Assessment of Fetal Well-being

Question 0

Low risk pregnancy

Answer 0

Evaluate normal growth and development

Question 1

At risk pregnancy

Answer 1

Evaluate fetal status

Question 2

What should be performed by all pregnant women

Answer 2

Maternal evaluation of fetal movement (kick counts 10 in 10)

Question 3

When should mother perform evaluation of fetal movement

Answer 3

After 27 weeks

Question 4

DFMC

Answer 4

Daily Fetal Movement Count

Question 5

How should mother perform DFMC?

Answer 5

Lying sideways - 1 hour after meal

Question 6

Number of times fetus should move in one hour

Answer 6

4

Question 7

Number of times a fetus should moved in 2 hours

Answer 7

10

Question 8

If a baby doesn’t moved much what are they usually?

Answer 8

Hypoxic

Question 9

If baby doesn’t move in the morning time, what should mother do?

Answer 9

Call the doctor

Question 10

Use of high frequency sound waves to create an image of the fetus

Answer 10

Ultrasound

Question 11

Limited obestric ultrasound

Answer 11

Basic screening

Question 12

Ultrasound for women suspected of caring an abnormal fetus

Answer 12

Comprehensive ultrasound

Question 13

What color is bone on an ultrasound?

Answer 13

White

Question 14

What color is soft tissue on an ultrasound?

Answer 14

Gray

Question 15

What color is fluid on an ultrasound?

Answer 15

Black

Question 16

If you see nuchal thickening and flattened nasal brindge on a baby in an ultrasound, what does the baby have?

Answer 16

Trisomy 21 or down syndrome

Question 17

The amount of amnionic fluid in the uterus is an indicator for what?

Answer 17

Fetal well-being

Question 18

Excess amniotic fluid

Answer 18

Polyhydramnios

Question 19

Decreased amounts of amniotic fluid

Answer 19

Oligohydramnios

Question 20

What is polyhydramnios associated with?

Answer 20

Diabetes or baby may have a neurological disorder and isn’t able to swallow

Question 21

What is Oligohydramnios associated with?

Answer 21

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

Question 22

How much fluid should a mother drink before having the amniotic fluid assessed?

Answer 22

1 to 1 1/2 quarts of water

Question 23

Amniotic fluid volume (AFV)

Answer 23

Measures only one pocket

Question 24

Amniotic fluid index (AFI)

Answer 24

A measure of 4 quandrants or pockets

Question 25

Biophysical Profile (BPP)

