Quad Screen and fetal heart rate Flashcards Preview

Year2 Repro exam II > Quad Screen and fetal heart rate > Flashcards

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

common cause of prolonged deceleration

umbilical cord compression