Antenatal assessment of fetal wellbeing. Noninvasive and invasive methods. Ultrasound significance. Fetal growth disorders: macrosomia and intrauterine growth restriction. Rh isoimunisation.

1. Antenatal assessment of fetal
wellbeing. Noninvasive and invasive
methods. Ultrasound significance. Fetal
growth disorders: macrosomia and
intrauterine growth restriction. Rh
isoimunisation.

2. Antenatal or
prenatal care
Antental or prenatal is the systematic
supervision of a woman during
pregnancy.

3. What to
think about
during the
pregnancy?
The determination of
the wellbeing of the
newborn.
The importance of the
mother history.

4. What are our areas of
concern:
• Risk factors
• Fetal well-being assessment
• Assessment of complications
• Education
• Birth care options

5. General assessment:
Hight
Weight
Pallor
Jaundice
Vital signs

6. Warnings signs of
pregnancy:
Anaemia
Diabetes
Poor nutrition

7. Complications
Premature
rupture of the
fetal membranes.
Bleeding in early
and late
pregnancy.
Pre-eclampsia
and eclampsia.

8. Noninvasive
methods:
• NIPT or NIPS
• Analyzing cf-DNA from the placenta
provides an opportunity for early detection
of certain genetic abnormalities.

9. Invasive methods:
• Chorionic villous sampling
• Amniocentesis
• Fetal blood sampling

10. Advanced prenatal
genetic testing:
https://youtu.be/bvVrFSBnbvM

11. Down syndrome
Trysomy 18
Trysomy 13

12. Ultrasound:
• Developing fetus, uterus and
placenta
• The health of their baby
• Gestational age
• Multiple pregnancies
• Congenital anomalies
• Problems with the placenta
• Fetal position and fetal growth
• The level of amniotic fluid

13. Problems
with the
Placenta
Placenta Previa
Placenta Accreta
Placenta Increta
Placenta Percreta

15. Types of ultrasound:
• Transvaginal ultrasound
• 3-D ultrasound
• 4-D ultrasound
• Fetal echocardiography

16. Macrosomia:
• A baby who is diagnosed as having fetal
macrosomia weighs more than 8 pounds, 13
ounces.
• Large fundal height.
• Excessive amniotic fluid (polyhydramnios).

17. Intrauterine
growth
restriction:
• The baby in the womb (a fetus) does not grow as
expected.
• Fetus doesn't get enough nutrients and
nourishment.
• The problem is mainly with placenta or the
umbilical cord.
• Prenatal ultrasound.
• Fetal monitoring to track the baby's heart rate and
movement.
• Amniocentesis to look for genetic causes of IUGR.

18. Rh isoimunisation:
• If the mother is Rh negative and the father is Rh positive,
the baby has at least a 50% chance of being Rh positive.
• It can happen if the baby’s Rh positive blood enters the
mother's blood flow.
• The mother's antibodies could affect a future pregnancy
with a baby with Rh-positive blood even if the blood is not
mixed.
• Rh immune globulin at week 28 of the pregnancy.

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20. References:
• https://www.mayoclinic.org/diseases-conditions/fetal-
macrosomia/symptoms-causes/syc-20372579
• https://kidshealth.org/en/parents/iugr.html
• https://www.bila.ca/2018/02/the-importance-of-ultrasound-in-
pregnancy/
• https://medlineplus.gov/genetics/understanding/testing/nipt/
• https://youtu.be/bvVrFSBnbvM
• https://www.winchesterhospital.org/health-library/article?id=11595