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RNC NIC > Maternal History And Risk > Flashcards

Maternal History And Risk Flashcards

(61 cards)

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1
Q

Maternal serum alpha fetoprotein (MSAFP)

A

16-18 weeks, neural tube defects if high, low can indicate T21

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2
Q

Glucose tolerance test

A

24-28 weeks, plus repeat H/H bc blood volume increases by 50%

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3
Q

RhoGham

A

Given at 28 weeks

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4
Q

Chorionic Villus Sampling

A

Chorionic tissue (inside layer of placenta) tests for fetal chromosomal anomalies, can test in 1st trimester. Can be transabdominal or transvaginal

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5
Q

Amniocentesis

A

Screen for chromosomal abnormalities, done in second trimester (have to wait for enough fluid). Uses fluorescence in situ hybridization (FISH)

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6
Q

Cordocentesis (Percutaneous Umbilical Blood Sampling - PUBS)

A

Takes blood from umbilical cord, guided by ultrasound. Test for blood disorders

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7
Q

Biophysical profile (BPP) variables

A

Fetal breathing movements, fetal movement, fetal tone, amniotic fluid volume, non-stress test

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8
Q

Fetal breathing movements (BPP)

A

Normal - one or more episodes lasting 30 seconds or more
Abnormal - absence of breathing movements or movements lasting less than 30 seconds

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9
Q

Fetal movement (BPP)

A

Normal- 3 or more body or limb movements
Abnormal - two or less

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10
Q

Fetal tone (BPP)

A

Normal - one or more episodes of active extension with return to flexion of limb or trunk, or opening and closing of hand
Abnormal - slow extension with return to partial flexion or absent movement

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11
Q

Amniotic fluid volume (BPP)

A

Normal - single vertical pocket >2cm
Abnormal - <2cm or no fluid

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12
Q

Non-stress test

A

Normal - reactive

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13
Q

BPP scoring

A

8-10 - normal
6 -10 - may be sleepy, watch and retest
4 or less - no reassuring, consider delivery

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14
Q

Preeclampsia

A

Hypertension with proteinuria (> 300mg/L)

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15
Q

HELLP

A

High blood pressure (hemolysis), elevated liver enzymes, low platelets

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16
Q

Superimposed PIH

A

Already had HTN, now worse due to pregnancy

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17
Q

CMV

A

Most common intrauterine infection, transmitted by exposure to infected blood or body fluids, most asymptomatic at birth.
Tx - gancyclovir

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18
Q

Oligohydramnios

A

AF <1 L at 36 weeks, < 800 ml at term
Potter sequence - renal agenesis, not urinating, no fluid, no lungs, can lead to hypoplastic lungs

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19
Q

Hydramnios (poly)

A

AF volume > 2L anytime
GI obstructions, tight nuchal cord (obstruction to swallowing), neuro defects, TE fistula

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20
Q

PROM

A

Premature rupture of membranes

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21
Q

PPROM

A

Preterm premature rupture of membranes (before 37 weeks)

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22
Q

Chorioamniotitis

A

Infection of placental membranes

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23
Q

Lectin/Sphigomyelin (L/S) ratio

A

Normal 2 or more
<2 indicates immature lungs, give steroids, try to stress baby, wait
>2 occurs when fetal lung surfactant is present in fluid (35 weeks)

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24
Q

Phosphatidylglycerol (PG)

A

If present in amniotic fluid, indicates lung maturity
More reliable than l/s ratio in diabetic moms

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25
Fetal-lung maturity (TDx-FLM)
Measures mg of surfactant/g of albumin >55 - probably maturity
26
Variability
Short term- beat to beat changes, vagal stimulation Long term- larger amplitude
27
Early Decelerations
Head compression
28
Variable decelerations
Cord compression
29
Late decelerations
Hypoxemia
30
Fetal tachycardia
>160 for 10 or more minutes Think infection if sustained
31
Tocolytics
Stop labor
32
Mag sulfate
Can cause neuromuscular or respiratory depression in baby
33
Indomethacin (prostaglandin inhibitors)
Risk of premature ductal closure, pulmonary hypertension, and altered renal function
34
Betamimetics (terbutaline)
Can cause hypoglycemia due to hyper insulin emit
35
Procardia
Decrease heart muscle contractors which decreases uterine contractility
36
Abruption
Abruptly pulling away from intrauterine wall, can be partial or total. Can bleed into pocket. Can cause hypoxia and hypoperfusion in baby
37
Cord prolapse
Occult - covering cervical opening 1st or 2nd degrees - dangling Risk of cord compression and fetal hypoxia
38
Placenta previa
Low placental implantation, bright red bleeding because right by cervical opening, low placental implantation
39
Vacuum
Consider hyperbili (RBC breakdown and bleeding)
40
C/s risk
Extra fluid on lungs bc they aren’t squeezed If c/s with no labor - RDS bc labor kicks out surfactant response
41
Fetal fibronectins
Found in fetal membranes throughout pregnancy, no longer detected in fluid after 22 weeks until ~2 weeks before delivery
42
Cervical ferritin
Inflammatory marker (think infection)
43
Corticotropin releasing hormone
Component of labor, both term and preterm
44
Placental a-microglobulin-1
Bio marker for rupture of membranes
45
Last menstrual period (LMP) assessment of gestational age
EDD= first day of LMP- 3 months + 7 days + 1 year
46
Fundal height gest age assessment
Uterus is at umbilicus at 20 weeks
47
Quickening
First feeling of fetal movement Primigravida - 18-20 weeks Multigravida - 16-18
48
Fetal heart tones detected when
as early as 9 weeks, commonly by 12 weeks
49
Fetal femur length for gest age assess
Second trimester on, accurate +/- 7 days
50
TORCH infections
Toxoplasmosis, others (parvo, syphilis), rubella, cytomegalovirus, herpes simplex All cross placenta
51
GBS
Screened at 35-37 weeks Mom given prophylaxis abx during labor if positive
52
Normal fetal baseline
110-160 - 2 minutes
53
Fetal bradycardia
Less than 110 for 10 min or more
54
Fetal tachycardia
Greater than 160 for 10 min or more
55
Category 1
Normal FHR
56
Category 2
Indeterminate FHR not predictive or abnormal fetal acid base balance Reevaluation needed
57
Category 3
Abnormal FHR, abnormal fetal acid base balance
58
Mag sulfate
CNS depressant to prevent seizures Decreases BP transiently
59
GDM etiology
Secretion of human placental lactogen increases cellular resistance to insulin Cortisol and glycogen levels increase Pancreas can’t meet need for increased insulin demand, leads to hyperglycemia
60
Kleihauer-Betke test
For placental abruption Tests for fetal blood in maternal circulation
61
Occult prolapse
Cord not visible or palpable but located between presenting part and pelvis or cervix

RNC NIC (6 decks)

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