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  1. #1
    Monsoonrain's Avatar
    Monsoonrain is offline Member 510 points
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    which one is correct?

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    A G1P1 at 38wks present to you with 36 hrs of no fetal movement?Previously on 37 th week everything was perfect. Doppler found Fetal Heart Motion.What is the most likely next best step of management?

    a) Induction of labor.
    b) Do NST
    c) Do BPP
    d) Tell the mother she can get pregnant again.
    Prevention is better than cure

  2. #2
    Ojelade's Avatar
    Ojelade is offline Newbie 510 points
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    At this point you want to check the status of the fetus with a real time USS which would correspond with a Biophysical Profile(Choice C).
    This patient is already at term having completed 37 weeks. The next course of action depends on what the BPP reveals.

  3. #3
    IMG SURVIVOR's Avatar
    IMG SURVIVOR is offline Moderator 536 points
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    nice and whats this?
    Biophysical Profile
    Moderator: USMLE AND Residency Forums.

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    why even bother with the obvious. Just know where you are need it and where you can help the most.

  4. #4
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    student-2 is offline Senior Member 510 points
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    BPP, I think the doppler that was done already already constitutes the NST, correct me if I am wrong

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    Bubbamier is offline Newbie 510 points
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    Bpp

    The BPP consists of 5 different tests 4 done by USG and the NST:
    - NST
    - Fetal movements (USG)
    - Fetal respiratory movements
    - Fetal Tone
    - Amniotic fluid quantity. (Some people also measure the AFI amniotic fluid index)
    The NST: it is a procedure done by cardio-tochography, in which the physician evaluates, the fetal heart rate and movements. It is named non stress test because there is no contractions or ociticin (no stress on the fetus).
    -------------------
    Dr. Mier
    -------------------

  6. #6
    BrotherMan's Avatar
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    I would make a venture of C
    But when I start to feel that pull, turns out I just pulled myself-Weezer

    Ah, you don't want to deal with patients- Words of a wise pathologist

  7. #7
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    AUCMD2006 is offline Ultimate Member 6129 points
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    it is B. you want to see if the NST is reactive before going to a full BPP. if the NST is non reactive then you do a full BPP. also dopler has heart motion but it doesn;t give you rate in the question...FHT of 120-160 are different than 90's if they are low you go to deliver surgically
    AUCMD2006
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  8. #8
    veleznic is offline Newbie 510 points
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    I think B is the right answer...because if you have decrease fetal movements then you should do first NST...but if you have no movement at all for some time then you should do sono to see the fetal heart rate....since it says that it has fetal heart rate...then choice b should be correct answer.

  9. #9
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    It is B. Do a NST first and then a BPP if it is needed. The original questions mentions heart sounds via doppler but as mentioned above there is no rate mentioned. The standard is a NST then a BPP if needed.

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