Fetus is another patient needs to be given adequate attention and importance to find out whether it is alright or sick. This presentation will give a brief skeleton of tests to be done.

1. Dr.Suresh Babu Chaduvula
Department of OBGYN
NRIIMS, Vizag.

2.  Assessment of fetal well being in-utero
before the onset of labor

3.  1. To prevent fetal death
 2. to prevent unnecessary interventions

4.  1. Maternal conditions:
Hypertension
Diabetes
Epilepsy
Kidney diseases
Heart Disease
Acute febrile illness
Anti-phospholipid syndrome
Collagen vascular disease
Sickle cell disease

5.  Fetal Indications:
Intrauterine growth restriction
Rh iso-immunisation
Fetal Cardiac arrhythmias
Hydrops fetalis
Fetal infection

6.  Pregnancy related conditions:
Preeclampsia
Multiple pregnancy
Post term pregnancy
Abnormal fetal movements
Placental abruption
Oligo or Polyhydramnios
Unexplained still births
Bad Obstetric History

7.  1. Clinical
 2. Biochemical
 3. Biophysical

8.  Monitoring is recommended when estimated
fetal maturity is sufficient to expect a
reasonable chance of survival

9.  1. Daily fetal movement score Or Cardiff kick
count – minimum of 10 movements per day
 2. Fundal growth
 3. Symphysio-fundal height
 4. Abdominal girth

10.  To assess pulmonary maturity:
 Lecithin Sphingomyelin ratio > 2 indicates
pulmonary maturity

11.  BPD
 FL
 HC
 AC

12.  1. Non Stress Test
 2. Vibro-acoustic test
 3. Contraction test
 4. Biophysical profile [ Manning score ]
 5. Modified Biophysical profile
 6. Doppler Blood flow study
 7. Fetal Scalp PH

13.  20 mts test
 2 fetal movements
 20 beats rise
 20 seconds sustenance
 Done by CTG machine
 Inference – Reactive / Non Reactive

14.  For sleeping baby
 Look for fetal heart rise like in NST

15.  Time consuming
 Oxytocin infusion
 Wail till 3 good contractions and look for late
deceletaions
 Inference – negative / Positive

16.  30 mts test
 5 components
NST
Amniotic fluid index
Fetal breathing count
Gross body movements
Fetal tone
Each compoment will score 2
Inference: 10/10 good
6/ 10 equivocal and 4/10 poor

17.  NST
 Amniotic fluid index

18.  Umbilical arteries are focused
 MCA
 Ductus Venosus and Umblical veins
 Inference:
 S/D ratio - > 2 abnormal
 Resistance index [RI]
 Pulsatile Index [PI]
 Absent diastolic flow
 Reversed diastolic flow

19.  Normal – 7.25
 Preacidemia – 7.21 -7.25
 Acidemia - < 7.21

20. Thank You All