> ASSESSMENT OF FETAL GROWTH

Question 1

predict the outcome of pregnancy
manage the remaining weeks of pregnancy
plan for possible complications at birth
plan for problems that may occur in the newborn infant
decide whether to continue the pregnancy
find condition that may affect future pregnancies

Answer 1

a. reasons for the tests for fetal growth and development:

Question 2

ask for prepregnant health history
gestational diabetes, heart diseases
drugs she is taking
nutritional intake
personal habits such as nicotine and alcohol intake
unintentional injuries and domestic violence

Answer 2

b. health history:

Question 3

maternal weight and general appearance
bruises: indicates domestic violence which could have harmed the fetus
elevated blood pressure

Answer 3

c. physical examination

Question 4

__ weeks: pubic symphysis
__ weeks: umbilicus
__ weeks: xiphoid process
FUNDAL HEIGHT

Answer 4

12, 20, 36

Question 5

18-20 weeks, peaks in intensity at 28-38 weeks

Answer 5

Fetal Movement (measured using doppler instrument)

Question 6

audible only through doppler Fetal Heart Tones

Answer 6

10th-12th week:

Question 7

audible using ordinary stethoscope Fetal Heart Tones

Answer 7

16th-20th week:

Question 8

measures the response of sound waves against solid objects
used to diagnose pregnancy as early as 6 weeks gestation
confirms the presence, size, and location of the placenta and amniotic fluid
established a fetus is growing and has no gross anomalies (hydrocephalus, anencephaly <absence> , or spinal cord heart, kidney, or bladder concerns)
establish the sex presentation and position of the fetus
predict gestational age; discover complications of pregnancy such as presence of IUD, hydramnios, oligohydramnios, ectopic pregnancy, etc.
used to detect a retained placenta or poor uterine involution in the new mother after labor
must be done with full bladder to hold uterus stable</absence>

Answer 8

Ultrasonography

Question 9

side-by-side measurement of the fetal head to predict fetal maturity

Answer 9

BIPARIETAL DIAMETE

Question 10

measures the velocity at which red blood cells in the urine and fetal vessels travel + determines vascular resistance present in women with gestational diabetes,

and whether resultant placental insufficiency is occurring (decreased velocity indicates uterine growth restriction—only limited amount of nutrients reach the fetus)

Answer 10

DOPPLER UMBILICAL VELOCIMETRY -

Question 11

graded based on the particular amount of calcium deposit present in the base

Answer 11

PLACENTAL GRADING FOR MATURITY

Question 12

b/w 12-24 weeks

Answer 12

0

Question 13

30-32 weeks

Answer 13

1

Question 14

36 weeks

Answer 14

2

Question 15

38 weeks

Answer 15

3

Question 16

• portion of the fluid is formed by the fetal kidney output + inadequate amniotic fluid can cause fetus stress, circulatory and kidney function is failing

Answer 16

AMNIOTIC FLUID VOLUME

Question 17

• pocket of fats or fluids found in the posterior neck seen (sonogram) in children with number of chromosomal abnormalities

Answer 17

NUCHAL TRANSLUCENCY

Question 18

identifies the structural anomalies or soft tissue disorder
not harmful to mother nor the fetus
helps in diagnosing complications like ectopic pregnancy or trophoblastic disease

Answer 18

MRI (Magnetic Resonance Imaging)

Question 19

AFP: a substance produced by the fetal liver that can be found in both amniotic fluid and maternal serum
high level of abnormality if fetus has an open spinal or abdominal defect because it allows more AFP to enter the mother’s circulation than usual
low level if fetoprotein indicates chromosomal abnormalities such as Down Syndrome

Answer 19

MSAF (Maternal Serum a-Fetoprotein)

Question 20

protein secreted by the placenta
low levels in maternal blood are associated with fetal chromosomal anomalies including trisomies 13, 18, and 21 or small for gestational age (SGA) babies
high PAPP-A level may predict a large for gestational age (LGA) baby

Answer 20

MATERNAL SERUM FOR PREGNANCY - ASSOCIATED PLASMA PROTEIN (PAPP-A)

Question 21

requires only a simple venipuncture of the mother
analyzes 4 indicators of fetal health:
1.) AFP;
2.) Unconjugated estriol (UE: enzyme produced by the placenta estimates general well-being)
3.) hCG (produced by the placenta) 1st hormone
4. Inhibin A (produced by the placenta and corpus luteum associated with down syndrome)

Answer 21

Quadruple Screening

Question 22

procedure used to extract amniotic fluid

Answer 22

Amniocentesis:

Question 23

also called CORDOCENTESIS ot FUNICENTESSIS; aspiration of blood from the Umbilical vein for analysis using a thin needle guided by ultrasound; studies CBC, direct Coombs test, blood gasses, and karyotyping)

Answer 23

Percutaneous Umbilical Blood Sampling (PUBS)

Question 24

fetus is visualized by inspection through a fetoscope (hollow tube inserted by amniocentesis technique) + allows a direct visualization of the fetus + (pic) + procedure can be done on the 16th to 18th week

Answer 24

Fetoscopy:

Question 25

from 8 weeks to term

Answer 25

Fetal -