1. Prenatal Assessment - Prof. Gonen ניטור טרום לידתי פרופ' רון גונן

2. Prenatal Assessment - Prof. Gonen CST = Contraction Stress Test 3 contractions / 10 min Interpretation No decelerations = NEGATIVE Decelerations > 50% contractions = POSITIVE False Negative – 0.4/1000 False Positive – up to 50% Time consuming

3. Prenatal Assessment - Prof. Gonen CST

4. Prenatal Assessment - Prof. Gonen Non Stress Test (NST)

5. Prenatal Assessment - Prof. Gonen NST – Non Stress Test Reactive: 2 accelerations in 20 minutes –> 15 BPM –> 15 seconds Non Reactive –DD: Fetal sleep –Continue 70 min. or –Repeat

6. Prenatal Assessment - Prof. Gonen Reactive NST = Normal

7. Prenatal Assessment - Prof. Gonen NST False Negative – 3.2/1000 False Positive – Up to 75% If Non Reactive – additional tests

8. Prenatal Assessment - Prof. Gonen Biophysical Profile Score  30 minutes observation Fetal Breathing Movements Gross Body Movements Fetal Tone Reactive Fetal Heart Rate Amniotic Fluid Volume

9. Prenatal Assessment - Prof. Gonen Fetal Breathing Movements Normal (Score = 2 points) At least one episode of at least 30 min. duration During 30 min. observation

10. Prenatal Assessment - Prof. Gonen Gross Body Movements Normal (Score = 2 points) At least 3 body / limb movements During 30 min. observation

11. Prenatal Assessment - Prof. Gonen Fetal Tone Normal (Score = 2 points) At least 1 episode of active extension with return to flexion of fetal limbs /trunk During 30 min. observation

12. Prenatal Assessment - Prof. Gonen Reactive Fetal Heart Rate > 2 accelerations in 20 minutes > 15 BPM > 15 seconds

13. Prenatal Assessment - Prof. Gonen Amniotic Fluid Normal (Score = 2 points) At least one vertical pocket of amniotic fluid that measures at least 2 cm.

14. Prenatal Assessment - Prof. Gonen management  8-10: Normal  6: Repeat  < 4: Consider delivery False Negative < 1/1000 False Positive < 20% Perinatal Mortality 3.5/1000

15. Prenatal Assessment - Prof. Gonen Modified BPS NST + AFI AFI – Sum of greatest AF pockets in 4 quadrants of maternal abdomen. (without fetal parts or cord)  < 4 severe oligohydramnion  < 7 oligohydramnion

16. Prenatal Assessment - Prof. Gonen AFI

17. Prenatal Assessment - Prof. Gonen Normal Values of AFI

18. Prenatal Assessment - Prof. Gonen The End