ASSESSING Fetal

well-being
C. Assessing Fetal Well-Being
1. Fetal movement –

a. Sandovsky method : felt by the mother ( quickening ) begins

approximately 18 to 20 weeks of pregnancy and peaks at 28 to 38
weeks.
- a healthy fetus moves at least 10x/day.
how to assess fetal movement:
* let the mother lie in recumbent position after a meal
* record how many fetal movements she feels over the next
hour. ( min. twice every 10 min or an average of 10-12 x/hour)
* if less than 10 movements let the mother
repeat the test for the next half hour.
* if still less within two hours – call hlth care provider
another protocol ….
b. Cardiff method ( count-to-Ten)
* the mother records the time interval it takes for her to
feel 10 fetal movements. Usually, this occurs within 60
minutes.
2. Fetal Heart Rate ( FHR )

FHR beat
- 120 to 160 per minute whole
pregnancy
- can be heard and counted
as early as 10th to 11th week
of pregnancy by doppler
tech.
- fetal heart rate of less than
90 bpm is high risk for
miscarriage at 5 to 8 weeks
of pregnancy
• Variability is categorized as:

a. Absent ( none apparent)

b. Minimal ( extremely small fluctuations)
c. Moderate ( amplitude range of 6-25 beats
per minute )
d. Marked ( amplitude range over 25 beats)
• If a 20-minute period passes without
any fetal movement, it may mean only
that the fetus is sleeping.

• If the mother is given an oral

carbohydrate snack, such as orange
juice, her blood glucose level may
increase enough to cause fetal
movement.
11. Triple Screening
- or analysis of three indicators ( MSAFP, unconjugated
estriol, and hCG)
- done to yield even more reliable results.
12. Chorionic Villi Sampling
- a biopsy and chromosomal analysis of chorionic villi
that is done at 10 to 12 weeks of pregnancy.
14. Percutaneous
Umbilical Blood
Sampling
- the aspiration of
blood from the
umbilical vein for
anaylsis.
- if fetus is found to
be anemic, blood may
be transfused using
the same procedure.
15. Amnioscopy
- the visual inspection of the amniotic fluid through the cervix
and membranes with an amnioscope ( a small fetoscope ).
- use to detect meconium staining.
• 16. Fetoscopy
• - fetus is visualized by
inspection through a
fetoscope ( an extremely
narrow, hollow tube inserted
by amniocentesis technique).
• -used for the following
purposes:
• * to confirm the
intactness of the spinal
column.
• * to obtain biopsy
samples of the fetal tissue
and fetal blood samples
• * to perform elemental
surgery
• 17. Biophysical Profile
• - combines five parameters ( fetal reactivity, fetal
breathing movements, fetal body movement, fetal tone,
and amniotic fluid volume) into one assessment.