A 1-4 page document written by a final year medical student with distinction grades in the uploaded modules. These notes are concise and of very high quality - using a combination of textbooks, lectures, and current guidelines (NICE and RCOG). These documents are the only resource you should need f...
Different eet ods of eeas uring foetal welleeing are us ed at different s tages of p regnanc and deliver v
Antep artue Surveillance
Antepartum = During pregnancy (before childbirth)
Onl indicated in p regnancies high-risk for uteroplacental insufciencn, ivev
- Maternal dis eas e (HTN, CKD, CVD, DM, Anaeeia, Collagen dis eas e )
- Advanced eaternal age
- IUGR
- Multip le p regnanc
- Pos t-tere p regnanc
- R is oieeunis ation
- Antep artue aeeorr age
Non-stress test (NST)/Cardiotocographn (CTG)
Meas ured via an external monitor (Doppler)
C ange in foetal HR p atern wit tiee refects t e eaturit of foetal autonoeic nervous s s tee
Advantages : Non-invas ive, eas to p erfore, readil availaele, c eap
Dis advantages : Suejective interp retation
Res ults :
- Reactive non-stress test (R-NST) = Reas s uring
- Non-reactive non-stress test (NR-NST) = Worris oee, as s ociated wit p oor p erinatal outcoee in 20%
of p regnancies
Variations /eoderations :
- Contraction stress test (CST)
o Artificial uterine contractions induced to s ee FHR res p ons e
o At leas t 3 contractions are needed in 10 einutes for t is tes t
o Negative CST = no deceleration wit contractions
o Pos itive CST = Severel variaele OR Late decelerations wit t e eajorit of contractions
o Dis advantages – p recip itates foetal dis tres s , tiee-cons ueing, requires s killed nurs ing s taff
- Vibro-acoustic stimulation
o A tes t w ic eeas ures t e res p ons e of FHR to a viero-acous tic s tieulus v
o Pos itive res ult = Acceleration on NST >15ep e for >15s ecs
Biophnsical profle (BPP)
Sonograp ic (ivev wit USS) s coring s s tee w ic as s es s es foetal welleeing
5 variaeles are eeas ured:
- Non-stress test (NST)
- Amniotic fuid volume (AFV) most important
- Foetal movement (FM)
- Foetal tone (FT)
- Foetal breathing (FB)
Eac variaele is given a s core
- 2 p oints = p res ent/noreal
- 0 p oints = aes ent/aenoreal
Recoeeended eanageeent is eas ed on t e BPP as s o:
- 8-10 points (normal) No intervention
- 6 points (suspected asphyxia) Rep eat in 4-6 rs v Cons ider deliver for oligo draenios
- 4 points (suspected asphyxia) Rep eat in 4-6 rs (if <36 weeks ) or Urgent deliver (if >36 weeks )
- 0-2 points (high suspicion of asphyxia) Tes t for 120eins to confire t en Urgent deliver
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