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prenatal diagnostic tests Flashcards

(75 cards)

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1
Q

how many weeks is in the FIRST trimester or pregnancy?

A

1-12 weeks

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2
Q

how many weeks is in the SECOND trimester or pregnancy?

A

13-26 weeks

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3
Q

how many weeks is in the THIRD trimester or pregnancy?

A

27-delivery

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4
Q

who gets consent for a prenatal test?

A

diagnostician

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5
Q

is the mom REQUIRED to complete a diagnostic test or screening, or is it OPTIONAL?

A

optional

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6
Q

what are some fetal & placental conditions ULTRASOUNDS determine?

A

presence & location of pregnancy, multifetal gestation, gestational age (how far along pregnancy is), viability confirmation (confirmed by FHR), identifying fetal abnormalities

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7
Q

can you determine fetal sex with an ultrasound?

A

yes, but not always

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8
Q

why should the mom (at 18 weeks/2nd trimester) drink 1-2 quarts of water and hold her bladder before an ultrasound?

A

because in the 2nd trimester, the fundus is below the umbilicus & holding the bladder will move the fundus up

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9
Q

what is used to perform the doppler ultrasound blood flow assessment?

A

ultrasound

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10
Q

indicates forward movement of blood in a vessel that is above baseline

A

doppler shift

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11
Q

in what pregnancies would a doppler ultrasound blood flow assessment be used?

A

in pregnancies complicated by hypertension & fetal growth restriction caused by placental insufficiency

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12
Q

what organs are affected in pregnancies complicated by hypertension?

A

placenta & umbilical cord

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13
Q

what ratio does the doppler ultrasound blood flow assessment use to measure blood flow?

A

systolic to diastolic ratio

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14
Q

what does color doppler imaging help you see?

A

the umbilical vein and the 2 umbilical arteries

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15
Q

how is the alpha-fetoprotein (AFP) SCREENING assessment performed?

A

by collecting maternal serum or amniotic fluid

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16
Q

what does alpha-fetoprotein (AFP) SCREENING assessment identify?

A

open body wall defects (neural tube defects) & chromosomal anomalies (trisomy 21/down syndrome)

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17
Q

low levels of amniotic fluid indicates ….

A

chromosomal anomalies (ex. down syndrome)

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18
Q

how many weeks of gestation is the AFP SCREENING assessment performed?

A

between 16 & 18 weeks of gestation

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19
Q

must be viewed as a first step in screening

A

AFP screening assessment

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20
Q

main protein in fetal plasma that diffuses from fetal plasma into fetal urine & gets excreted into amniotic fluid or to mom’s blood as waste product

A

alpha feto protein

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21
Q

is AFP screening assessment able to diagnose (diagnostic) or a screening tool & requires follow up?

A

screening

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22
Q

what does elevated AFP levels indicate?

A

failure of embryo neural tube or anterior body wall to close properly (ex. ancephaly or spina bifida)

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23
Q

another term for AFP screening assessment

A

MSAFP (maternal serum AFP)

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24
Q

what are the two additional markers (multiple marker SCREENING) added to the MSAFP/AFP SCREENING?

A

HCG & unconjugated estriol (estrogen)

