42 Obstetrics and Gynecology Board Review •••
Pregnancy-related conditions:- Decreased fetal movement.
- Post-term pregnancy.
- Gestational hypertension or preeclampsia.
- Oligo/Polyhydramnios.
- Intrauterine growth restriction.
- Previous fetal demise.
- Multiple gestation.
- Isoimmunization.
❍ What aspects of the fetal condition might be predicted by antepartum testing?
Perinatal death, intrauterine growth restriction, concerning fetal status, metabolic acidosis, postnatal motor and
intellectual impairment, premature delivery, congenital abnormalities, and need for specific therapy.
❍ What medical factors place patients at risk of uteroplacental insufficiency?
Post-term pregnancy, diabetes mellitus, hypertension, previous stillbirth, severe asthma, suspected intrauterine
growth restriction, substance abuse (cocaine), advanced maternal age, cholestasis of pregnancy, abnormal analytes
(elevated inhibin, decreased PAPP-A).
❍ When can fetal heart tones first be heard via transabdominal Doppler?
10 to 12 weeks.
❍ When can fetal heart tones first be ascultated via nonelectronic fetoscope?
18 to 20 weeks.
❍ By what gestational age, should all pregnant patients begin monitoring fetal activity?
24 weeks or the currently accepted gestational age of viability.
❍ Which technique has been found to be ideal in assessing fetal movement?
Kick counts.
❍ What maternal physiologic condition is associated with decreased fetal movement?
Hypoglycemia.
❍ What is the count-to-ten approach in maternal assessment of fetal movement?
The patient should count a minimum of 10 fetal movements in a 2-hour period.
❍ What are the fetal and placental factors that influence the maternal assessment of fetal activity?
Placental location, the length of fetal movements, the amniotic fluid volume, and fetal anomalies.
❍ What placental location is associated with decreased perception of fetal movements?
Anterior.