Flashcards in Quad Screen and fetal heart rate Deck (51):
1
Describe the office visit plan for pregnant women
every 4 weeks for first 28 weeks
every 2-3 weeks until 36 weeks
every week after 36 weeks
2
what is the quad screen
maternal blood screening that looks for 4 specific substances
AFP, hCG, Estriol and Inhibin A
3
what produces AFP
fetus
4
what produces hCG
placenta
5
what produces estriol
fetus and placenta
6
what produces Inhibin A
placenta and ovaries
7
how will downs present on quad screen
decreased AFP, estriol
Increased hCG and inhibin A
8
US of downs may show what
nuchal translucency
9
how will edwards trisomy 18 present on quad screen
decreased: AFP hCG and estriol
normal inhibin A
10
signs of trisomy 18
severe mental retardation, rocker bottom feet, micrognathia, low set ears, clenched hands, prominent occiput
11
lifespan of neonates with trisomy 18
50% die within first week
only 8% live beyond year 1
12
What is trisomy 13
pataus
13
patau on US
nuchal translucency
14
trisomy 13 on quad screen
sometimes hCG dec
15
survival baby with patau
2.5 days
5% make it a year
16
quad screen recommended especially for women who
+FMH birth defects
35+ y.o
use of harmful medications or drugs during pregnancy
DM and use insulin
viral infection during pregnancy
exposed to high levels radiation
17
the quad screen is combined with what factors
mothers age and ethnicity
18
high AFP suggests what
spina bifida or elevated ARP levels from inaccurate dating of pregnancy
19
low levels AFP
abnormal hCG and estriol suggest what
baby has Trisomy 21 and 18
20
what causes the decrease in fetal heart rate as it develops
response to parasympathetics
21
what are the components of the fetal heart rate tracing
-baseline rate
-baseline fetal heart rate variability
-presence of accelerations
-periodic of episodic decelerations
-changes of trends of FHR patterns over time
-Frequency and intensity of uterine contractions
22
what is the baseline fetal heart rate
during 10 minute segment rounded to nearest 5 beat per min
23
minimum amount of time for baseline fetal heart rate
2 minutes
24
what is bradycardia in fetus
mean FHR <110 BPM
in absence of other non-reassuring patterns is not usually a sign of compromise
25
etiologies of bradycardia in fetus
heart block, occiput posterior or transverse position, serious fetal compromise
26
what is tachycardia in fetus
mean FHR >160BPM
27
etiologies of tachycardia in fetus
maternal fever, fetal hypoxia, fetal anemia, amnionitis, fetal tachyarrhythmia(no variability), fetal heart failure, drugs, rebound
28
what constitutes a baseline change in fetal heart rate
decrease or increase in HR that lasts longer than 10 minutes
29
what is baseline variability
fluctuations of fetal heart rate more than 2 cycles per minute
30
grades of HR variability depend on what
amplitude range
31
what is minimal HR variability?
moderate?
marked?
25 BPM
32
what is a sinusoidal pattern of fetal heart tracing
smooth, undulatin pattern
lasting at least 10 minutes with a fixed period of 3-5 cycles per minute with amplitude of 5-15 bpm
33
what is the most significant intrapartum sign of fetal compromise
persistently minimal or absent FHR variability
34
what can cause decreased variability in fetal heart rate
metabolic acidosis, CNS depressants, fetal sleep cycles, congenital anomalies, prematurity, fetal tachy, preexisting neurologic abnormality, betamethasone
35
what is an acceleration in fetal heart racing
onset peak of acceleration <30 sec and less than 2 minutes in duration
36
what is adequate acceleration for <32 weeks old fetus
>10 BPM above baseline for >10 seconds
37
what is adequate acceleration for >32 weeks old fetus
>15 BPM above baseline for >15 seconds
38
what is a prolonged acceleration in HR
2-10 minutes
39
absence of acclerations in HR more more than how long correlates with increased neonatal morbidity
80 minutes
40
what can be used to induce accelerations in fetal heart rate
fetal scalp stimulation
41
what is "reactivity" in fetal heart rate
increase 15 BPM above baseline for 15 sec duration
42
what are episodic patterns in fetal heart rate
not assoc with uterine contractions
43
what are periodic patterns in fetal heart rate
associated with uterine contractions
44
what are the types of deceleration patterns
gradual- decrease and return to baseline with time from onset of deceleration to nadir >30 sec
abrubt- decrease in FHR >15 bpm with onset deceleration to nadir <30 sec
45
what is nadir when talking about decelerations
low point of FHR
46
early deceleration
gradual decrease in FHR with onset duration to nadir >30 sec
47
late deceleration
gradual decrease in FHR with onset deceleration to nadir >30 sex
onset deceleration occurs after begining of the contraction
nadir of contraction occurs after peak
48
decelerations occur with what
>50% of uterine contractions
49
what is a prolonged deceleration
decrease in FHR >15 bpm measure from most recent baseline rate
50
etiologies of prolonged deceleration in fetal heart patterns
maternal hypotension, uterine hyperactivity, cord prolapse, cord compression, abruption, artifact, maternal seizure
51