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OB > Chapter 6 - Antepartal Tests > Flashcards

Chapter 6 - Antepartal Tests Flashcards

1
Q

Screening

A

not definite

-designed to ID those who are NOT affected by a diasease or abnormality

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2
Q

Diagnostic Tests

A

give a definite yes or no re if fetus is normal or abnormal

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3
Q

Types of Screening Tests

A
  • AFI
  • BPP
  • CST
  • daily FKC
  • multimarker screening [AFP, triple/quad marker)
  • NST
  • ultrasonography
  • nuchal translucency
  • umbillical artery doppler flow
  • VAS
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4
Q

Types of Diagnostic Tests

A
  • amniocentesis
  • CVS
  • MRI
  • PUBS
  • ultrasonography
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5
Q

types of biophysical assessments

A
  • ultrasonography
  • umbilical artery doppler flow
  • MRI
  • *alll screen, not diagnstc
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6
Q

Amniocentesis

A

needle is inserted thru abdominal wall to get amniotic fluid

  • 15 20 wk
  • diagnostic for cell growth + chromosomal
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7
Q

Amniocentesis

results

A
  • high bilirubin= hemolytic disease
  • pos culture= infectn
  • L/S > 2:1 is mature lungs
  • L/S < 2:1 immature, risk for RDS
  • pos PG= mature lungs
  • neg PG = immature
  • LBC>50K= mature lungs
  • LBC<50K= immature
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8
Q

Amniocentesis risks

A
  • loss
  • trauma to fetus/placenta
  • bleed/leak of amnio fluid
  • preterm labor
  • mom infectn
  • Rh sensitization bc risk for blood mixing
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9
Q

PUBS percutaneous umbilical blood sampling

A
  • removal of fetal blood fr umbilical cord
  • diagnostic test for metab, hematologic, disorders, fetal infectn, fetal karyotyping
  • 18 wks
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10
Q

PUBS risks

A
  • loss
  • trauma to fetus/placenta
  • bleed/leak of amnio fluid
  • preterm labor
  • mom infectn
  • Rh sensitization bc risk for blood mixing
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11
Q

Types of maternal assays

A
  • AFP/MSAFP
  • Triple Marker Screen
  • Quad Marker Screen
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12
Q

Alpha-FetoProtein [AFP]
aka
Maternal Serum AFP [MSAFP]

A

AFP is a glycoprotein produced by the fetal liver, GI tract + yolk sac in early gestation

  • screening tool for NTD + ventral wall defects
  • 15-20 wks
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13
Q

high levels of AFP

A
  • NTD
  • anencephaly
  • omphalocele
  • gastroschisis
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14
Q

low levels of AFP

A

-trisomy 21 aka down syndrome

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15
Q

abnormal AFP findings will require additional testing such as…

A
  • amniocentesis
  • CVS
  • ultrasonography
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16
Q

AFP has a high risk for…

A

false positives

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17
Q

Triple Marker Screen/Quad Marker Screen

A
  • triple: AFP, hCG, + estriol
  • quad: +inhibin A
  • tests for trisomy (down syndr) + NTD
  • 15-16 wks
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18
Q

high levels of hCG + inhibin A

A

trisomy 21 (down syndrome)

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19
Q

low levels of estriol

A

Down syndr

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20
Q

Fetal Kick Count FKC

A
  • kicking starts at 16-20wk
  • utilized after 28 wks
  • palpate ab + track mvmt for 1-2 hrs
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21
Q

FKC norm + abnorm

A

norm: 10+ w/in 2 hrs; 4+ in 1 hr
abnorm: less than 4 in 4 hrs, contact HCP

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22
Q

Non Stress Test

A

monitors FHR pattern + acceleration to assess oxygenation

-monitor for 20-40 min

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23
Q

norm/reactive NST

A

2 or more accells in 20 min

<32wk, 2 accells (10 bpm + 10 secs) in 20 min period

24
Q

nonreactive NST

A

no sufficient FHR in 40 min

25
nonreactive NST should be followed up w...
ultrasound or BPP | -give juice, reposition, VAS
26
presence of repetitive variable decel that last ____ requires further assessment of ____
>longer than 30 sec amniotic fluid or prolonged monitoring
27
vibroacoustic stim VAS
used when NST is nonreactive | -repeated in 1 min intervals for 3 times
28
VAS is CI in...
deceleration or bradycardia
29
reactive VAS
2 or more accells in 20 min <32wk, 2 accells (10 bpm + 10 secs) in 20 min period
30
contraction stress test CST
fka oxytocin challenge test - assess ability to maintain FHR in response to UC in women w nonreactive NST at term - screens risk during delivery
31
CST procedure
- monitor FHR for 20 min | - if no spontaneous UC, then stim nipples for 10 mins (to produce oxytocin) or admin IV oxytocin
32
normal/negative result in CST
no significant var.decel or no late.decel in 10 min strip w 3 UC
33
positive results in CST
late decel w half of UC
34
pos result in CST is linked w...
- incr fetal death - fetal growth restriction - lower 5 min apgar score - c section - need for neonatal resuscitation
35
admin of oxytocin during CST places mom at risk for..
tachysystole | -more than 5 UC in 10 min
36
AFI
screening to measure volume of amniotic fluid | -based on fetal urine production
37
in prolonges fetal hypoxemia...
blood is shunted away fr kidneys to other vital organs | >>decr in amniotic fluid production
38
norm/avg AFI
8 - 24 cm
39
low AFI
less than 5 cm - oligohydramnios - incr prenatal mortality
40
high AFI
more than 24 cm - polyhydramnios - NTD, GI obstruction, or hydrops
41
BPP
30 min ultrasound screening for fetal status w NST
42
BPP asses 5 variables
``` 1 FHR reactivity 2 fetal mvmt 3 tone 4 breathing 5 amniotic fluid vol ```
43
BPP mvmt score
2: 3+ trunk/limb mvmt 0: less than 3
44
BPP tone score
2: 1+ active extension + return to flexion 0: absent mvmt
45
BPP breathing score
2: 1+ breathing lasting 30 sec 0: absent breathing or less than 30s of sustained breathing
46
BPP amniotic fluid
2: at least one pocket measures 2cm 0: absent pocket
47
NST in BPP score
2: reactive 0: nonreactive
48
BPP scoring results
8/10: reassuring 6/10: equivocal, may need more testing 4/10: non-reassuring, needs more eval or delivery 2/10: immediate delivery
49
nuchal translucency
checks fluid on neck - 18 wks - incr risk for chromosomal disorders
50
abdominal ultrasound requires....
full bladder
51
fetal ultrasound
to obtain info on: - gestatl age - growth/anatomy - amt amniotc fluid - placentl sytat - nuchal transluscency
52
is fetal ultrasound invasive?
no, | noninvasive, no risks, + accurate
53
MRI purpose
to check tissue, organ, vasc structure
54
MRI requires...
iodine contrast. drink lots of fluid | -supine w left lateral tilt to prevent hypotension
55
Doppler flow studies
noninvasive screening to assess BF to placenta | -calculated by using difference bw sys vs diastole flow
56
umbilical artery doppler results is considered abnormal if..
``` sys/dias ratio is above 95th percentile for age or above 3.9 or en-diastole flow is absent or reversed ```

OB (18 decks)

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