BPP
Name all required parameters of the BPP examination.
Fetal Breathing, Movement, Tone, Amniotic Fluid Volume (Heart rate also, but points aren't rewarded for it).
Which single biometric parameter is considered the most sensitive indicator for fetal growth restriction (IUGR), and why?
Abdominal Circumference (AC) — because it directly reflects liver size and glycogen storage, which are the first to deplete when placental perfusion is compromised.
What does fetal lung maturity depend on?
The amount of Amniotic Fluid
What vessels are found in the normal umbilical cord?
Two arteries, One Vein
What is the terminology for a placenta that is crossing over the internal cervical os?
Placenta Previa
How many seconds of breathing are required for a BPP?
30 CONTINUOUS seconds
To obtain an accurate, circular Abdominal Circumference (AC) measurement, what three anatomical structures should be visible (and what should NOT be seen)?
Fluid-filled stomach bubble, the "J-shape" or "hockey stick" of the umbilical vein joining the portal sinus, and a cross-section of the spine.
Must NOT see: Fetal kidneys (indicates the slice is too low) or heart/lungs (too high).
If there is an abnormality of Amniotic fluid, which fetal organs are most likely to blame?
Fetal Genitourinary Tract (Kidneys, Bladder, even in some cases to lungs may also be involved)
Which vessel(s) carry OXYGENATED blood to the fetus?
Umbilical Vein
If you cannot see the end of the placenta due to fetal position on an anatomy scan, what should you do to rule out a previa?
Transvaginal Ultrasound
What is the difference between fetal body movement and fetal tone?
Body movement includes a rotation of the fetal abdomen or head, essentially a full body part. Tone requires a limb (or hands opening and closing) to have a full flexion/extension movement to be recorded.
When measuring the Biparietal Diameter (BPD) at the level of the thalami and cavum septi pellucidi (CSP), how should the calipers be placed on the calvarial wall?
Outer edge of the proximal parietal bone to the inner edge of the distal parietal bone ("outer-to-inner" or "leading edge-to-leading edge").
How often does a fetus bladder typically empty?
Usually every 30 minutes, but it MUST empty at least every hour or a blockage may be suspected.
Describe the normal healthy wave form of an umbilical arterial doppler.
Continuous pulsatile flow, never falling below the baseline, no skips and no reversals.
What are the maternal and fetal surfaces of the placenta called, respectively?
Maternal: Basal Plate
Fetal: Chorionic Plate
T/F Hiccupping is considered to be normal breathing on a BPP.
True!
An estimated fetal weight (EFW) falling below which percentile threshold classifies a fetus as Small for Gestational Age (SGA) or raises concern for Intrauterine Growth Restriction (IUGR)?
Below the 10th percentile for gestational age.
What is the normal range for total AFI, and what is a normal MVP?
AFI: 5-25 cm
MVP: At least 2cm
What is the normal heart rate for a fetus between 20-38 weeks?
120-160 bpm
How does placental grading work? What does a Grade 0 Placenta look like in comparison to a Grade 3 Placenta?
Grades go from 0 being the most smooth and homogeneous, to Grade 3 being calcified, containing placental lakes and separating chorionic villi.
What week do we usually start BPP scans, and why?
Generally after 28 weeks- before this time, baby rarely or does not breathe at all.
What are the four standard biometric measurements combined to calculate Estimated Fetal Weight (EFW)?
Biparietal Diameter (BPD), Head Circumference (HC), Abdominal Circumference (AC), and Femur Length (FL).
What MVP would denote the presence of polyhydramnios (even if AFI is below 25cm?)
Greater than 8 cm indicates poly.
Where does the umbilical cord insert into the body? Where is the easiest place to identify its bifurcation?
It inserts at the fetal abdomen (belly button) and the bifurcation is shown at the level of the bladder.
The edge of the placenta should be how far away from the internal cervical os?
Must be over 2.0 cm away from the internal os to be considered safe from previa.