Basic Needs: Antepartum

only includes testing

Expected Date of Delivery: EDD

calculated 280 days from the beginning of the last menstrual period.

Serum Alpha-Fetoprotein (AFP):

what is it? what can it indicate? when is it performed?

A protein produced mainly by the fetal liver. Used as a screening test weeks 16-22 to assess risk complications:

Low AFP: chromosomal abnormalities

High AFP: increased risk for neural tube defects

Noninvasive Prenatal Testing (NIPT)

Blood test that analyzes cell-free fetal DNA circulating in their blood, screening for chromosomal abnormalities and can be done as early as 10 weeks.

Group Beta Streptococcus (GBS) what is it? when is screening? what happens if + ?

Bacteria that can colonize vagina/rectum and if passed to newborn it can cause sepsis, pneumonia, and meningitis. Screening at 36-37 weeks via vagina/rectal swab and if + IV antibiotics are given during labor and then newborn is treated.

Glucola Test - what is it? when is it performed?

Are used to determine if mother has gestational diabetes at 24 to 28 weeks.

Glucola Test (50g) - How is it performed and plasma glucose cut off value.

First: nonfasting patient consumes 50g oral glucose and blood is drawn 1 hr. after consuming. If plasma glucose is over 130mg/dL patient needs to do the 3-hr glucose test.

Glucola Test (100g / 3-hr) - How is it performed? values plasma glucoses need to be and how is it confirmed pt has GDM?

Fasting 100g oral glucose tolerance test (OGTT) for over 3 hrs.

fasting patient consumes 100g of oral glucose solution; blood is drawn before and 3x every 1 hr after consuming.

Values Plasma Glucose levels needs to be:

• Fasting glucose: < 95 mg/dL

• 1 hour after: < 180 mg/dL

• 2 hours after: < 155 mg/dL

• 3 hours after: < 140 mg/dL

If 2 or more values are not met pt is diagnosed with GDM

Most widely used glucola test (75g): what happens and values? diagnosis?

One step approach:

fasting pt gets blood drawn should be <92 mg/dL coinsumes 75g oral glucose solution and is tested 1 hr after and should be < 180 mg/dL glucose. after 2 hrs <153 mg/dL. If any of these values are not met pt is diagnosed with GDM

A1C Test

Reflects glucose control over the previous 4-8 weeks the target level for people with preexisting diabetes planning pregnancy is <6.5%, it is not a reliable GDM screening.

Amniocentesis

Invasive diagnostic test where needle removes small amount of amniotic fluid to test chromosomal/genetic abnormalities.

Used @ 15-20 weeks