Chapter 26 Flashcards
what are biophysical risk factors
Originates with the mother or the fetus
May affect development and functioning of both
Genetic disorders, nutritional and general health status, and medical or obstetric-related illnesses
what are psychosocial risk factors
Maternal behaviors and adverse lifestyles that have a negative effect on health of mother or fetus
emotional distress
disturbed interpersonal relationships
Inadequate social support
Unsafe cultural practices
sociodemographic risk factors
Arise from mother and her family
Lack of prenatal care
low income
marital status
ethnicity
what is a daily fetal movement count test (DFMC)
Used to monitor fetus in pregnancies complicated by conditions that may affect oxygenation
A count of fewer than three kicks in 1 hour warrants further evaluation by a nonstress test (NST).
kick counts
what are the types of ultrasounds
abdominal and transvaginal
what are the indication for an ultrasound?
Fetal heart activity
Gestational age
Fetal growth
Fetal anatomy
Fetal genetic disorders and physical anomalies
Placental position and function
information about abdominal ultrasound
done during 1st trimester to look at maternal abnormalities
Pts instructed to drink 1-2 liters before to keep bladder full and push everything up
transvaginal ultrasound information
gives better detail of pelvis
used for placental location
probe inserted vaginally,
infection risk
contraindicated in cervical complications, placenta previa, preterm labor
can see more accurate cervical length
what are tests to assess fetal well being
Doppler blood flow analysis
Amniotic fluid volume
Biophysical profile (BPP)
Modified biophysical profile
what is included in a Biophysical profile (BPP) assessment
done via ultrasound
looks at fetal movement
muscle tone
HR
amniotic fluid index
non stress test
How many total points in a BPP
10 total points, each section is 2 pts, 10 pts is fetal well being, anything above 8 is good, under a 4 means further investigation and possible immediate delivery
what is a modified biophysical profile
just amniotic fluid index and nonstress test
what is a doppler used for
used to look at placenta and cord to make sure perfusion is adequate
How is placenta graded
1-4, 4 is the oldest placenta
Info about aged placenta
the older the placenta is it will have calcium deposits and less efficacy
baby wont get nutrients , lack of oxygen , IUGR can occur
what can be seen in an MRI ?
Fetal structure, overall growth
Placenta
Quantity of amniotic fluid
Maternal structures
Biochemical status of tissues and organs
Soft-tissue, metabolic, or functional anomalies
what are the indications for an amniocentesis?
Genetic concerns
Fetal maturity
Fetal hemolytic disease
Used for:
preterm labor
diabetic mother
fetal lung maturity for induction
what are potential complications with an amniocentesis ?
poke baby and placenta, rupture membrane, infection, hemorrhage
ultrasound guided is necessary
Chorionic Villus sampling (CVS)
Technique for genetic studies
Earlier diagnosis, rapid results
Performed at 10 weeks gestation up to 13 wks
Involves removal of small tissue specimen from fetal portion of placenta
Transcervically or transabdominally
risk for infection and hemorrhage
what is percutaneous umbilical blood sampling (PUBS) aka cordocentesis
Insertion of needle directly into fetal umbilical vessel under ultrasound guidance
Direct access to the fetal circulation during the second and third trimesters
Most widely used method for fetal blood sampling and transfusion
Used for fetal blood transfusions , if severe anemia
what does the Maternal serum alpha-fetoprotein (MSAFP) test for ?
Maternal serum levels used as screening tool for neural tube defects (NTDs) in pregnancy
Detects 80% to 85% of all open NTDs and open abdominal wall defects early in pregnancy
Triple- and quad-screening to detect autosomal trisomies
what are important considerations with the maternal assays test (MSAFP)
This test is not a requirement
Not accurate, This one has a lot of false positive and false negatives
when is the maternal serum alpha fetoprotein test done (panorama test)
14-22 wks
what is the cell free DNA screening in maternal blood?
Noninvasive prenatal genetic testing
Provides definitive diagnosis noninvasively for fetal Rh status, fetal gender, and certain paternally transmitted single gene disorders , Trisomy 21
