OB FINALS 1

18-20 weeks

Quickening or first movements, typically occurs between ____ of pregnancy

No 10 movements within two consecutive 1hr periods

When to contact healthcare provider?

Rhythm strip testing

Assessed by recording heart rate for 20mins

Semi-fowler position

Short term variability

Second to second changes indicating healthy oxygen supply

Long term variability

Rate changes over the full 20 mins

Absent

No detectable peak-to-trough range

Requires immediate attention

Minimal

Amplitude range detectable but 5 beats per minute or fewer

Moderate or normal

Detectable amplitude with 6-25 beats per minute

Healthy range

Marked

Amplitude range greater than 25 beats per minute

Nonstress testing

Measures how the baby’s heart rate respond to movement

Vibroacoustic stimulation

Produces sharp 80dB sound at 80Hz can startle and wake the baby

Invasive testing

Provides definitive diagnostic information

Amniocentesis

Aspiration of amniotic fluid through the maternal abdomen

Performed after 15 weeks gestation

Chromosomes analysis

Detection of chromosomal abnormalities and genetic disease

Fetal skin cells cultured for karyotyping

Biochemical markers

AFP and acetylcholinesterase levels identify neural tube defects

Bilirubin determination

Assesses blood incompatibility

Metabolic screening

Detection of inborn errors

Sickle cell disease, cystic fibrosis, muscular dystrophy, Tay-Sachs disease, MSUD

Fibronectin

For placental attachment to the uterine decidua

Becomes undetectable after 20 weeks

Ultrasound localisation

Umbilical cord is identified and visualized using sonography

Determine optimal puncture site

Vein puncture

Allows aspiration of fetal blood for comprehensive analysis

Kleihauer-Betke test

Confirms fetal origin

Measures differences between adult and fetal hemoglobin concentration

PUBS

Enables intrauterine blood transfusion when fetal anemia is identified

Fetoscopy

Direct visualization of fetus and amniotic fluid

16-17 weeks gestation