Flashcards in Antepartum Fetal Testing Deck (19):
Most common reason for antenatal fetal testing
decreased fetal movement.
Next steo in management is come in for NST
Other indications for antenatal fetal testing?
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
What is an acceleration?
abrupt increases in FHR above baseline for 32 weeks, they should be >15 beats/min lasting >15 sec
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
MUST meet all of the criteria for reactive NST.
-usually due to fetus being asleep, drug sedatives, CNS anomaly
Management of nonreactive NST?
Vibroacoustic stimulation- baby wakes up and moves--> accel
--If still nonreactiuve then you do Biophysical Profile (BPP)
What is oligohydramnios on the amniotic fluid index? Is it a part of the BPP?
What is borderline on the amniotic fluid index?
What is normal on the amniotic fluid index?
What is polyhydramnios on the amniotic fluid index?
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]
NST and AFI are good enough to be evaluated alone
A score of 8-10 on the BPP tells you what?
highly reassuring of fetal wellbeing
-repeat test weekly
A score of 4-6 on the BPP tells you what?
worrisome: deliver if >36 weeks; lungs are matured
A score of 0-2 on the BPP tells you what?
hypoxia--> prompt delivery
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
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)