Scribd Logo
Upload

Welcome to Scribd!

  • 4 views

    Fetal Assessment and Fetal Well Being

    Uploaded by

    Shoaib Akhtar

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd

    Fetal Assessment and Fetal Well Being

    Uploaded by

    Shoaib Akhtar
    4 views22 pages

    Copyright

    © © All Rights Reserved

    Available Formats

    PPTX, PDF, TXT or read online from Scribd

    Did you find this document useful?

    Is this content inappropriate?

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    4 views22 pages

    Fetal Assessment and Fetal Well Being

    Uploaded by

    Shoaib Akhtar

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    of 22

    Fetal Assessment

    DR. SAIMA ASHRAF


    M.B.B.S (Gold medalist), F.C.P.S (Gold medalist), AdCMT
    Associate Professor
    Head of Department. Gynae Unit III
    Nishtar Medical University Multan
    Aims of Fetal Assessment

    1. To ensure satisfactory growth and well being of fetus.

    2. To screen risk factors that affect the growth.

    3. To avoid fetal death.


    Early Pregnancy Assessment
    Ultrasound
    1. Early dating scan 10^6 weeks to 13^6 weeks
    2. Anomaly scan 18^6 weeks to 22 weeks
    We access by scan
    Gestational Amenorrhea
    Heart Activity
    Amniotic Fluid
    OBS Ultrasound
    Amniotic Fluid

    Accessed in 2nd and Early 3rd Trimester

    1. Maximum vertical pool

    2. Amniotic fluid index(10-25 cm)

     Less than 10 cm(Reduced amniotic fluid)

     Less than 5 cm(Oligo hydromnios)

     Greater than 25 cm(Poly hydromnios)


    Cardiotocograph

    Continuous tracing of fetal heart rate(30


    minutes)
    It includes four parameters
    1. Base line heart rate(110-160 BPM)
    2. Base line variability
    3. Accelerations
    4. Decelerations
    Base line heart rate

     110-160 bpm ( Normal)

     Less than 110 bpm

    (Bradycardia)

     Greater than 160

    bpm(Tachycardia)
    Variability

     Beat to beat variability in one


    minute strip

     Difference between highest and


    lowest beat

     Normal 5-25 bpm


    Accelerations

     Increase in heart rate of 15 bpm


    in 15 s

     2 or 3 accelerations in a normal
    CTG trace
    Decelerations
     Decrease in heart rate of 15 bpm
    in 15 s

     There should be no deceleration


    in a normal CTG trace
    Interpretation of CTG

    Interpretation Features
    Normal All four features are
    normal
    Suspicious One feature is abnormal
    Pathological Two or more features
    abnormal
    Biophysical Profile

    A biophysical profile is a way to check on


    overall fetal health. It consists of two
    painless, noninvasive tests: fetal
    monitoring and ultrasound. Typically, it
    takes about 30 to 70 minutes to complete
    Scoring System
    Parameter Score 2 Score 0
    Non-stress CTG Reactive Fewer than two
    accelerations in 40 minutes
    Fetal breathing movements ≥ 30 movements in 30 Fewer than 30 seconds of
    minutes fetal breathing in 30
    minutes

    Fetal body movements ≥ 3 movements in 30 Two of fewer gross body


    minutes movements in 30 minutes

    Fetal tone One episode of limb No evidence of fetal


    flexion movement or flexion
    Amniotic fluid volume Large cord free pocket Less than 1 cm pocket of
    over 1 cm fluid
    Interpretation
    Score Interpretation It is time

    8-10 Normal consuming and


    affected by fetal

    0,2,4 Abnormal sleep activity that’s


    why it is not

    6 Repeat reliable.
    Doppler Study

     Used to access placental insufficiency

     It gives idea of resistance to blood flow

    It includes

     Umbilical Artery Doppler

     Middle Cerebral Artery Doppler

     Uterine Artery Doppler


    Abnormal UA Doppler Waveform depends on the
    severity of disease

    Normal pregnancy Reduced end diastolic


    velocity

    Absent end diastolic velocity Reversed end diastolic


    velocity
    Invasive Procedures

    These are used to access the karyotype for different genetic diseases

     Amniocentesis

     Chorionic Villous Sampling

     Cordocentesis
    Amniocentesis

     Done at 15 weeks

     Risk od miscarriage is 1%
    Chorionic Villous Sampling

     Done at 11 weeks

     Risk of miscarriage is 1-2 %


    Cordocentesis

     Done at 20 weeks

     To see Alloimmune Thrombopenia

     Risk of miscarriage is 2-5%


    Dr. Saima Ashraf
    Head of Department. Gynae Unit III
    Nishtar Medical University Multan

    You might also like