Flashcards in Antepartum Assessment for High Risk Pregnancy Deck (45)
Risk factors for high risk pregnancy
Uninsured pregnant women without access to prenatal care
What is high risk pregnancy?
High risk pregnancy: life or health of mother or fetus is jeopardized
How long is mother at risk for ?
it extends through puerperium! 30-45 days after birth
When do complications usually resolve for mother's at risk?
within 1 month of birth.
What are the 3 leading causes of maternal mortality?
Factors related to maternal death ?
Age: <20 years or > 35 years
Lack of prenatal care
Low educational attainment
Fetal and neonatal health problems?
Causes of neonatal death include?
Disorders related to short gestation and low birth weight
Sudden infant death
Respiratory distress syndrome
Effects of maternal complications
** Healthy People 2020- Progress being made
Nursing role in antepartal assessment for risks?
-Assist with History intake
-Initial nursing assessment
-Assists physician/ provider -with procedures-
-Performs non-stress tests (NSTs), contraction stress tests (CSTs), BPPs
What are the 3 antepartum assessments for risk antepartum testing?
Electronic Fetal Monitoring
When does the fetal movement test start? Why?
28 weeks. 22 might be too early for some to be moving and kicking around.
If it's been more than 12 hours without any fetal movement is this alarming? What should you do?
have woman drink something cold and sugary, or eat, lie down on left side...see if baby wakes up. if not you can zap it for 3 second.
What do ultrasounds do?
Fetal heart rate activity
Fetal growth & Fetal anatomy
Placental position & function
Assess anatomy following abnormal maternal screens
Adjunct to other invasive tests
What does the fluid surrounding the baby do for it?
Fluid allows baby to grow and helps with lung development.
What can an ultra sound show?
Fetal well being
Amniotic fluid volume
Doppler blood flow analysis (slide 16)
Biophysical profile (slide 15)
If the Nasal Bridge and Nuchal translucency is thick what can this mean?
Thick nb and nt: it be can connected to downs syndrome
What does the biophysical profile show you? (4)
Gonna look at breaths, fetal movements, fetal tone , amniotic fluid volume
Max points someone to get is a 10.
If 8/10 that’s still acceptable.
What does MRI show ? (5)
Quantity of amniotic fluid
Biochemical status of tissues and organs
Soft tissue, metabolic, or functional anomalies
Is contrast used in pregnancies?
What is fetal hemolytic disease?
moms blood is attacking the baby.
What does amniocentesis show for a fetus?
Prenatal diagnosis of disorders (genetic/ anomalies)
Fetal maturity (L/S ratio) – DM (PG)
Fetal hemolytic disease
Maternal complications with amniocentesis?
Amniocentesis complications in Fetus/infants?
Injury from needle
Miscarriage or preterm labor
Leakage of amniotic fluid
What is Chorionic villus sampling ? CVS
Removal of portion of placenta through abdomen or intravaginally through the cervix under USG guidance for genetic studies.
How fast do results happen with Chorionic villus sampling?
10 and 13 weeks gestation
Risks and nursing considerations for Chorionic villus sampling?
Risks- spotting, SAB
Rhogam if RH NEG
What is Percutaneous umbilical blood sampling? (PUBS)
and who is it indicated for?
fetuses @ risk for isoimmune hemolytic anemia
Insertion of needle directly into a fetal umbilical vessel under ultrasound guidance
indication: fetuses @ risk for isoimmune hemolytic anemia
What are the risks and nursing considerations for Percutaneous umbilical blood sampling? PUBS
Risks- cord laceration, PTL, infection, PPROM
Nursing considerations: FHT, Rhogam post procedure if needed
What is the Alpha-fetoprotein test ?
Maternal serum levels (MSAFP) screened for neural tube defects (NTDs)- done @ 15-22 wks