Recommended
More Related Content
Similar to Antenatal Fetal monitoring.ppt
Similar to Antenatal Fetal monitoring.ppt (20)
More from taneja_poonam
Recently uploaded
Recently uploaded (20)
Antenatal Fetal monitoring.ppt
- 2. Antenatal Fetal monitoring Aim Forecast that the fetus is well To avoid fetal death Timely delivery of sick fetus
- 3. When is AN fetal monitoring required? Ideally in every pregnancy But may not be feasible/affordable
- 4. When is AN fetal monitoring required? So, only in special situations The special situations are Maternal Placental Fetal
- 5. Maternal indications Pre eclampsia Diabetes mellitus Hypertensive disorders Elderly primigravida Post-datism and post-term H/O intrauterine death in previous pregnancy Antiphospholipid antibody syndrome
- 6. Placental indications Placenta praevia Abruptio placentae
- 7. Fetal indications IUGR Rh isoimmunisation Non immune hydrops Twins – discordance Suspected chorioamnionitis Oligohydramnios
- 8. When to start? Prognosis for neonatal survival 32 weeks What is the underlying pathology or severity of maternal condition
- 9. Indirect indicators of fetal well being Ante natal checkups • Weight gain • BP • Size of uterus • Quantity of liquor • Fetal movements while examining
- 10. Fetal well being in late pregnancy Biophysical Amniocentesis Biochemical
- 11. Fetal well being in late pregnancy Biophysical Fetal movements count (DFMC) Non stress test (NST) Acoustic stimulation test Biophysical profile Modifies biophysical profile Contraction stress test Fetal cardiotocography Umbilical artery Doppler velocimetry Ultrasonography
- 12. Biophysical performance Depends on CNS function So Hypoxia Acidosis CNS depression
- 13. Fetal movements Cardiff count to 10 DFMC (Daily Fetal Movements Count)
- 14. Fetal movements Absent fetal movements Fetal death in 24 hrs
- 15. Non Stress Test Principle Reactive NST Non reactive NST
- 17. Reactive NST
- 18. NST-non reactive Hypoxia Fetal sleep cycle Maternal sedation
- 19. NST-useless acute fetal events Cord prolapse Placental abruption Meconium aspiration Uterine hyperstimulation
- 20. Acoustic Stimulation Test Acoustic stimulus
- 21. Biophysical profile five parameters score of 2 or 0
- 22. Biophysical profile (Manning’s) NST Fetal breathing Fetal movements Fetal tone Amniotic fluid volume
- 23. Biophysical profile NST 2 accelerations >15 bpm >15 secs in 20 min
- 24. Biophysical profile Fetal breathing >1 episode of breathing lasting for 30 secs within 30 min
- 25. Biophysical profile Fetal movements >3 discrete body movements 30 min
- 26. Biophysical profile Fetal tone > 1 episode of extension
- 27. Biophysical profile Amniotic fluid volume Single vertical pocket >2cm
- 28. Biophysical profile Total score < 4-immediate action 4-6 repeat 8 and above good (amniotic fluid volume is most important)
- 29. Modified Biophysical profile why ? NST AFI
- 30. Amniotic fluid volume AFI Principle AFI AFI < 5cm-abnormal
- 31. Contraction Stress Test Principle Test of uteroplacental function Methodology
- 35. Contraction Stress Test Interpretation Negative Positive Suspicious Hyperstimulation Unsatisfactory
- 37. Umbilical artery Doppler Velocimetry
- 38. Umbilical artery Doppler Velocimetry
- 39. Umbilical artery Doppler Velocimetry S/D ratio RI PI
- 40. Fetal cardiotocography Basal heart rate Beat to beat variability Periodic heart rate function
- 41. Fetal cardiotocography Basal heart rate 110-160 bpm
- 44. Fetal cardiotocography Beat to beat variability Change in HR from one beat to other
- 45. Fetal cardiotocography Beat to beat variability
- 47. Fetal cardiotocography Periodic heart rate function Acceleration Early deceleration Late deceleration Variable deceleration
- 48. Fetal well being in late pregnancy amniocentesis Pulmonary maturity Rh isoimmunization
- 49. Biochemical Tests Urinary / plasma estriol Plasma hPL
- 50. Intrapartum fetal monitoring FHR auscultation <120 >160
- 51. Intrapartum fetal monitoring Fetal cardiotocography
- 53. Fetal Scalp Blood Sampling
- 54. Fetal Scalp Blood Sampling Can be performed only after rupture of membranes
- 55. Fetal Scalp Blood Sampling Drop of blood is collected in a heparinised capillary tube from the fetal scalp
- 56. Fetal Scalp Blood Sampling pH of the scalp blood is promptly measured
- 57. Fetal Scalp Blood Sampling pH > 7.25 – no acidosis
- 58. Fetal Scalp Blood Sampling pH - 7.20 – 7.25 : repeat after 30 min
- 59. Fetal Scalp Blood Sampling pH < 7.20 – repeat immediately If same result deliver
- 60. Intrapartum fetal monitoring Fetal pulse oximetry <30% persisting for more than 10 min hypoxia
- 61. Thank you