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Obstetric investigations - Coggle Diagram

- - - - Pertusiss (16-36 weeks)
      - COVID antyime
      - Influenza anytime
- - - - BMI
      - BP
      - Urinalysis
    - - FBC
      - Blood group
      - Antibody screening
      - HIV
      - Hepatitis B,C
      - Syphilis
      - Rubella
      - VZV - not every hospital
    - - Toxoplasmosis
      - CMV
      - TFT
  - - - Determine estimated due date (EDD)
      - Measure number of fetus
      - Size fetus - Crown Rump Length <14 w
      - Assess risk for congenital abnormalities
    - - High risk pts
        
        Nuchal translucency
        
        Serum PAPP-A
        
        Beta-hCG
        
        Chorionic villous Sampling - CVS
        
        Amniocentesis
        
        Foetal blood sampling
        
        Cordocentesis
        
        Foetal ECHO
      - Non Invasive Prenatal Test
        NIPT
        
        Optional
- - - - Based on foetal biometry
        
        BPD: Biparietal diameter
        
        HC Head circumference
        
        AC abdominal Circumference
        
        FL Femur length
        
        AFI Amniotic fluid index
        Normal limit :
      - Screening
        
        SGA
        
        LGA
        
        IUGR
    - - Based on deepest vertical pool
        2cm o more
    - - Umbilical Artery Doppler (UAD)
        
        Interpretation
        
        High resistance
        
        Evidence of placentala dysfunction - need surveillance
        
        Absent end diastolic flow
        
        Likely need delivery
        
        Reversed end diastolic flow
        
        Urgent delivery
        
        Normal
        
        Indications
        
        PET
        
        FGR
        
        SGA
        
        Hypertensive disorders of pregnancy
      - Middle Cerebral Artery (MCA)
        
        Low resistance
        
        Brain sparing effect
        
        Use
        
        Assess severe fetal growth restriction and foetal anaemia
      - Ductus Venosus (DV)
        
        Use
        
        Measure cardiac function in extreme preterm fetus (<28w)
        Not routine - requires expertsie
    - - After 24 weeks
  - - - One or more episodes of rhythmic foetal breathing movements of 30 seconds or more within 30 min
    - - ≥ 3 discrete body or limb movemements within 30min
    - - ≥ 1 episodes of extension of foeal extremity with return to flexion, or opening / closing of a hand
    - - Singel deepest vertical pocket greater than 2cm and less than 8cm
    - - Score of 2 for each normal response
        0 for abnormal response
      - Normal BPP 8/8
        Abnormal <8
  - - - Every 2 weeks
    - - 1 / 2 per week depending on foetal growth
    - - Anytime - at every scan
- - - - (LMP + 1year + 7 days) - 3 months
      - LMP + 7days + 9 months
  - - - Pts who could not determine LMP
      - Pts with irregular cycle
      - Pts who conceive <3 months after stopping contraception
- - - - From 10 weeks - Early
    - - 1-2%
    - - Oromandibular limb hypoplasia
      - Mosaicism
    - - Placental tissue by transcervical method
  - - - After 15 weeks
    - - 0.5%
    - - Talipes
      - Infection
    - - Amniotic fluid transabdominally
- - - - Send MSU C&S
    - - DDX renal stones if severe abdominal pain
    - - Ddx Pre-eclampsia
    - - Ddx dehydration
        HG
      - CAreful assessmen if Type 2 diabetic
- - - - Normal
    - - Borderline
        Repeat in 30-60min if not delivered
    - - Abnormal
        Deliver by forceps, ventouse or CS