Assessment of Risk Factors E1

Question 1

Frequency of high risk preg

Answer 1

500,000 out of 4 million
(where life/health of mom or fetus is jeopardized)

Question 2

Categories of high risk

Answer 2

Biophysical: genetic disorders, nutritional
Psychosocial: Emotional distress, depression, IPV (inimate partner violence)
Sociodemographic: lack of prenatal care, low income, ethnic minority
Environmental: workplace or chemicals

Question 3

Biophysical Antepartum testing

Answer 3

Daily fetal kick count (at home)
Should have 10 kicks in 2hr - Most within 30 min -

LESS THAN 3 in 1hr requires FOLLOW UP

Question 4

First trimester ultrasound

Answer 4

Confirm pregnancy’s, viability (ectopic), gestational age, multiple gestations, detect maternal abnormailites (cysts, bicornate uterus - split)

Question 5

Second Trimester Ultrasound

Answer 5

Establish/confirm term, vibility, amniotic fluid (poly/oligo) detect abnormalities, confirm placental placement, IUGR (intrauterine growth restriction)

Question 6

Third trimester ultrasound

Answer 6

Confirm viability and gestation, macrosomia, anomalies, IUGR, fetal position, placenta (previa/abruption) BPP (biophysical profile - 4D), placental maturity and doppler flow studies

Question 7

Doppler blood flow analysis

Answer 7

During third trimester looks at flow in fetus and placenta

Question 8

Amniotic Fluid Volume

Answer 8

AFI - Amniotic fluid intex
Over 25 (poly)
10-25 normal
5-10 low normal
<5 (oligo)

Question 9

BPP-Biophysical Profile

Answer 9

Fetal breathing, gross body movements, fetal tone, reactive fetal HR, AFI
Score rated 0-10
8-10 normal, equioval 6, abnormal <4

Question 10

Chorionic Villus Sampling

Answer 10

At 10-12 wks, removes tissue specimen from fetal portion of placenta for genetic screening

Question 11

PUBS

Answer 11

Percutaneous umbilical sampling - needle directly into fetal umbilical cord

Question 12

AFP

Answer 12

Maternal blood test (Serum alpha-fetoprotein) checks for certain genetic problems, AFP is produced by fetal liver, done at 16-18 wks

Question 13

QUAD Screen

Answer 13

Alpha feto protein, Estriol (1 of main estrogens) Inhibin (protien produced by placenta)

TESTS FOR: Downs (tri 21) Trisomy 18 (fatal by 1) Spina Bifida and abdominal wall defects

Question 14

Coombs

Answer 14

Screens for Rh incompatibility

Question 14

cgDNA

Answer 14

early as 9 weeks, highly sensitive, maternal blood sample
Tests for trisomies, sex chromosomes, microdeletions, and triploidy

Question 14

Fetal monitoring

Answer 14

NST - nonreactive non-stress test no reassuring
CST - contraction stress test
Variability (In HR) - 98% accurate in predicting fetal well being