High Risk OB + Monitoring

Question 1

Placenta Previa
TOD
AFS

Answer 1

36-37.6
no recommendation

Question 2

Accretta
TOD
AFS

Answer 2

34-35.6
individualized

Question 3

Vasa Previa
TOD
AFS

Answer 3

34-term
individualized

Question 4

Prior Classical or
Prior uterine rupture
TOD

Answer 4

36-term

Question 5

Prior Myomectomy requiring CD
TOD

Answer 5

term

Question 6

Polyhydramnios
TOD
AFS

Answer 6

39-40.6
once or twice weekly, 32-34 range

Question 7

Oligohydramnios
TOD
AFS
TOD same as previa

Answer 7

36-37.6
once or twice weekly… start at dx

Question 8

Di-Di
Di-Di with growth restoration
Di-Di + condition
TOD
AFS
AFS- complicated

Answer 8

38th week
36 to 37.6
individualized

NST weekly at 36 weeks
diagnosis, complicated

Question 9

Mo-Di
Mo-di with growth restriction
TOD
AFS

Answer 9

34 to 37.6
32 to 34.6

weekly at 32 weeks

Question 10

Mo-Mo
TOD
AFS

Answer 10

32 to 34

individualized

Question 11

CHTN
No meds
With meds
Difficult to control
AFS - controlled
AFS-poor control or other conditions

Answer 11

38 to 39.6
37 to 39.6
36 to 37.6

weekly at 32 weeks
individualized

Question 12

GHTN/Pre-eclampsia
non severe
AFS

Answer 12

37 weeks

Twice weekly at diagnosis

Question 13

GHTN/Pre-eclampsia - severe
AFS

Answer 13

34 weeks or at diagnosis
Daily

Question 14

HELLP syndrome

Answer 14

after maternal stabilization

Question 15

Pre-eclampsia severe before viability

Answer 15

after maternal stabilization

Question 16

Pregestational DM
AFS

Answer 16

39th week
twice weekly at 32 weeks

Question 17

Pregestational DM
poor control or
with vascular compromise or
with prior still birth

Answer 17

before 39th week
36 to 38.6

Question 18

GDM A2 well controlled

Answer 18

39th week

Question 19

GDM: poor control
AFS

Answer 19

individualized
twice weekly at 32 weeks

Question 20

GDM A1
AFS

Answer 20

39 to 40.6
no AFS recommended

Question 21

HIV
Viral load > 1,000 intact membranes
Viral load <1,000 intact membranes on HRT

Answer 21

38 weeks
39 weeks

Question 22

Cholestasis
Bile acids >100 MICRO MOLES
Bile acids < 100

AFS

Answer 22

36 weeks
36 to 39.0

twice weekly at diagnosis

Question 23

Fetal Growth Restriction
1. Uncomplicated
2. Severe
3. Abnormal UA Doppler (increased impedance)
4. Absent UA doppler
5. Reverse UA doppler

AFS
*comanage with MFM

Answer 23

1. 38-39.6
2. 37 weeks
3. 37 weeks
4. 33-34.0
5. 30-32.0

UAD elevated: twice weekly
UAD absent of additional comp- twice weekly. Comanage with MFM

Question 24

FGR + maternal condition or olig

Answer 24

Wide range… 34 to 37.6

Question 25

Decreased FM AFS

Answer 25

NST once at diagnosis

Question 26

Prior stillbirth >32 weeks AFS Prior stillbirth < 32 weeks AFS

Answer 26

once weekly, start at 32 weeks individualized... start within 1 week of the IUFD

Question 27

Late term AFS

Answer 27

NST @ 41 weeks and AFI

Question 28

Prior FGR infant in prior pregnancy requiring preterm delivery AFS

Answer 28

NST at 32 weeks, weekly

Question 29

IVF AFS

Answer 29

NST at 36 weekly

Question 30

APS or Sickle Cell AFS SLE

Answer 30

twice weekly at 32 weeks

Question 31

Renal Disease Cr > 1.4 AFS

Answer 31

twice weekly at 32 weeks

Question 32

Polysubstance abuse AFS Etoh> 5 drinks / week AFS

Answer 32

individualized NST at 36 weekly

Question 33

Velamentous cord insertion AFS SUA AFS

Answer 33

NST at 36 weekly

Question 34

Chronic placenta abruption AFS

Answer 34

once or twice weekly at diagnosis