2. I’M SORRY, I CAN’T INTERPRET SOME OF THE PICTURE HERE!!!BUT I’LL TRY MY BEST!!!
3. AIMS OF FETAL MONITORING Assessment of fetal well-being especially in high-risk mother Assessments of fetal growth Identification of fetal abnormalities and condition in all stages of pregnancy Determination of gestational period To ensure a safe delivery
13. FETAL KICK CHART Commonest methods – Cardiff ‘count to ten’ Start count at 9am every morning Record the time taken for baby to move 10 times Normal fetal activity-little variation in time taken ↓ fetal activity [fetal compromise] - delay in time taken Benefit: detection of fetal compromise, more easier and cheap Limitation: Maternal anxiety is common, unsure of movement, is a crude guide and sometimes inconsistent
18. DIAGNOSTIC ULTRASOUND SCAN - 2 dimensional map of content of uterus. - Image constantly updated in real time and fetal cardiac and other movement can be studied. - < 12 weeks usage oftransvaginaltransducer. - > 12 weeks usage of abdominal transducer. - Good image depend on operator skill. - Disadvantages : Bio effects on cells, inducing heating.
20. Age Assessment Early Problems Measurement Amniotic Fluid Volume Symmetry Umbilical Cord Abnormalities Growth Weight Invasive Procedure Anatomy Location Morphology
21. EARLY PREGNANCY PROBLEMS - transvaginal ultrasound role in diagnosis of disorder in early pregnancy. E.g. miscarriage - fetus present, absent fetal heart E.g. ectopic pregnancy - absent of gestational sac within uterus
23. FETAL MEASUREMENT Common = relatively ‘spared’ in growth restriction Sensitive = organ that are sensitive to changes to any factor that cause IUGR [liver/spleen]
31. GESTATIONAL AGE ASSESSMENT CRL/BPD these measurements are plotted on the normogram Predictions of gestational age by ultrasound scan before 20 weeks is more accurate than predictions from last menstrual period. Measurements are done at least 2 week apart Measurements are plotted in centile-charts against a normogram
51. Doppler Uterine Artery Waveforms Assessment of uterine artery waveforms at 24th weeks’ gestation. Benefits: Even at absence of risk factors, severely abnormal waveforms identify 75% of pregnancies at risk of adverse neonatal outcome in early 3rd trimester. Limitations: Less effective at prediction of later problems.
76. Meconium Stained Liquor Sign of fetal compromise Can only be diagnose during labour, or only after the membrane have been ruptured May be due to Intestinal hurry Spontaneous dilatation of anal sphincters Manifestations of foetal hypoxia.
