Fetal Surveillance & Fetal Distress

Question 1

Causes of stillbirth

Answer 1

Chronic placental insufficiency
Actute placental insufficiency:
Abruptio placenta, placenta previa
Infection
Unexplained

Question 2

Acute events that occur suddenly may not be identifiable by antepartum testing such as:

Answer 2

Cord accident
Abruptio placenta
Hydrops fetalis
Intrauterine infection

Question 3

Candidates for testing

Answer 3

Pts with DM
Chronic HTN
Autoimmune disease
Maternal CHD
Maternal hypothyroidism
(All around 32-34 wks)
Post date pregnancy at 42 wks

Question 4

Conditions that need urgent testing at the time of diagnosis

Answer 4

PET
Suspected IUGR
Discordinate twins

Question 5

Progressing fetal hypoxia can be detected by changes in :

Answer 5

Fetal heart rate
Amniotic fluid volume
Fetal behavior
Fetal umbilical artery blood velocity

Question 6

Antepartum fetal surveillance techniques :

Answer 6

FM count
Non stress test (NST)
Contracting stress test (CST)
Biophysical profiles (BPP)
Amniotic fluid index
Doppler velocimetry

Question 7

Causes if decrease variability in non stress test:

Answer 7

Fetal hypoxia
Drugs (alcohol, opiates, pethidine, diazepam.)
Premature
Fetal sleep (but not longer >30 min)
CNS & Cardiac abnormality

Question 8

Causes of ++ variability

Answer 8

It is called sinusoidal pattern dt:
Severe fetal anemia (e.g in Rh isoimmunization, bleeding from vasaprevia)
Hypoxia of fetal myocardium

Question 9

Causes of fetal tachycardia

Answer 9

Idiopathic
Prematuritry
Infection
Maternal pyrexia
Maternal thyrotoxicosis
Drugs (B sympathomemtics)

Question 10

Causes of fetal bradycardia

Answer 10

Idiopathic
Asphyxia
Fetal cardiac dysarrhythmias and cardiac anomalies
Fetal hge
Drugs (morphine, local anasthesia, digoxin)

Question 11

Expain CST

Answer 11

It evaluates fetal O2 reserves in the present of uterine contraction

Question 12

Absolute contraindications to CST:

Answer 12

Classical C/S and other uterine surgery with exception LSCS
Placenta previa

Question 13

Types of fetal heart deceleration

Answer 13

Early deceleration
Late deceleration
Variable deceleration

Question 14

Which deceleration associated with UPI:

Answer 14

Late deceleration

Question 15

Deceleration that is dt head compression

Answer 15

Early deceleration

Question 16

Deceleration that has no consistent relationship to uterine contractions and it is usually dt **transient compression of the umbilical cord

Answer 16

Variable deceleration

Question 17

If variable deceleration is prolonged and reccurent, may be associated with

Answer 17

Fetal acidosis

Question 18

V shaped deceleration:

Answer 18

Early

Question 19

It occurs during a contraction and is over by the end of contractuon

Answer 19

Early

Question 20

It begins after the beginning of the contraction, and recovery occurs after the contraction is finished

Answer 20

Late
Often with slow return to base line

Question 21

Late deceleration is associated with

Answer 21

IUGR, PET, DM, Abruptio placenta, and maternal hypotension

Question 22

Which deceleration is normal

Answer 22

Early

Question 23

Biophysical profile items:

Answer 23

Fetal breathing movement
Fetal gross movement
Fetal tone
Amniotic fluid index
Non stress test

Question 24

In Doppler, blood flow, abesnt, or even reverse flow at the end of diastole are strongly suggestive of

Answer 24

Fetal hypoxia

Question 25

Monitor fetal well-being in labor by:

Answer 25

Intermittent auscultation by fetostethscope Continues electronic fetal heart monitoring Fetal scalp ph

Question 26

Mothod for performing Continues FHR in labor

Answer 26

**External FHR monitoring** Uses doppler device ro detect **movement of fetal cardiac valve** or movement of blodd in **fetal heart and vessels** **Internal** By using small electrode applied to fetal scalp (a fetal ECG is obtained)

Question 27

Causes of acute fetal distress

Answer 27

Abruptio placenta and cord prolapse

Question 28

Effects of hypoxia on the fetus

Answer 28

• Neurological abnormalities: **cerebral palsy & mental retardation • Fetal death : can result from **severe intrapartum asphyxia**

Question 29

The dx of suspected fetal distress in labor by:

Answer 29

CTG abnormalities

Question 30

In management of fetal distress **vaginal examination** should be performed to exclude:

Answer 30

Cord prolapses or rapid progess to full dilatation (PPT labor)

Question 31

Main indication for fetal scalp sampling:

Answer 31

Abnormal CTG

Question 32

Factors that may reduce the threshold to carry out a fetal scalp sampling:

Answer 32

Meconium staining Post term Suspected IUGR