Chapter 26 Flashcards
Daily Fetal Movement Count
Used to monitor fetus in pregnancies complicated by conditions that may affect oxygenation
A count of fewer than 3 kicks/hour warrants further evaluation by a nonstress test
Ultrasonography
Abdominal or transvaginal
Used for fetal heart activity, gestational age, fetal growth, and fetal anatomy
Able to detect fetal genetic disorders and physical anomalies, and placental position and function
Purpose of First Trimester Ultrasound
Confirm pregnancy
Verify location of the pregnancy
Detect multifetal gestations
Identify markers
Usually transvaginal
Purpose of Second and Third Trimester Ultrasound
Confirm viability
Evaluate fetal anatomy
Determine gestational age
Assess serial fetal growth
Compare growth of fetuses in multifetal gestations
Evaluate four of five markers in multifetal gestations
Locate the placenta when placental previa is suspected
Determine fetal presentation
Guide needle for amniocentesis or percutaneous umbilical cord sampling
Usually transabdominal
Antepartum MRI
Examines fetal structure, placenta, quantity of amniotic fluid, maternal structures, biochemical status of tissues and organs
Noninvasive radiologic technique
Amniocentesis
Aspiration of amniotic fluid from the amniotic sac for examination
Percutaneous Umbilical Blood Sampling
High-resolution ultrasound used to locate the fetus, placenta, and umbilical cord and guide needle insertion
Most widely used method for fetal blood sampling and transfusion
Needle is inserted into the umbilical cord near the site at which the cord meets the placenta
Rho(D) immune globulin (RhoGAM) is given to Rh-negative women
Risks of life-threatening complications for the fetus
Chorionic Villus Sampling
Technique for genetic studies
Earlier diagnosis, rapid results
PERFORMED BETWEEN 10 AND 13 WEEKS OF GESTATION
Involves removal of small tissue specimen from fetal portion of placenta
Transcervically or transabdominally
Maternal Serum Alpha Fetoprotein
Maternal serum levels used as screening tool for neural tube defects in pregnancy
Detects 80-85% of all open NTDs and open abdominal wall defects early in pregnancy
Screening recommended for all pregnant women
Triple and quad screening to detect autosomal trisomies
Coombs’ Test
Screening tool for Rh incompatibility
Detects other antibodies that may place fetus at risk for incompatibility with maternal antigens
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
Performed as early as 10 weeks of gestation
Results are usually available in about 10 business days
Nonstress Test Procedure
Before procedure woman should void and baseline vital signs should be taken
Woman may be seated in a reclining chair or have her head elevated at least 45 degrees
EFM applied to abdomen
Ultrasound transducer records FHR
Tocotransducer records uterine activity
Interpretation of Nonstress Test
Reactive is reassuring
Nonreactive: tracing does not demonstrate the required characteristics of a reactive tracing within a 40-minute period
Advantages of Nonstress Test
Noninvasive Painless Believed to be without risk to mother or fetus Easily administered Results available immediate;ly
Disadvantages of Nonstress Test
High false-positive rate
Additional testing related to a nonreactive nonstress test
