Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

OB > 12. Lab Testing and Antepartal Fetal Surveillance > Flashcards

12. Lab Testing and Antepartal Fetal Surveillance Flashcards

(83 cards)

Start Studying
1
Q

Purpose of test: Blood Grouping

A

To determine blood type and Rh

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Purpose of test: Hemoglobin or Hematocrit

A

To detect anemia. (Often checked several times during pregnancy)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Purpose of test: CBC

A

Complete Blood Count:

To detect infection, anemia, or cell abnormalities

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Purpose of test: Rh Factor and Antibody Screen

A

To screen for possible maternal-fetal blood incompatibility

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Purpose of test: VDRL or RPR

A

To screen for syphillis

Venereal Disease Research Laboratory, Rapid Plasma Reagin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Purpose of test: Rubella Titer

A

To determine immunity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Purpose of test: Tuberculin Skin Test

A

To screen for tuberculosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Purpose of test: Hemoglobin Electrophoresis

A

To screen for sickle-cell trait (if client is African-American

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Purpose of test: Hepatitis B

A

To detect presence of antigens in Maternal Blood

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Purpose of test: HIV screen

A

Voluntary test encouraged to detect HIV antibodies

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Purpose of test: Urinalysis

A

To detect renal disease or infection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Purpose of test: Papanicolau Test

A

To screen for cervical neoplasia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Purpose of test: Cervical Culture

A

To detect group B strep and STDs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Purpose of test: Triple Screen

A

To screen for fetal anomalies

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What three tests comprise a “Triple Screen”

A
  • Maternal serum alpha-fetorotein
  • Human Chorionic Gonadotropin
  • Estriol
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Purpose of test: Maternal Blood Glucose

A

To screen for gestational diabetes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Test Significance / Course of Action: Blood Grouping

A

Identifies possible causes of incompatibility with the blood of the fetus that may cause jaundice

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Test Significance / Course of Action: Hemoglobin or Hematocrit

A

Hgb < 11 g/dL or Hct < 33% may indicate a need for iron supplementation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Test Significance / Course of Action: CBC

A

12,000 mm3 or more white blood cells or decreased platelets require follow-up

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Test Significance / Course of Action: Rh Factor and antibody screen

A

If mother is Rh (-) and Father is Rh (+) or antibodies are present, additional testing and treatment are required.

(If mom is negative, RhoGAM will be given at 26-28 weeks)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Test Significance / Course of Action: VDRL and RPR

A

Treat if positive; retest at 36 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Test Significance / Course of Action: Rubella Titer

A

If titer is 1:8 or less, mother is not immune. Immunize post-partum if not immune.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Test Significance / Course of Action: Hemoglobin Electrophoresis

A

If mother is positive, check partner. Infant is at risk only if both parents are positive.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Test Significance / Course of Action: Hepatitis B

