Flashcards in Assessment of Fetal Well-being Deck (78):
At risk pregnancy
Evaluate fetal status
Low risk pregnancy
Evaluate normal growth and development
What should be performed by all pregnant women
Maternal evaluation of fetal movement (kick counts 10 in 10)
When should mother perform evaluation of fetal movement
After 27 weeks
Daily Fetal Movement Count
How should mother perform DFMC?
Lying sideways - 1 hour after meal
Number of times fetus should move in one hour
Number of times a fetus should moved in 2 hours
If a baby doesn't moved much what are they usually?
If baby doesn't move in the morning time, what should mother do?
Call the doctor
Use of high frequency sound waves to create an image of the fetus
Limited obestric ultrasound
Ultrasound for women suspected of caring an abnormal fetus
What color is bone on an ultrasound?
What color is soft tissue on an ultrasound?
What color is fluid on an ultrasound?
If you see nuchal thickening and flattened nasal brindge on a baby in an ultrasound, what does the baby have?
Trisomy 21 or down syndrome
The amount of amnionic fluid in the uterus is an indicator for what?
Excess amniotic fluid
Decreased amounts of amniotic fluid
What is polyhydramnios associated with?
Diabetes or baby may have a neurological disorder and isn't able to swallow
What is Oligohydramnios associated with?
The fetus may be swallowing but are not urinating - when baby is hypoxic, their kidneys shut off to support the heart and therefore - no urine
How much fluid should a mother drink before having the amniotic fluid assessed?
1 to 1 1/2 quarts of water
Amniotic fluid volume (AFV)
Measures only one pocket
Amniotic fluid index (AFI)
A measure of 4 quandrants or pockets
Biophysical Profile (BPP)
Fetal breathing movements
Gross body movements
Reactive fetal heart rate
How many possible points can you get from a BPP?
10 (2 points each)
What is the normal BPP score?
What BPP score do you evaluated for possible delivery?
BPP score of 4 or less
If a mom is 32 weeks pregnant and the BPP score is 4 or less, what action takes place?
They induce labor
If baby is not flexed in the womb, what is wrong?
The baby is hypoxic and therefore has lack of muscle fetal tone
What are the 2 most important components of BPP?
Amniotic fluid index (AFI)
Reactivity of the fetal heart rate
Observe for accelerations of fetal heart rate in response to fetal movement
Nonstress Test (NST)
What indicates an intact nervous system, not effected by hypoxia?
How and when is an NST given?
Can be performed after 30 weeks gestation - in semi-fowlers position with an empty bladder
What does NST require?
The use of an electronic fetal monitor
Electronic fetal monitor
Two or more accelerations of fetal heart rate within 20 minutes
Reactive NST (good)
Does not meet criteria for reactive NST
Acceleration of fetal heart rate
An increase in heart rate of 15 bpm or more lasting 15 seconds (15 by 15 rule)
Fetal Acoustic Stimulation test (FAST)
Horn to wake up baby - sound stimulus
Vibroacoustic stimulation test (VST)
Vibrator to wake up baby for NST
When would you NOT buzz to wake up a baby?
When baby is nonreactive - when their heart rate keeps dropping
This test is to observe the response of the fetal heart rate to contractions
Contraction stress test (CST)
What do they give mothers in a contraction stress test (CST)?
Oxytocin or Pitacin
What does the CST evaluate?
When is the CST used?
In at risk pregnancies
- non reactive NST
- post dates
What does the CST require?
Three contractions of 40 seconds duration in a 10 minute period
How are contractions induced?
By IV oxytocin or breast nipple) stimulations
No late decelerations occur after any contraction
Negative CST (good)
Late decelerations occur with at least 2 out of the 3 contractions
Positive CST (bad)
Late decelerations with a single contractions or late decelerations occur with hyperstimulation pattern
Equivocal CST (don't know, keep watching)
Needle is inserted into uterine cavity through the abdomen
When giving an amniocentesis, what do you do with it?
An Ultrasound is used to identify locations of placental, fetal parts
What is amniocentesis determining?
What is amniocentesis used to determine in early pregnancy?
What is amniocentesis used to determine in late pregnancy?
Fetal lung maturity or intrauterine infections
This is necessary for normal respirator functioning of the newborn - to prevent RDS
What should the L/S ration be at 35 weeks to indicate lung maturity?
2:1 (even 1.7:1 is bad)
What appears in amniotic fluid at about 36 weeks gestation and indicates fetal lung maturity?
Phosphatidylglycerol (PG +)
Test for neural tube defects
This is present in maternal serum and amniotic fluid
This rises throughout pregnancy and peaks at 30 weeks gestation
Maternal serum AFP (MSAFP)
When does amniotic fluid AFP (AFAFP) peak?
At 15 weeks
What is AFP produced by in the first 6 weeks?
What is AFP produced by after the first 6 weeks?
When is MSAFP most accurate?
Between 16-18 weeks
What does increased levels of AFP indicate?
Open neural tube defect (anencephaly or spina bifida)
Abdominal wall defect
Lacking upper part of brain
Decreased levels of AFP
Components of Penta screen
Inhibin A (a hormone)
H-HcG (what is added to the Quad screen to make it Penta screen)
Hyperglyosated human chorionic gonadotropin
Sample of the chorionic villi from the edge of the placenta is obtained
Chorionic Villus Sampling (CVS)
When is CVS done?
Between 8 and 12 weeks gestation
Glue that holds the placenta down
The presence of vaginal fibronectin between 20-34 weeks is a strong indicator of what?