Flashcards in Week 2 Fetal & Neonatal Assessment (everything) Deck (151)
What two techniques can be used to determine fetal macrosomia and are equally accurate?
abdominal palpation (Leopold maneuvers)
What is Macrosomia?
Macrosomia is a term that describes a baby who is born much larger than average for their gestational age, which is the number of weeks in the uterus.
The ability to predict fetal macrosomia is poor no matter the method used, what factors compound the inaccuracies? (four things)
low amniotic fluid volume, advancing gestational age, maternal obesity, and fetal position.
(bold in ppt)
What "extra" and investigational techniques have been used to "try" and more accurately predict fetal macrosomia? (bold in ppt)
(I cant blv we actually have to know these?)
fetal abdominal circumference alone, umbilical cord circumference, cheek-to-cheek diameter, and subcutaneous fat in the mid humerus, thigh, abdominal wall, and shoulder. However, these measurements remain investigational.
Despite the inaccuracy in the prediction of fetal macrosomia, an EFW should be documented by either clinical estimation or ultrasonography in WHAT group of pregnant women and What week?
in all high risk women at apprx. 38 weeks gestation.
Why is Suspected fetal macrosomia not an indication for induction of labor? (bold in ppt)
because induction does not improve maternal or fetal outcomes and may increase the risk for cesarean delivery.
at what weight does the American College of Obstetricians and Gynecologists (ACOG) recommends performance of an elective cesarean delivery?
4500g in a diabetic women and 5000g in a nondiabetic women.
at what weight in a non diabetic women would it be suggested by the ACOG to have an elective C section?
5000g fetus weight (suspected birth weight technically)
What situation can cause an otherwise expected vaginal delivery to turn into a C-section? (recommended to do C section)
a cesarean delivery is recommended in laboring women when the suspected birth weight exceeds 4500 g in the setting of a prolonged second stage of labor or arrest of descent in the second stage (bold in ppt)
What in the heck does arrest of descent mean? (talking about delivering a baby)
In an “arrest of descent”, the head of the fetus is in the same place in the birth canal during the first and second examinations, which your doctor performs one hour apart. This signifies that the baby hasn't moved farther down the birth canal within the last hour.
Does every pregnant women have regular antenatal care throughout their pregnancy?
What would be considered a low FHR and what is it associated with?
A low FHR (< 100 bpm) is associated with an increased risk for pregnancy loss, although congenital complete heart block should be excluded. (bold in ppt)
what should be excluded when a fetus has a low FHR?
CONGENITAL COMPLETE HEART BLOCK
What does nulliparous and parous women mean?
nulliparous = has not given birth
Parous = has given birth (even if to stillborn)
what week of gestation is quickening (fetal movements) reported typically by nulliparous women vs parous women? (bold in ppt)
nulliparous = 18-20 weeks
parous = 16-18 weeks
(just think it takes longer to feel the baby move if you have never had a baby before)
The presence of fetal movements is strongly correlated with what?
on average how many gross body movements per hour does the fetus exhibit? (bold in ppt)
(range of 0-130 (seems like a big weird range)
When is fetal activity (that you can feel) fewer and increased? (think times of days) (bold in ppt)
with fewer movements during the day and increased activity between 9:00 PM and 1:00 AM
Maternal factors that make someone a high risk pregnancy? (7 things listed, think pre-existing dz or dz process that can take place in pregnancy)
Preeclampsia(gestational proteinuric hypertension)
Diabetes mellitus (including gestational diabetes)
Maternal cardiac disease
Chronic Renal Disease
Chronic pulmonary disease
Active thromboembolic disease
High risk pregnancy do to fetal factors would be? (all the things that could be wrong with the fetus or bad signs)
Nonreassuring fetal testing (fetal compromise)
Fetal growth restriction
Isoimmunization (development of antibodies against
the antigens of another individual of the same species)
Known fetal structural anomaly
Prior unexplained stillbirth
What is the most common Isoimmunization when talking about mom and fetus?
rh factor incompatibility
What are Uteroplacental factors that make for a high risk pregnancy?
Premature rupture of fetal membranes
Prior classic (high vertical hysterotomy) (hysterotomy is incision in the uterus) -- always a weak spot
What is placenta previa?
occurs when a baby's placenta partially or totally covers the mother's cervix — the outlet for the uterus. Placenta previa can cause severe bleeding during pregnancy and delivery.
What is placenta abruption?
Placental abruption occurs when the placenta partly or completely separates from the inner wall of the uterus before delivery. This can decrease or block the baby's supply of oxygen and nutrients and cause heavy bleeding in the mother.
What is Vasa previa?
a condition which arises when fetal blood vessels implant into the placenta in a way that covers the internal os of the uterus.
(internal os is the opening into the cervix)
labor abnormalities increase with what?
birth weights b/w 4000 and 4499 g.
newborn and maternal morbidity increases significantly with ?
birth weights b/w 4500 and 4999 g
perinatal mortality increase w/birth weights greater than
shoulder dystocia is 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.