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19 Cards in this Set
- Front
- Back
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Define term pregnancy.
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37.0-41.6 wks
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What are two reasons LMP is inaccurate when used alone to date a pregnancy?
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Incorrect recall
variable follicular phase/ovulation date |
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When should dating ultrasound be offered to all pregnant women? why?
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11-14wks
reduces post-dates pregnancies |
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When is first trimester ultrasound dating used instead of LMP dating to determine EDC?
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if the ultrasound date disagrees by > 5 days
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When is second trimester ultrasound dating used instead of LMP dating to determine EDC?
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if the ultrasound date disagrees by > 10 days
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By establishing accurate dates, first trimester ultrasound has been shown to:
a) increase or decrease the number of post-term pregnancies? b) increase or decrease the number of labour inductions for post-term status? |
a) decrease
b) decrease |
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List RF for post-term pregnancy
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previous post-term pregnancy (OR 2-3)
nulliparity male fetus obesity caucasian race |
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What maternal and fetal risks do post-term pregnancies carry?
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IUFD/neonatal death (absolute and relative)
increased meconium stained fluid/aspiration lower cord pH lower APGAR scores shoulder dystocia macrosomia higher C/S rate higher operative vag delivery rate increased perineal lacerations |
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Relative to term gestations, what is the risk of perinatal mortality to a >=42wks gestation?
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double the risk of perinatal death
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Induction of labour at 41.0 has been shown to
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decrease perinatal mortality (RR 0.3)
decrease/not increase C/S rate increase patient satisfaction |
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When should women be offered induction of labour and counselled as to the risks of continuing expectant management?
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41.0-42.0 weeks
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How many inductions at 41.0 weeks would be required to prevent 1 perinatal death?
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About 500
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What has membrane sweeping been shown to do?
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reduce the rate of post-term pregnancies and induction for post-term pregnancy
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What are the established risks of membrane sweeping?
is infection increased? |
uncomplicated PV bleeding
patient discomfort no (no evidence it is) |
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What is the NNT for membrane sweeping to reduce 1 post-term induction of labour?
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8
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When should post-term monitoring be started?
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41.0
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What options are there for monitoring post-term pregnancies?
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fetal movement counting
non-stress test biophysical profile modified biophysical profile (non-stress test plus amniotic fluid volume estimation) contraction stress test |
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What does SOGC recommend for antenatal fetal surveillance in post-term pregnancy?
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From 41.0 weeks, twice-weekly monitoring by at least
NST amniotic fluid assessment (this is based on case studies and expert opinion) |
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In the presence of intact membranes in post-term pregnancy, how long can it take amniotic fluid to go from normal to severely reduced?
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24-48h
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