Ob Fetal Assessment - Beck

Front 1

First trimester is when?

Back 1

up to 14 weeks

Front 2

what is chorionic villus sampling?

Back 2

removes a small piece of tissue (chorionic villi) from the uterus and about 10-13 weeks to screen for genetic defects

may indicate any of more than 200 disorders

done under ultrasound

Front 3

risk occurrences of CVS?

Back 3

only slightly higher than amniocentesis.

Fetal loss occurs about 2% of the time

Front 4

risks of CVS - what should be reported to provider?

Back 4

excessive bleeding
excessive vaginal mucous
fever
abdominal cramping
miscarriage

Front 5

what are the possible complications of CVS?

Back 5

ROM
Spontaneous Ab (miscarriage)
infection
bleeding
Rh incompatibility in the mother
contamination of the sample with maternal cells

Front 6

ultrasound

basic screening done for:

Back 6

determining fetal age, (do asap)
fetal presentation
fetal viability (alive)
placenta localization
AFI (2nd and 3rd trimester)

or to R/O ectopic pregnancy

Front 7

Comprehensive ultrasound scan (Level II US)

when is it done?
who does it?

Back 7

after 16 weeks

performed by perinatologists

Front 8

Why do a comprehensive U/S scan?

Back 8

detects fetal abnormalities, genetic disorders

Front 9

What is anacephaly?

Back 9

no brain, no skull

not compatible with life
die within hours to days of birth

Front 10

Non-invasive U/S is called:

Invasive U/S is called:

Back 10

non-invasive is abdominal

invasive is called intravaginal U/S

Front 11

Lemon-shaped skull is a marker for what?

Back 11

Open Neural Tube Defects

Front 12

What is mylemingeocele?

Back 12

The spine is open and outside the body

Front 13

What are extra digits called?

Back 13

polydactyl

Front 14

what is club foot?

Back 14

foot is turned inward

Front 15

What's the role of the nurse in U/S?

Back 15

counseling
client education
performing scans

Front 16

When is 2nd trimester?

Back 16

14-28 weeks

Front 17

When is Amniocentesis performed?

Back 17

2nd trimester, ideally 16 weeks

Front 18

How is amnio performed?

Back 18

under U/S

obtains fetal cells directly from amniotic fluid

Front 19

When is amnio indicated?

Back 19

Dx genetic disorders
Dx congenital anomalies
assessing fetal lung maturity
AMA > 35

Front 20

Alpha-Fetoprotein (aka triple screen)

what does it test for?

Back 20

Downs syndrome,
ONTD
Trisomy 18

Front 21

AFP -

Does it require consent?
Does it require counseling?
What's the major drawback?

Back 21

Does not rquire consent
Does require counseling prior
has a lot of false positives

Front 22

When is AFP performed?

possible outcome with positive results?

Back 22

14021 weeks

termination possible with positive results - so counseling should be available

Front 23

Maternal factors for AFP?

Back 23

age,
race
weight
insulin dependent diabetic
estimated gestational age

Front 24

why do an u/s in the 3rd trimester?

Back 24

viability
BPP
macrosomia (>9 lbs)
IUGR
Fetal position
placenta localization
AFI
amniocentesis for lung maturity

Front 25

What's a BPP?

When is a BPP done?

Why is a BPP done?

Back 25

Biophysical Profile

last trimester of pregnancy (32-34 weeks or earlier)

high risk pregnancies
some women may have a BPP test q week or twice a week in the 3rd trimester

Front 26

Indications for a BPP?

Back 26

bleeding problems
chronic kidney disease
diabetes
chronic HTN/preeclampsia
oligohydramnios (too little fluid)
Polyhydramnios (too much fluid)
multiple gestation
pregnancy beyond due date (between 40-42 weeks)

Front 27

What does a BPP score reflect?

Back 27

Fetal tone - muscle
fetal breathing movement
fetal movement
amniotic fluid evaluation
non-stress test

score of 2 if normal
score of 1 if decreased
score of 0 = absent

10 is good score

if <7 may repeat next day - may even admit

if score is real low, get the baby out

Front 28

External Fetal Monitoring

monitors what?

Back 28

contractions and fetal heart rate

Front 29

Mom's monitor is called what?

Baby's monitor is called what?

Back 29

Toco (tocodynamometer)

U/S transducer - placed over baby's heart

Front 30

Non-Stress test - do when and on whom?

Back 30

after 30 weeks - can do on anybody

non-invasive, no clinical contraindications

Front 31

NST - is reactive good or bad result?

Back 31

Reactive is good result

Non-reactive is bad result.

*there should be NO decelerations in the FHR during test

Front 32

Reactive means how many fetal heart accelerations in what time period?

Back 32

2 accelerations in a 20 minute window

15 beats above baseline - sustained for 15 seconds

Front 33

Non-reactive means?

Back 33

no fetal accelerations noted in a 20 minute window with movement

Front 34

what is a contraction stress test?

where is it done?

what does it mean?

Back 34

invasive procedure - pitocin administered via infusion pump to elicit contractions

Positive result = compromised fetus

Front 35

What are indications for CST?

Back 35

non-reactive NST

Front 36

What are contraindications for CST?
(basically of Pitocin)

Back 36

ruptured membranes
previous classical C/S (incision up and down
preterm labor
hydramnios
incompetent cervix
placenta previa
abruptio placentae

Front 37

what is a kicks count and how is it done?

Back 37

mother counts the kicks

done at the same time each day - usually after mom eats

usually done in last trimester and in post date pregnancies

Front 38

Good kicks count?

Back 38

Normal/reassuring = 10 movements in 12 hours