This document discusses fetal surveillance in high-risk pregnancies due to conditions like pre-eclampsia. It notes that fetal monitoring is important to monitor for risks like premature delivery, growth restriction, and fetal distress or death. It outlines methods for monitoring fetal growth like symphysiofundal height measurements and ultrasound scans, and for monitoring fetal well-being like ultrasound biophysical profiles, Doppler studies, and cardiotocography (CTG) monitoring during labor. The goal of monitoring is to detect any problems early to optimize outcomes for both mother and baby.

1. FETAL SURVEILLANCE IN
HDP
DR NAZIMAH IDRIS
O&G
HOSPITAL ALOR SETAR

2. WHY DO WE NEED TO
MONITOR?

3. FETAL RISK
PREMATURE DELIVERY
GROWTH RESTRICTION
PREMATURE DELIVERY AND
GROWTH RESTRICTION
IUD

4. FETAL RISK - cont.
PRE-ECLAMPSIA > GESTATIONAL
HYPERTENSION
ECLAMPSIA - RISK OF ACUTE
ASPHYXIA IN AN ALREADY
COMPROMISED FETUS

5. MONITORING
GROWTH
WELL-BEING

6. ANTEPARTUM MONITORING FETAL GROWTH
SYMPHYSIOFUNDAL HEIGHT
MEASUREMENT - FROM 22-24W, AT
EVERY ANTENATAL VISIT
ULTRASOUND SCANNING - BPD,
FL,HC,AC,AFI. DONE SERIALLY
MATERNAL WEIGHT GAIN - LIMITED
VALUE

7. ANTEPARTUM MONITORING FETAL WELL-BEING
ULTRASOUND - FETAL BIOPHYSICAL
PROFILE - FHR, FETAL TONE, FETAL
BREATHING MOVEMENTS, AMNIOTIC
FLUID INDEX AND CTG. MODIFIED:
CTG,AFI.
DOPPLER STUDIES - ABSCENCE OR
REVERSED END DIASTOLIC FLOW IN
UMBILICAL ARTERY IS ASSC.WITH POOR
FETAL DIFFUSION AND HYPOXIA.

8. FETAL WELL BEING - cont.
FMC - CHEAP, EASY, MOTHER’S
PARTICIPATION
CTG
FHR - PINARD’S STETHOSCOPE

9. FETAL MONITORING
DURING LABOUR
INTERMITTENT AUSCULTATION EVERY 15 MIN AT END OF
CONTRACTION
CTG - PREFERABLY CONTINUOUSLY
FETAL BLOOD SAMPLING - WHEN
AVAILABLE

10. FETAL MONITORING
DURING LABOUR
INTERMITTENT AUSCULTATION EVERY 15 MIN AT END OF
CONTRACTION
CTG - PREFERABLY CONTINUOUSLY
FETAL BLOOD SAMPLING - WHEN
AVAILABLE