A

If present, infants should be given hepatitis immune globulin and vaccine soon after birth.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
HIV Screen
Positive results require retesting, counseling, and treatment to lower infant infection
26
Test Significance / Course of Action: Urinalysis
Requires further assessment if positive for more than trace: * Protein (renal damage, preeclampsia, or normal) * Glucose (diabetes or normal) * Ketones (Fasting or dehydration) * Bacteria (Infection)
27
Test Significance / Course of Action: Pap Test
Treat and refer ib abnormal cells are present
28
Test Significance / Course of Action: Cervical Culture
* Treat and retest as necessary. | * Treat GBS during labor.
29
Test Significance / Course of Action: Triple Screen
Abnormal results may indicate Down Syndrome or neural tube defects.
30
Test Significance / Course of Action: Maternal Blood Glucose
If elevated, a 3-hour glucose tolerance test is recommended.
31
Test to be done in the 1st trimester
nuchal translucency screening +PAPP-A
32
When should the MSAFP Triple / Quad Screen be administered?
15-22 weeks
33
When should an ultrasound to check fetal anatomy be administered?
18-20 weeks
34
What five tests should be done at the 28 week visit?
* CBC * Antibody screen * RPR (Rapid plasma regain) * GCT * Rhogam
35
What four tests should be done at the 36 week visit?
* CBC * RPR (Rapid plasma regain) * GC/CT * GBS vaginal culture
36
What does MSAFP stand for
Maternal screen for Alpha-Fetoprotein
37
What is AFP?
Alpha-Fetoprotein: the main protein in fetal plasma
38
Where is AFP?
* Diffuses from fetal plasma into fetal urine and is excreted into the amniotic fluid. * Some AFP crosses placental membranes into the maternal circulation. Therefore, AFP can be measured both in maternal serum (MSAFP) and amniotic fluid (AFAPFP)
39
Abnormal concentrations of AFP -- implications
Associated with serious fetal anomalies, requiring additional testing to determine the reason for the abnormal concentration.
40
Levels associated with neural tube defects
Elevated AFP indicates NFP
41
Levels associated with down's syndrome (3)
* Low AFP * Low Estriol * Elevated hCG
42
Recommendations: Abnormal triple screen (3)
* Genetic counseling * Ultrasound * Amniocentesis TRIPLE SCREEN IS NOT DIAGNOSTIC
43
Amniocentesis (def)
Aspiration of amniotic fluid, wihch contains fetal cells
44
When is an amniocentesis typically performed?
After 14 weeks, in 3rd trimester
45
Purpose of amniocentesis (3)
DIAGNOSIS of prenatal anomalies • Genetic disorders / anomalies • Pulmonary maturity (3rd trimester) • Fetal hemolytic disease
46
Indications of amniocentesis (5)
* Maternal age >35 * History of child with chromosomal abnormality * Family history of chromosomal abnormalities * Inherited disorders of metabolism * Abnormal triple screen
47
Complications involved with an amniocentesis: Prevalence
• Occur in <1% of cases
48
Complications involved with an amniocentesis: Maternal
Hemorrhage
49
Complications involved with an amniocentesis: Fetal (6)
``` Fetal death secondary to... • Hemorrhage • Infection • Direct injury from needle • Miscarriage • PTL • Leakage of fluid ```
50
Chorionic villus sampling: Purpose
DIAGNOSTIC TOOL | • Used to diagnose fetal chromosome or metabolic abnormalities
51
Chorionic Villus sampling: What can it NOT diagnose?
• Cannot diagnose anomalies for which amniotic fluid is essential (eg open neural tube defects, which require measuring AFP levels)
52
Chorionic Villus sampling: Method
* Removal of small tissue specimen from fetal portion of the placenta * Performed transcervically or transabdominally
53
Chorionic Villus sampling: Benefit
• Allows for early diagnosis and rapid results
54
Chorionic Villus sampling:When performed
10-12 weeks
55
Chorionic Villus sampling: Complications (6)
* Vaginal spotting or bleeding * Miscarriage (0.3%) * Rupture of membranes (0.1%) * Chorioamnioitis (0.5%) * Maternal-fetal hemorrhage * Limb deformities
56
Fetal movement counts (def)
Movements by the fetus, as assessed by the mother: “Kick counts”
57
Fetal movement counts -- Reason
Fetal movement is associated with fetal condition. Daily evaluation of these movements provides a way for evaluating the fetus.
58
Fetal movement counts -- Timing
Begins at 28 weeks; recommended daily.
59
Fetal movement counts-- Advantages (3)
* Inexpensive * Non-invasive * Convenient for client, encourages participation in care
60
Fetal movement counts-- Disadvantages (4)
* Fetal resting state normally decreases movements * Maternal perception of fetal movement varies widely; even in the same woman at different times. * Time of day may affect movement (less in the morning, greater in evening) * Maternal use of drugs (sedative drugs, methadone, heroine, cocaine, alcohol, tobacco) may affect fetal activity.
61
Non-Stress Test: Purpose
To assess fetal well-being: • Evaluation of fetal response (fetal heart rate) to natural contractile uterine activity or an increase in fetal activity • Fetus will produce characteristic heart rate patterns in response to fetal movement
62
What causes a diminished fetal response? (4)
* Hypoxia * Acidosis * Drugs * Fetal sleep cycle
63
Benefits of Non-Stress Test (2)
* Non-invasive | * No contraindications
64
NST: Interpreting Results (3)
* Reactive: Two accelerations in 20 minutes * Non-reactive: Doesn’t meet criteria for reactive * Unsatisfactory: Cannot identify baseline (marked variability) or technical problems / poor tracing
65
Contraction Stress Test: Function (2)
* Identifies the fetus who is compromised, under stress | * Used to identify the jeopardized fetus that was stable at rest, but showed evidence of compromise after stress
66
Contraction Stress Test: What to identify (3)
o Must identify fetal baseline, moderate variability, and the possible occurrence of spontaneous contractions.
67
Contraction Stress Test: Methodology
* Uterine contractions are stimulated | * When adequate contractions or hyperstimulation occurs, stimulation is stopped
68
Contraction Stress Test: What would indicate fetal distress?
LATE DECELERATION o Uterine contraction decreases uterine blood flow and placental perfusion • If the decrease is sufficient to produce hypoxia in the fetus, a deceleration in FHR will result, beginning at the peak of the contraction and persisting after its conclusion (late deceleration).
69
Contraction Stress Test: Interpreting Results
* Negative CST: No decelerations with contractions | * Positive CST: Repetitive decelerations with contractions
70
Contraction Stress Test: How are uterine contractions stimulated? (2)
* Nipple stimulation: Warm cloth applied to both breasts for 10 minutes, then massage the nipples for ten minutes * Oxytocin: Given IV to stimulate contractions
71
Hyperstimulation (def)
Contractions lasting more than 90 seconds or five or more contractions in 10 minutes.
72
Biophysical Profile: Methods (2 components)
* Ultrasound – uses real-time ultrasound that enables monitoring of fetal biophysical responses to stimuli * External fetal monitoring
73
What is the fetal response to central hypoxia? (BPP)
Alteration in movement, tone, breathing, HR
74
Biophysical Profile: Five components measured
* Fetal breathing movements * Gross body movements * Fetal tone * Fetal heart rate * Amniotic fluid volume
75
Biophysical Profile: Results (3)
• Normal: 8-10 if AFV is WNL Indicates CNS if functional, fetus is not hypoxemic * Equivocal: 6 * Abnormal: <4 with abnormal AFV. Induction indicated.
76
What tool is used to measure amniotic fluid?
Ultrasound
77
What does the AFI measure?
Depth in cm of amniotic fluid in all four quadrants
78
AFI: Normal / Abnormal (3)
* Normal range: Between 5cm and 20 cm | * Oligohydraminos: 20cms
79
Ultrasounds: 2 types
o Abdominal | o Transvaginal
80
Abdominal ultrasound (2 characteristics)
* More effective after 1st trimester | * Must have a full bladder
81
Transvaginal ultrasound (2 characteristics)
* Optimal during 1st trimester | * Bladder can be empty
82
What does a first trimester sonogram indicate? (5)
o Number, size, location of gestational sacs o Presence or absence of fetal cardiac and body movements o Uterine abnormalities or adenexal masses o Estimated gestational age (EGA) o Presence and location of IUD
83
What does a 2nd / 3rd trimester sonogram indicate?
``` o Fetal viability o Number of fetuses o Gestational age, growth pattern o Fetal anomalies o Amniotic fluid volume (AFV) o Placental location and maturity o Fetal position o Uterine fibroids and anomalies o Adnexal masses o Cervical length ```

OB (15 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions