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33 Cards in this Set
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- 3rd side (hint)
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first trimester ultrasound what is the purpose ?
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1-Conf. of preg: observe fetus, fetal heart beat, movement; AS EARLY AS 38 DAYS AFTER LMP.
2-Detect multiples |
3-EGA: crown-rump is most reliable indicator of EGA;
4-Location of preg: within or outside of the uterus-tubal or abdominal preg |
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what are some purposes of a ultrasound in the last two trimesters?
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Estimate gestational age,
assess amniotic fluid volume, position of placenta, sex, fetal presentation, |
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what are some anomolies that can be detected with U/S in the 2nd & 3rd trimesters?
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1Neural tube defects: anencephaly, myelomeningocele
2-abdominal wall defects: gastroschisis-organs outside of body; omphalocele? 3-malformed kidneys 4-hydrocephalus 5-cleft lip and palate 6-limb abnormalities |
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what is an Alpha-feto Protein (AFP) test
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test for AFP in maternal serum and/or amniotic fluid by blood test offered at 16-18 wks.
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low levels of AFP are indicative of what?
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downs syndrome, overestimation of gest. age
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high levels of AFP are indicative of what?
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open neural tube defects (ancephaly & spina bifida)
Abdominal wall defects (gastroschisis, ompalocele) underestimation of fetal age (gest age) |
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what 3 things does the triple marker screening consist of?
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Human chorionic gonadotropin (hCG) Unconjugated estriol
MSAFP (alpha fetoprotein) |
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what is the main purpose for the triple marker test?
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Increases the detection of trisomy 18 and 21
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what causes the triple marker test to read positive (aka bad)?
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• MSAFP=low
• Estriol=low • hCG=high |
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what is Chorionic Villi Sampling (CVS)?
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a test that takes cells from the chorion (which are immature fetal cells) and let them multiply to test for genetic abnormalities
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what are the two types of CVS and how are they performed?
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Transcervical or vaginal: flexible catheter is inserted through the cervix and a sample of chorionic villi is aspirated
TransAbdominal:a needle is inserted through the abdominal and uterine walls to collect the tissue |
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what are the risks for amnio and CVS?
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miscarriage
limb reduction uterine infection RH sensitization |
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what is amniocentesis?
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Aspiration of amniotic fluid----guided by ultra sound./ Not going to do in first trimester, not enough fluid.
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what does amnio test for when performed in the 2nd trimester?
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chromosomal or metabolic abnormalities
AFP level and evaluation of fetus with an RH- mom (bilirubin level) |
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what does amnio test for when performed in the 3rd trimester?
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Diagnose fetal hemolytic disease (Rh incompatibility)
Fluid reduction w/ polyhydramnios to test for fetal lung maturity (less than 38 wks) |
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what is a Non stress test? (NST)
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Use of toco for U/C, FHR, & fetal movement. Evaluates the ability of the fetal heart to accelerate, often in association w/fetal well being
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accels are associated with ?
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• adequate oxygenation of the autonomic nervous system
• a healthy neural pathway from the fetal CNS to the fetal heart • the ability of the fetal heart to respond to stimuli |
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what are the parameters for a reactive(good) (NST) at ≥32 weeks?
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2x15x15x20----anything greater than 2 is fine as well
2 accels peaking at 15 bpm above the baseline lasting 15 seconds in 20 minutes |
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what are the parameters for a reactive (good) (NST) at <32 weeks weeks?
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2x10x10x30
2 accels peaking at 10 bpm above the baseline lasting 10 seconds in 30 minutes |
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what are the advantages of fetal kick counts?
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noninvasive, inexpensive, convenient for the client, encourages participation in care
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what are the disadvantages of fetal kick counts?
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1-A lot of variables make interpretation of fetal movements counts difficult
2-Fetal resting state normally decreases movement 3-Maternal perception of fetal movement varies considerably 4-Time of day may affect fetal movement (i.e. less in the am, greater in the pm) 5-Maternal use of drugs (sedatives, methadone, heroin, cocaine, alcohol, tobacco) may affect activity |
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what is fetal fibronectin?
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its like biological glue
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what is a CST?
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induction of uterine contractions via oxytocin to see how baby will react under pressure. identical to NST with the addition of the induced contractions.
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what are the 3 invasive tests?
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Amnio and CVS and PUBS (in utero cord blood sampling)
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what are the 4 tests that can cause harm to the fetus?
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amnio, CVS, PUbS (cord sampling), and CST
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how does the CST work?
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the FHR will respond according to reserves available:
FHR will be stable, reactive if fetus has enough 02 reserves (neg test) FHR will exhibit decels and possible ↓ variability if fetus does not have enough 02 reserves (pos test) |
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CST is contraindicated with which disorders/problems?
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Placenta previa
Preeclampsia previous classic C/S incision Preterm rupture of membranes prematurity or high risk for prematurity |
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what does a Biophysical Profile test (BPP) ?
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1-NST
2-Fetal breathing 3-Gross fetal movements (large trunk) 4-Fetal tone (small or fine body) 5-Amniotic fluid volume |
you get a score of 2 in each area for normal and 0 for abnormal.
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which parts of the BPP are acute markers and which are chronic markers?
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ACUTE MARKERS: FHR and Fetal breathing movements
Chronic Markers: Amniotic fluid volume, gross body movements, and fetal tone |
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how does the BPP work anyway?
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etal CNS and ANS centers that control some parameters of the BPP, develop at different gestational ages and react differently to hypoxemia
Earliest developed will disappear last (gross body movements, muscle tone, amniotic fluid volume) Later developing require increased oxygen levels so they disappear first (FHR and fetal breathing) |
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what are the 5 parameters of the Gradual Hypoxia Concept?
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1. Late decelerations (first sign)
2. Accelerations disappear (next sign) 3. Fetal breathing movement stops 4. Fetal movement ceases (late sign) 5. Fetal tone absent (fetus already compromised) |
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what are the scores for a normal BPP?
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8-10
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what are the scores for a equivocal BPP/
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6
(less than 4 is abnormal and delivery may be considered) |
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