Answer 25

``` Fetal breathing movements Gross body movements Fetal tone Reactive fetal heart rate Amniotic fluid ```

Question 26

How many possible points can you get from a BPP?

Answer 26

10 (2 points each)

Question 27

What is the normal BPP score?

Answer 27

8-10

Question 28

What BPP score do you evaluated for possible delivery?

Answer 28

BPP score of 4 or less

Question 29

If a mom is 32 weeks pregnant and the BPP score is 4 or less, what action takes place?

Answer 29

They induce labor

Question 30

If baby is not flexed in the womb, what is wrong?

Answer 30

The baby is hypoxic and therefore has lack of muscle fetal tone

Question 31

What are the 2 most important components of BPP?

Answer 31

Amniotic fluid index (AFI) Reactivity of the fetal heart rate

Question 32

Observe for accelerations of fetal heart rate in response to fetal movement

Answer 32

Nonstress Test (NST)

Question 33

What indicates an intact nervous system, not effected by hypoxia?

Answer 33

Accelerations

Question 34

How and when is an NST given?

Answer 34

Can be performed after 30 weeks gestation - in semi-fowlers position with an empty bladder

Question 35

What does NST require?

Answer 35

The use of an electronic fetal monitor

Question 36

EFM

Answer 36

Electronic fetal monitor

Question 37

Two or more accelerations of fetal heart rate within 20 minutes

Answer 37

Reactive NST (good)

Question 38

Does not meet criteria for reactive NST

Answer 38

Nonreactive NST

Question 39

Acceleration of fetal heart rate

Answer 39

An increase in heart rate of 15 bpm or more lasting 15 seconds (15 by 15 rule)

Question 40

Fetal Acoustic Stimulation test (FAST)

Answer 40

Horn to wake up baby - sound stimulus

Question 41

Vibroacoustic stimulation test (VST)

Answer 41

Vibrator to wake up baby for NST

Question 42

When would you NOT buzz to wake up a baby?

Answer 42

When baby is nonreactive - when their heart rate keeps dropping

Question 43

This test is to observe the response of the fetal heart rate to contractions

Answer 43

Contraction stress test (CST)

Question 44

What do they give mothers in a contraction stress test (CST)?

Answer 44

Oxytocin or Pitacin

Question 45

What does the CST evaluate?

Answer 45

Uteroplacental sufficiency

Question 46

When is the CST used?

Answer 46

In at risk pregnancies - non reactive NST - post dates

Question 47

What does the CST require?

Answer 47

Three contractions of 40 seconds duration in a 10 minute period

Question 48

How are contractions induced?

Answer 48

By IV oxytocin or breast nipple) stimulations

Question 49

No late decelerations occur after any contraction

Answer 49

Negative CST (good)

Question 50

Late decelerations occur with at least 2 out of the 3 contractions

Answer 50

Positive CST (bad)

Question 51

Late decelerations with a single contractions or late decelerations occur with hyperstimulation pattern

Answer 51

Equivocal CST (don't know, keep watching)

Question 52

Needle is inserted into uterine cavity through the abdomen

Answer 52

Amniocentesis

Question 53

When giving an amniocentesis, what do you do with it?

Answer 53

An Ultrasound is used to identify locations of placental, fetal parts

Question 54

What is amniocentesis determining?

Answer 54

Karyotype (DNA)

Question 55

What is amniocentesis used to determine in early pregnancy?

Answer 55

Chromosomal abnormalities

Question 56

What is amniocentesis used to determine in late pregnancy?

Answer 56

Fetal lung maturity or intrauterine infections

Question 57

This is necessary for normal respirator functioning of the newborn - to prevent RDS

Answer 57

Surfactant

Question 58

What should the L/S ration be at 35 weeks to indicate lung maturity?

Answer 58

2:1 (even 1.7:1 is bad)

Question 59

What appears in amniotic fluid at about 36 weeks gestation and indicates fetal lung maturity?

Answer 59

Phosphatidylglycerol (PG +)

Question 60

Test for neural tube defects

Answer 60

AFP

Question 61

This is present in maternal serum and amniotic fluid

Answer 61

Alpha-fetoprotein (AFP)

Question 62

This rises throughout pregnancy and peaks at 30 weeks gestation

Answer 62

Maternal serum AFP (MSAFP)

Question 63

When does amniotic fluid AFP (AFAFP) peak?

Answer 63

At 15 weeks

Question 64

What is AFP produced by in the first 6 weeks?

Answer 64

Fetal Yoke

Question 65

What is AFP produced by after the first 6 weeks?

Answer 65

Fetal Liver

Question 66

When is MSAFP most accurate?

Answer 66

Between 16-18 weeks

Question 67

What does increased levels of AFP indicate?

Answer 67

Open neural tube defect (anencephaly or spina bifida) Abdominal wall defect

Question 68

Anencephaly

Answer 68

Lacking upper part of brain

Question 69

Increased AFP

Answer 69

Fetal death | Multiple gestation

Question 70

Decreased levels of AFP

Answer 70

Down's syndrome

Question 71

Components of Penta screen

Answer 71

``` AFP Unconjugated estriol HcG H-HcG Inhibin A (a hormone) ```

Question 72

H-HcG (what is added to the Quad screen to make it Penta screen)

Answer 72

Hyperglyosated human chorionic gonadotropin

Question 73

Sample of the chorionic villi from the edge of the placenta is obtained

Answer 73

Chorionic Villus Sampling (CVS)

Question 74

When is CVS done?

Answer 74

Between 8 and 12 weeks gestation

Question 75

Glue that holds the placenta down

Answer 75

Fetal fibronectin

Question 76

The presence of vaginal fibronectin between 20-34 weeks is a strong indicator of what?

Answer 76

Preterm delivery

Question 77

What protein is produced by fetal tissues that is the glue that holds the placenta down?

Answer 77

Glycoprotein