Chapter 15 Fetal Monitoring Flashcards Preview

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Flashcards in Chapter 15 Fetal Monitoring Deck (10)
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Indication for ultra sound in first trimester

Transvaginal ultrasound
Presence and location of pregnancy
Detect multifetal gestation
Estimate GA
Confirm fetal viability
Identify need for follow up testing

1

2nd and 3rd trimester ultrasound indication

Transabdominal
Fetal viability, evaluate fetal anatomy
Estimate GA
Assess progress of fetal growth over series of scans
Evaluate amniotic fluid
Determine location and relation of the placenta and umbilical cord
Determine fetal position/presentation
Guide needle placement for amniocentesis
Umbilical cord sampling

2

Alpha fetal protein

Main protein in fetal plasma
Measured at 16-18 weeks to SCREEN for fetal defects
Not a diagnostic

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What is an amniocentesis?

Aspiration of amniotic fluid from amniotic for exam

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Indications for amniocentisis

Age 35 or older
Chromosomal abnormalities in close family members
Gender determination for maternal carrier of x linked disorder
Birth of previous infant with abnormality
Elevated afp

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Purpose of amniocentesis during 2nd trimester

Examine fetal cells to identify chromosomal or biochemical abnormalities
Evaluate fetal condition when the women is sensitized to rh- blood

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Purpose of amniocentesis during 3rd trimester

Determine fetal lung maturity
Evaluate fetal hemolytic disease caused by rh incompatibility

7

Advantages of amniocentesis

Simple relatively safe
Brief and painless
Few complications

8

Multiple marker screen
Positive next step

Detects hcg and unconjugated estridol
Increases detection of tirstomy 18-21. Taken between 16-18 weeks
If positive amniocentesis should be offered for karyotyping or an ultrasound to look for physical abnormalities

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Non stress test

Increase in heart rate adequate oxygenation, healthy neural pathway
False positive may occur
Non invasive
Reactive: at least 2 accelerations increase in 15 bpm for 15 seconds in 20 minutes