA), and ductus venosus (DV).