By Punit S. Bhojani

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However preterm labor can also be there due to polyhydramnios. • Pseudoshoulder dystocia is seen as the soft head/face can slip through incompletely dilated cervix. Classically, fetuses with spina bifida have one or more of the following cranial signs on USG: 1. Small biparietal diameter. 2. Ventriculomegaly 3. Frontal bone scalloping or the so-called lemon sign. 4. Elongation and downward displacement of the cerebellum, the so-called banana sign. 5. Effacement or obliteration of the cisterna magna.

Beat-to-Beat Variability • Normal beat to beat variability should be 6–25 beats/minute. • Diminished beat-to-beat variability can be an ominous sign and may indicate a seriously compromised fetus. • Loss of beat-to-beat variability along with decelerations is associated with fetal acidemia. • A common cause of diminished beat-to-beat variability is analgesic drugs given during labor. • A large variety of CNS depressant drugs like narcotics, barbiturates, phenothiazines, tranquilizers, general anesthetics, and magnesium sulfate can cause transient diminished beat-to-beat variability.

Genetic predisposition and vascular interruption may contribute to this. There is a strong association between Moebius syndrome and antenatal use of misoprostol. Misoprostol is thought to cause an ischemic event in the embryonic brainstem early in gestation. Exposure to ergotamine, thalidomide, cocaine during early fetal development has also been implicated in several cases of Moebius syndrome. , Pg. 354–5. com. Highest cardiac output is seen:  a. After delivery b. Second trimester c. First trimester d.

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