Antepartum Fetal Testing Flashcards Preview

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Flashcards in Antepartum Fetal Testing Deck (19):
1

Most common reason for antenatal fetal testing

decreased fetal movement.
Next steo in management is come in for NST

2

Other indications for antenatal fetal testing?

Diabetes
Post dates
Chronic HTN
IUGR

3

Non Stress Test (NST)

uses external electrodes to see if the fetal is moving. If is it, there will be accelerations then comes back down. -good if they are spontaneous and not related to contractions

4

What is an acceleration?

abrupt increases in FHR above baseline for 32 weeks, they should be >15 beats/min lasting >15 sec

5

If we have a reactive NST, is that good?

yes the rate of fetal compromise is 3/1000
-FOLLOW up in a week
-requires 2 or more accel in 20 mins

6

Non-reactive NST

MUST meet all of the criteria for reactive NST.

-usually due to fetus being asleep, drug sedatives, CNS anomaly

7

Management of nonreactive NST?

Vibroacoustic stimulation- baby wakes up and moves--> accel
--If still nonreactiuve then you do Biophysical Profile (BPP)

8

What is oligohydramnios on the amniotic fluid index? Is it a part of the BPP?

9

What is borderline on the amniotic fluid index?

5-8 cm

10

What is normal on the amniotic fluid index?

9-25 cm

11

What is polyhydramnios on the amniotic fluid index?

>25cm

12

BPP measures 5 parts of fetal wellbeing?

1. Nonstress Test [0-2]
2. four quadrant AFI [0-2]
3. fetal gross body movements (head mvmts) [0-2]
4. fetal extremity tone (extension of toes) [0-2]
5. fetal breathing movements (chest wall mvmts) [0-2]

13

Modified BPP

NST and AFI are good enough to be evaluated alone

14

A score of 8-10 on the BPP tells you what?

highly reassuring of fetal wellbeing
-repeat test weekly

15

A score of 4-6 on the BPP tells you what?

worrisome: deliver if >36 weeks; lungs are matured

16

A score of 0-2 on the BPP tells you what?

hypoxia--> prompt delivery

17

Contraction Stress test (CST)

tests the fetus' ability to tolerate temporary decreases in blood flow as when occurs in contraction. a baby that is acidotic will show acidosis--> late decelerations. Don't want to see gradual decrease below baseline.
Contraction begins, decel begins
Contraction ends, decel ends

18

If no spontaneous contractions present, how do you proceed? Is this positive or negative CST?

may induce with oxytocin or nipple stim with warm towel
--it is positive (nonreassuring)

19

if >3 contractions are present in 10 mins, the CST component can be assessed as

negative or positive
...Negative is reassuring
...Positive is non-reassuring