Chapter 30: The Biophysical Profile PPT

What’s a vital part of the clinicians examination?

Direct observation of a patient.

What kind of direct observation does ultrasound allow?

Qualitative and quantitative aspects of fetal motor behavior throughout the course of the pregnancy.

What does a clinical investigation demonstrate?

The presence of fetal physiologic processes.

—These parameters allow the clinician to determine the fetal risk for mortality and take appropriate action.

What is a method developed to detect fetal asphyxia?

Antepartum testing.

What kind of pregnancies is antepartum testing used for?

High risk pregnancies, particularly in fetuses at risk for in utero demise.

What is antepartum testing used to determine?

If a fetus should be delivered or remain in utero.

What is frequently used for fetal surveillance?

Electronic fetal monitoring, in the form of nonstress test or oxytocin challenge test.

What do these kind of electronic fetal monitoring, non stress tests, monitor the fetal heart rate in relation to?

Uterine contraction, either spontaneous (NST) or induced (OCT).

What helps identify fetal mortality risk?

Deceleration of the fetal heart rate late in the contraction cycle.

The development of real time ultrasound has made it possible to perform what kind of in utero observations?

Noninvasive.

—It helps to evaluate the fetus’s state of health.

What provides a more complete evaluation of the state of fetal health and addresses parameters of fetal well-being other than just heart rate?

The BPP.

What are the biophysical components of a nonstress test (NST) for a fetus?

• Breathing

• Movements

• Tone

• Qualitative amniotic fluid volume

What is the fetal movement pattern called where there is slow and small shifting of the fetal contour, lasting from 0.5-2 seconds?

Just-discernible movements.

What is the fetal movement pattern called where there is quick, generalized movement always initiated in limbs and sometimes spreading to neck and trunk; flexion or extension of limbs usually of large amplitude, but can be small or just discernible; movements last about one second?

Startle.

What is the fetal movement pattern called where there is whole-body movement without a distinctive pattern or sequence of body part movement?

General movements.

What is the fetal movement pattern called where it consists of a jerky contraction of diaphragm; abrupt displacement of diaphragm, thorax, and abdomen?

Hiccups.

What is the fetal movement pattern called where there is "inspiration" consisting of fluent, simultaneous movement of diaphragm (caudal direction), leading to movements of thorax (inward) and abdomen (outward)?

Breathing movements.

What is the fetal movement pattern called where there are rapid or slow movements involving extension, flexion, external and internal rotation, or abduction and adduction of an extremity without movements in other body parts?

Isolated arm or leg movements.

What is the fetal movement pattern called where displacement of the head can be small or large. Large movements may cause overextension of the fetal spine?

Isolated retroflexion of the head.

What is the fetal movement pattern called where their head may turn from a midline position to one side and back, often associated with hand-face contact?

Isolated rotation of the head.

What is the fetal movement pattern called where it is carried out at a slow velocity; occurs independently or with hand-face contact, with observable sucking?

Isolated anteflexion of the head.

What is the fetal movement pattern called where there are rhythmic bursts of regular jaw opening and closing at rate of about one per second may be followed by swallowing. Swallowing consists of displacements of tongue or larynx?

Sucking and swallowing.

What is the fetal movement pattern called where their hand slowly touches face and fingers frequently extend and flex?

Hand-face contact.

What is the fetal movement pattern called where it’s carried out at a slow speed; consists of forceful extension of back, retroflexion of head, and external rotation and elevation of arms?

Stretch.

What is the fetal movement pattern called where there is prolonged wide opening of jaws, followed by quick closure, often with retroflexion of head and sometimes elevation of arms?

Yawn.

What is the fetal movement pattern called where rotation occurs around sagittal or transverse axis; complex general movements change around transverse axis and include alternating leg movements. Leg movements with hip rotation or head followed by trunk around the longitudinal axis?

Rotation of fetus.

How can fetal breathing be visualized?

By obtaining a longitudinal sectional view with a real time scanner.

What is required to satisfy the breathing requirement of the BPP?

The presence of at least one episode of sustained fetal breathing of at least 30 seconds duration (with breath to breath intervals of less than 6 seconds) within a 30 minute observation period.

What can fail to meet the criterion for a BPP?

Shorter breathing episodes.

Why is the study of fetal movements in pregnancy important?

Because it reflects the development of the fetal CNS (Central Nervous System).

What can be seen as a function controlled by the CNS and can reflect both the neural development and possible disturbances of the CNS?

Fetal motor activity.

When are gross fetal movements considered present?

If three or more rolling movements of the trunk are observed within a 30-minute observation period.

What are movements that count in the CNS category?

Large limb movements, face and hand movements, and swallowing.

When is fetal tone considered normal?

If at least one episode of extension of extremities with return to position of flexion, or extension of the spine with return to position of flexion is visualized in the 30 minute observation period.