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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91

*** Fetal heart activity can be detected with doppler US by

10-12 weeks
-18-20 wks w/ fetal stethoscope

92

**Fundal height at 20 weeks (in a singleton pregnancy) should be approx.

20cm above the pubic symphysis (usually corresponding to the umbilicus)

93

"Quickening" occurs at

18-20 weeks (nulliparous )
16-18 weeks (parous)

94

Nulliparous woman is

a woman who has never carried a pregnancy

95

Parous woman is

a woman who has carried a pregnancy

96

***Routine US is recommended for all pregnancies given its ability to:

-accurately determine gest. age
-viability
-fetal number
-placental location
-screen for fetal structural abnormalities (in second trimester)

97

Perinatal outcomes have been shown in some studies to have an improvement b/c of the use of

US

98

**perinatal period is defined as

20-28th week of gestation and ends 1 to 4 weeks after birth

99

What did the RADIUS study conclude?

that screening US did NOT improve perinatal outcomes and had no impact on the mgmt of the anomalous (normal) fetus

100

Normal fetal growth is a critical component of a healthy pregnancy and the subsequent

the subsequent health of the child.

101

An increased risk for delivering a small-for-gestational age baby and/or having a preterm delivery is associated

with low maternal gestational weight gain.

102

Higher risk for delivering a large-for-gestational age baby and/or cesarean delivery is associated with

excessive gestational weight gain.

103

*** Leopold Maneuvers/ abdominal examination has several limitations - especially in the setting of

-a small fetus **
-maternal obesity,
-multiple pregnancy,
-uterine fibroids, or
-polyhydramnios,

104

what exam technique is safe, is well tolerated, and may add valuable information to assist in antepartum management

abdominal examination
Leopold maneuvers

105

Leopold Maneuvers (fig 6.1);

Each maneuver is is designed to identify specific fetal landmarks or to reveal a specific relationship between the fetus and the mother.

-First maneuver: fundal height

106

uterus can be palpated above the pelvic brim at approximately

12 weeks’ gestation

107

the uterus should increase at what rate/week? reaching what Landmark when?

1 cm per week, reaching the umbilicus at 20-22 weeks

108

Fundal height between 20 and 32 weeks gestation (in cm) is approximately equal to

the gestational age ( in weeks)

in a healthy women of average weight with an appropriately growing fetus

109

Maximal fundal height occurs at

approximately 36 weeks’ gestation,

110

after 36 weeks gestation, fundal ht drops as a result of

the fetus drops into the pelvis in preparation for labor

111

Fundal height measurements alone fail to identify 50% of these:

fetuses with fetal growth restriction

112

Fetal Growth Restriction is associated with a number of significant adverse perinatal outcomes:

1.Intrauterine Demise
2.Neonatal Morbidity
3.Neonatal Mortality
4. Cognitive Delay in Childhood
5. Chronic Diseases (Obesity, Type II Diabetes, CAD, Stroke in Adulthood

113

The definition of fetal growth restriction is

an EFW less than the 10th percentile for gestational age

114

the term small for gestational age (SGA) is reserved for newborns with

a birth weight less than the 10th percentile for gestational age.

115

a birth weight less than the 10th percentile for gestational age

small for gestational age (SGA)

116

EFW (est fetal weight) less than the 10th % for gestational age is called

fetal growth restriction

117

1.Intrauterine Demise
2.Neonatal Morbidity
3.Neonatal Mortality
4. Cognitive Delay in Childhood
5. Chronic Diseases (Obesity, Type II Diabetes, CAD, Stroke in Adulthood

these are perinatal outcomes associated with

fetal growth restriction

118

*** The fetal injuries associated with shoulder dystocia include which two issues? (one results in Erb-Duchenne paralysis)

fracture of the clavicle and damage to the nerves of the brachial plexus, resulting in Erb-Duchenne paralysis.

**exam

119

Of the fetal injuries associated with shoulder dystocia, a vast majority will resolve by what age?

1 year of age

**specifically erb-duchene paralysis mentioned

120

Shoulder dystocia of vaginal births is 0.2-0.3%, the risk for shoulder dystocia goes up to 9-14% if the baby is?
and then increases even higher to 20-50% if the momma has what issue?

birth weights of 4500 grams or more = 9-14% shoulder dystocia.

If momma has maternal diabetes shoulder dystocia at birth is 25-50%

(maternal diabetes babies are big!)