Antenatal Assessment of Fetal WellBeing
Common indications for antepartum fetal monitoring;
1. Pregnancy with obstetric complication
IGUR
Multiple pregnancy
Polyhydraminos
Oligohyramnios
Rhesus alloimmunization
Asphyxia
2. Pregnancy with medical complication
DM, HTN, Epilepsy, Renal or Cardiac disease infection (tuberculosis), LSE.
3. Others
Advanced maternal age >35years
Previous still birth
Recurrent abortion
Congenital defect
Cystic fibrosis
Anencephaly
Spina bifida
Chromosomal abnormalities
Teratogenic disorder (due to drug)
4. Routine
Antenatal testing
Aims of antenatal fetal monitoring
1. To ensure growth and development and well being of fetus throughout pregnancy.
2. To screen out high risk factor that affect growth of fetus.
Clinical evaluation of fetal well being at antenatal clinic
1. Maternal weight gain
Excess weight gain due to excess fluid retention (first sign of pre-eclampsia).
Weigh gain less than normal; intrauterine growth restriction
2. Blood pressure
Recording blood pressure; help to differentiate pre-existing chronic hypertension from pregnancy induced hypertension.
Imapir fetal growth.
3. Assessment of size of uterus and height of fundus
Calculate gestational age
To do measurement for fetal growth restriction.
4. Clinical assessment of excess liquor
Evidence of scanty liquor; indicate placental insufficiency .
5. Abdominal examination
Documentation of girth of abdomen in last trimester of pregnancy.
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