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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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