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high risk OB > assessment high risk pregnancies > Flashcards

assessment high risk pregnancies Flashcards

1
Q

categories risk factors (4)

A

-existing health conditions (asthma, heart conditions)
-age (<19 yo, or >35 yo)
-lifestyle factors
-conditions of pregnancy

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2
Q

pregnancy complications that increase with young age (<19 yo)

A

-preterm labor/preterm birth
-IUGR/SGA infant
-congenital anomalies
-preeclampsia

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3
Q

pregnancy complications that increase with older age (>35 yo)

A

-diabetes (preexisting and GDM)
-HTN (chronic, gestational, preeclampsia)
-multiple gestation
-preterm birth
-LBW/SGA
-congenital anomalies
-C-section birth
-miscarriage/stillbirth

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4
Q

lifestyle factors that contribute to antepartum risk

A

-substance use
-nutrition/physical activity
-intimate partner violence
-socioeconomic and demographic factors
-teratogen exposure

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5
Q

conditions of pregnancy that increase antepartum risk

A

-preeclampsia
-diabetes (GDM)
-placenta previa/abruption
-multiple gestation
-preterm labor/birth
-obstetric history (previous complications)

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6
Q

when can you do cell free DNA

A

10+ weeks

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7
Q

what does cell free DNA test and what does it test for

A

-uses mothers blood
-tests for trisomy 13, 18, 21 and sex
*decreased reliability of test for obese moms

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8
Q

when can you do first trimester multiple marker test

A

10-13 weeks

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9
Q

what does first trimester multiple marker test and what does it test for

A

-uses mothers blood
-tests for trisomy 13, 18, 21
-sonogram for nuchal translucence
*requires accurate EGA

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10
Q

what is increased MSAFP associated with

A

neural tube defects

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11
Q

when can you do second tri multiple marker test (quad test)

A

15-22 weeks

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12
Q

what does quad test use and what does it test for

A

-mothers blood (MSAFP):
-trisomy 18, 21
-neural tube defects

-sonogram:
-major defects

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13
Q

when can you do amniocentesis test

A

14+ weeks

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14
Q

what indicates fetal lung maturity

A

LS ratio 2:1

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15
Q

when can you chorionic villi sampling
what does it test for

A

10-13 weeks
advantage compared to amnio = earlier test, faster turn around time
tests for genetic anomalies

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16
Q

rare fetal complication of amniocentesis

A

club foot (talipes equinovarus)

17
Q

tests for fetal well being

A

-kick count
-sonogram (doppler blood flow, BPP, AFI)
-MRI

18
Q

maternal indications for daily fetal kick counts (4)

A

-HTN in pregnancy
-diabetes in pregnancy
-previous history of 3rd tri loss
-high stress parent(s)

19
Q

what amount of kick counts per hr needs follow up

A

<3 movements/hr
*biggest thing is trends

20
Q

how many hours in a row without fetal movement needs followup (fetal alarm signal)

A

12 hrs

21
Q

BATMaN for biophysical profile

A

-breathing
-amniotic fluid
-tone
-movements
-nonstress test (reactive)

22
Q

what is included on modified biophysical profile

A

-nonstress test (reactive)
-amniotic fluid volume (>2 or index >5)

23
Q

what indicates a reactive nonstress test

A

2+ accelerations (15bpm/min) lasting 15 secs in 20 mins

24
Q

what indicates a nonreactive nonstress test

A

20 mins without 2+ accels lasting 15 secs (can extend test to 40 mins)

25
Q

what indicates a reactive vibroacoustic stimulation

A

increased FHR variation and acceleration

26
Q

what indicates a nonreactive vibroacoustic stimulation

A

no response after 3 stimulations (1 min intervals)

27
Q

absolute contraindications for contraction stress test

A

-previous classic incision for C/S
-preterm labor
-placental previa
-vasa previa
-reduced cervical competence
-multiple gestation
-any contraindication to labor

*basically anyone who shouldn’t be having contractions or shouldn’t have a vaginal birth

28
Q

what is considered a negative contraction stress test

A

no late decels (good outcome)

29
Q

what is considered a positive contraction stress test

A

late decels with >50% contractions

30
Q

what is considered suspicious/equivocal contraction stress test

A

prolonged, variable or late decels with <50% of contractions

31
Q

what is considered equivocal-hyperstimulatory contraction stress test

A

decels occur in presence of contractions >q2min or lasting >90 secs

32
Q

what is considered unsatisfactory contraction stress test

A

unable to obtain 3 contractions in ten min period

high risk OB (14 decks)

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