Assessment of fetal wellbeing
during pregnancy
Dr Suhaila Al-Shaikh
Learning objectives
• To be able to assess the fetus in utero and say
confidently it’s health is good or bad
• Understand the fetal heart pattern changes and
discriminate the abnormalities
• Outline the role of U/S in assessment of fetal
condition
• Understand CTG and Doppler study and their
role in fetal assessment and management in
high risk pregnancies to avoid adverse outcomes
Methods for fetal assessment
• Fetal heart auscultation
• Fetal movements counting
• U/S , Biophysical profile
• CTG
• Ultrasound Doppler study
Visible fetal movement through the
abdomen and kick count
•
https://www.youtube.com/watch?v=gFf1sVxa
xSA&t=1s
•
https://www.youtube.com/watch?v=2E7i00hk
17Q
CASE STUDY 1
An 18 yrs old woman in her 1
st
pregnancy, at
32 wks gestation attend the antenatal care
clinic complaining of reduced fetal movements
and activity for 2 days duration
How can you manage her?
Fetal heart auscultation
•
https://www.youtube.com/watch?v=bMAe44
n5AyU
•
https://www.youtube.com/watch?v=J4FeCJup
bOk
Obstetric U/S
U/S CAN BE USED FOR
• ASSESS VIABILITY
• GA
• NO. OF FETUSES
• FETAL SIZE AND GROWTH
• DX OF FETAL ABNORMALITY
• PLACENTAL LOCALIZATION
• AMNIOTIC FLUID VOLUME
• BIOPHYSICAL PROFILE & DOPPLER STUDY
CASE STUDY 2
An 18 yrs old woman in her 1
st
pregnancy, at 34
wks gestation attend the antenatal care clinic
for routine check up, the doctor notice that her
fundal height is 30 cm
What is your comment?
What is the role of U/S to help the doctor in
her management?
CASE STUDY 3
An 18 yrs old woman in her 1
st
pregnancy, at 34
wks gestation attend the antenatal care clinic
for routine check up, the doctor notice that her
fundal height is 30 cm
The doctor decided to perform CTG test
Q/ what is CTG?
Q/ what are the normal findings of CTG?
Q/ if abnormal CTG what is your next step?
Normal CTG
1. baseline fetal heart 120-160 BPM
2. Baseline variability (5-25) beats
around the mean
3. The are accelerations
4. No decelerations
Doppler study
Doppler study of fetal vessels
• MCA
• UA
• C/P ratio