RT Book, Section
A1 Jobe, Alan H.
A2 Rudolph, Colin D.
A2 Rudolph, Abraham M.
A2 Lister, George E.
A2 First, Lewis R.
A2 Gershon, Anne A.
SR Print(0)
ID 6733926
T1 Chapter 39. Care of the Fetus
T2 Rudolph's Pediatrics, 22e
YR 2011
FD 2011
PB The McGraw-Hill Companies
PP New York, NY
SN 978-0-07-149723-7
LK accesspediatrics.mhmedical.com/content.aspx?aid=6733926
RD 2024/04/19
AB The  goals  of  prenatal  care  are  to  assess  pregnancy  and  fetal  risks  and  to  monitor  the  pregnancy  to  optimize  the  chances  for  a  good  outcome.  Ideally,  a  pregnancy  is  planned,  and  counseling  and  health  assessments  can  begin  before  the  fetus  is  conceived.  There  are  risk  assessment  tools  for  evaluating  the  mother’s  family  and  medical  history,  previous  pregnancy  history,  and  the  progress  of  this  pregnancy.1  Currently,  most  women  receive  a  level  1  fetal  ultrasound  before  20  weeks’  gestation  to  assess  gestational  age,  screen  the  fetus  for  anomalies,  determine  placental  position,  and  identify  multiple  births.  A  level  1  ultrasound  obtained  prior  to  20  weeks  is  more  accurate  than  the  date  of  the  last  menstrual  period  to  determine  gestational  age.  The  early  screening  ultrasound  is  not  intended  to  identify  more  subtle  structural  abnormalities.  If  anomalies  are  noted,  the  woman  will  be  referred  for  a  complete  ultrasound  evaluation  of  the  fetus  using  more  sensitive  equipment  and  expert  evaluations.  In  the  United  States  it  is  now  unusual  for  infants  to  deliver  with  major  skeletal,  cardiac,  or  other  internal  organ  structural  anomalies  that  have  not  been  identified  prior  to  delivery.  Common  chromosome  anomalies  such  as  trisomy  21  also  have  structural  signatures  that  can  be  identified  by  early  gestational  ultrasound.  The  genetic  abnormality  then  can  be  verified  by  amniocentesis.  An  accurate  early  assessment  of  gestational  age  is  the  cornerstone  for  subsequent  monitoring  of  the  pregnancy  and  decisions  about  the  timing  of  delivery.