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25
increases detection of trisomy 18 & 21
multiple marker screening
26
what indicates a positive test in multiple marker screening?
if MSAFP & estriol are low but HCG is high
27
if testing is positive in multiple marker screening what DIAGNOSTIC test is recommended?
amniocentesis
28
uses transcervical or transabdominal sampling to obtain villi & performed much earlier than amniocentesis
chorionic villus sampling
29
how many weeks of gestation is the chorionic villus sampling done in?
between 10 & 13 weeks gestation
30
provides information about chromosomal defects, metabolic & DNA abnormalities
chorionic villi cells
31
what is the advantage with chorionic villus sampling?
it's performed early and can lead to earlier decision of elective abortion
32
what are the risks associated with chorionic villus sampling?
infection, bleeding, fetal injury, fetal loss
33
aspiration of amniotic fluid from sac for further examination (by going through the abd)
amniocentesis
34
when is the SECOND trimester amniocentesis perfomed & what does it detect?
between 15 & 20 weeks, detects chromosomal or biochemical abnormalities
35
when is the THIRD trimester amniocentesis performed & what does it determine?
during the third trimester, determines fetal lung maturity or hemolytic disease
36
what does it mean when the fetal lungs are mature?
they have enough surfactant
37
the two substances that create surfactant
lecithin & sphingomyelin
38
decreases surface tension in alveoli to make breathing easier & prevent atelectasis
surfactant
39
when mom is RH negative, has been exposed to RH antigen, developed antibodies against RH-positive fetal RBC and destroys them
hemolytic disease
40
what are the indications for second trimester amniocentesis?
maternal age of 35 yrs or older, chromosomal d/o in close family members, gender determination for maternal carrier of x-linked disorders (ex. hemophilia or duchenne muscular dystrophy), birth of previous infant with chromosomal d/o or neural tube/body wall defect, pregnancy after multiple spontaneous abortions (miscarriages), unexplained elevated levels of maternal serum afp, maternal rh sensitization of maternal rh-neg blood to fetal rh-positive blood
41
what are the risks associated with amniocentesis?
infection, bleeding, fetal injury, fetal loss
42
aspiration of fetal blood from umbilical cord near placenta where it's inserted for prenatal diagnosis or therapy
percutaneous umbilical blood sampling/ cordocentesis
43
what does PUBS/cordocentesis detect?
blood disorders, acid-base imbalance, infection, or fetal genetic dz
44
what are the risks associated with pubs?
infection, bleeding, fetal injury, fetal loss
45
what are the different types of antepartum fetal surveillance tests?
nst, cst, bpp
46
a prenatal diagnostic test which evaluates FHR accelerations WITH or WITHOUT fetal movement
NST
47
The fetal heart rate should increase as the baby moves. What indicates a reactive/reassuring result in NST testing?
if FHR increases for 15bpm for 15 seconds , two times, in the twenty minute long NST test
48
what is reactivity in the NST test associated with?
adequate fetal oxygenation & intact neural pathways
49
fetal reactivity may not develop until __________ weeks
32
50
uses sound to confirm if NST findings are reactive/reassuring
vibroacoustic stimulation
51
adds a stressful situation to the baby/contraction
cst
52
contractions cause a temporary _________ in blood flow that the baby can tolerate and adjust to
decrease
53
used to cause a contraction in the CST testing
nipple stimulation or low dose oxytocin
54
what does the CST testing determine?
if fetal heart responds to uterine contractions that temporarily decrease placental blood flow
55
if stimulated uterine contractions are contraindicated, can an CST testing be perfomed?
NO
56
negative/reassuring result in CST
is a good sign
57
late/positive/nonreassuring result in CST
means the FHR has dropped & baby is not ok
58
what are the five parameters included in the Biophysical Profile (BPP)?
NST, fetal breathing/chest movements, gross fetal movements, fetal tone, & amniotic fluid volume
59
if the five parameters are present in a BPP, how many points does each parameter receive?
2
60
method used to quantify the amount of amniotic fluid visualized by ultrasound in a BPP
amniotic fluid index
61
if NST is NOT done in a BPP but the rest of the five parameters are present, what is the result?
8/10
62
if NST IS done in a BPP, is reactive, & the rest of the five parameters are present, what is the result?
10/10
63
score below 8 in a BPP could indicate
hypoxia
64
FIRST sign of fetal hypoxemia & acidosis
late decelerations appear
65
SECOND sign of fetal hypoxemia & acidosis
accelerations disappear
66
THIRD sign of fetal hypoxemia & acidosis
fetal breathing movement stops
67
LATE sign of fetal hypoxemia & acidosis
fetal movement ceases
68
LAST sign of fetal hypoxemia & acidosis
fetal tone absent & fetus is already compromised
69
fetal movements assessed by the mother
kick counts
70
how many fetal movements should be in 1-2 hours?
10
71
how many fetal movements should be per hour?
5-10
72
purpose of the AFP screening
to detect pregnancies at high risk for neural tube defects
73
Normally, a 2:1 ratio lecithin/sphingomyelin indicates lung maturity in a 3rd trimester amniocentesis. A 3:1 lecithin/sphingomyelin ratio would reveal lung maturity in a fetus of a pregnancy complicated by ______________________
diabetes
74
should the mother empty her bladder before NST testing?
yes
75
when should a mother notify the provider about fetal movements?
if movement suddenly changes and/or decreases

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