Transvaginal fetalgrowthand fetalgrowthand wellbeing

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Unformatted text preview: n at 36 weeks. C If the transabdominal scan is unclear, If a transvaginal scan should be offered. transvaginal Fetal growth and Fetal growth and well­being Abdominal palpation for Abdominal palpation for fetal presentation Fetal presentation should be Fetal assessed by abdominal palpation at 36 weeks or later, palpation when presentation is likely to influence the plans for the C birth. Abdominal palpation for fetal presentation Routine assessment of presentation by abdominal palpation should not be offered before 36 weeks should because it is not always accurate and may be uncomfortable. accurate uncomfortable C Suspected fetal malpresentation Suspected should be confirmed by ultrasound. ultrasound Measurement of Measurement of symphysis–fundal distance Pregnant women should be offered Pregnant estimation of fetal size at each antenatal fetal appointment to detect small- or large-for A gestational- age infants. gestational Symphysis–fundal height should be Symphysis–fundal measured and plotted at each antenatal appointment. appointment. Routine monitoring of Routine monitoring of fetal movements Routine formal Routine fetal-movement counting should not be offered. should A Auscultation of fetal Auscultation of fetal heart Auscultation of the fetal heart Auscultation may confirm that the fetus is alive but is unlikely to have any predictive value any D and routine listening is therefore not recommended. therefore Auscultation of fetal heart When requested by the When mother, auscultation of the fetal heart may provide reassurance. reassurance D Cardiotocography Cardiotocography The evidence does not support the The does routine use of antenatal electronic fetal heart rate monitoring fetal (cardiotocography) for fetal assessment in women with an uncomplicated pregnancy and therefore it should not be offered. it A Ultrasound assessment Ultrasound assessment in the third trimester The evidence does not support The the routine use of ultrasound scanning after 24 weeks’ scanning gestation and therefore it should not be offered. A should Umbilical artery Umbilical artery Doppler ultrasound The use of umbilical artery The umbilical Doppler ultrasound for the prediction of fetal growth restriction should not be restriction A offered routinely. offered Uterine artery Doppler ultrasound The use of uterine artery uterine Doppler ultrasound for the prediction of pre eclampsia prediction should not be offered B routinely. routinely. Pregnancy after 41 weeks Pregnancy after 41 weeks Prior to formal induction of Prior labour, women should be offered a vaginal examination for membrane sweeping. sweeping. Women with uncomplicated Women pregnancies should be offered induction of labour beyond 41 A weeks. weeks. Breech presentation at term Breech presentation at term 1. 2. 2. 3. 3. 4. 4. 5. 5. All women who have an uncomplicated All singleton breech pregnancy at 36 weeks’ gestation should be offered external cephalic version (ECV). version A Exceptions include : women in labour, and women a uterine scar or abnormality; uterine fetal compromise; fetal ruptured membranes; ruptured vaginal bleeding....
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