Week 2 Fetal & Neonatal Assessment (everything) Flashcards Preview

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Flashcards in Week 2 Fetal & Neonatal Assessment (everything) Deck (151)
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61

most patients undergo a detailed fetal anatomic surgery at 18-22 weeks gestation to assess?

assess fetal growth and screen for structural defects.

62

indications for US at 14 weeks gestation

are different from second trimester and third trimester

63

What is the definition of Fetal macrosomia?

growth beyond an absolute birth weight of 4000 g or 4500 g regardless of gestational age.

64

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,44 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.

65

what percentage of fetuses born in the US are LGA?

10%

66

What birth weights are associated with risks for labor abnormalities? (bold in ppt)
(three diff. weight classes)

the risk for labor abnormalities increases with birth weights between 4000 and 4499 g

newborn and maternal morbidity increases significantly with birth weights between 4500 and 4999 g

and perinatal mortality (e.g., stillbirth and neonatal mortality) increase with birth weights greater than 5000 g

67

What is the most serious consequence of fetal macrosomia? (bold in ppt)

Shoulder dystocia, defined as a failure of delivery of the fetal shoulder(s) after initial attempts at downward traction, is the most serious consequence of fetal macrosomia, and requires additional maneuvers to effect delivery.

68

obstetric providers have two patients

mother and fetus

69

Of the two patients (mother/fetus), who will take priority ?

mother

70

Some tests are recommended for all pregnancies; like?

Ultrasound

71

Some tests are recommended for women with pregnancy complications; like?

middle cerebral artery doppler velocimetry

72

Fetal interventions are employed to improve

fetal outcome

- such as maternal corticosteroid administration
-Intrauterine fetal procedures

73

Around what year did neonatal concern/study begin by Dr. Little?

1861

74

** Barcroft wrongly concluded that

the term infant faced either asphyxia in utero or escape through the initiation of labor

75

Who proved Barcroft wrong? He concluded?

his student, D. Barron.
-concluded no deterioration environment until onset of labor

76

Who's data has had the greatest impact on clinical practice?

Barcroft
- all current methods of fetal monitoring grew out of the belief that oxygen availability is the single most important factor influencing the well-being of newborns

77

*** Mean duration of a singlton pregnancy

280 days / 40 weeks

78

singleton pregancy

birth of only one child during a single delivery w/a gestation of 20 weeks or more

79

*** Term is defined as

ultimate time for delivery

** 37-42 weeks

80

The optimal time for delivery:

37-42 weeks

81

**preterm births =

delivery before 37 weeks

82

**delivery after 42 weeks =

post term birth

83

**what are associated with increased perinatal and neonatal morbidity and mortality:;

Preterm and post term births
<37 weeks and >42 weeks

84

**Early Term:

37-38 wks

85

**Full Term:

39-40 wks

86

**Late Term:

41-42 wks

87

1. The American College of Obstetricians and Gynecologists
2. The Society of Maternal-Fetal Medicine
3. The American Institute of Ultrasound in Medicine

Have established:

recommendations for determining the gestational age (measure ot eh age of a preganancy) and EDD (est. due date)

88

** Gestational age is most accurate when US measurement of the fetus or embryo is performed

in the first trimester (< or = 14 weeks)

** assisted reproductive tech; EDD should be assigned based on the age of the embryo and the date of transfer

89

Criteria commonly used to confirm gestational age:

-Reported date of LMP
-size of uterus on bimanual exam in first trimester should be consistent w/dates
-Perception of fetal movement
-Fetal heart activity
-US to determine fetal crown to rump length during first trimester

90

Naegele's Rule

EDD calculated by subtracting 3 mos and adding 7 days to the first day of the last normal menstrual period