Ch. 30- The Biophysical Profile

Incorrect negative test result when the state being tested is present; example: the fetus reacts during a BPP; however, there is fetal compromise owing to acidosis

false negative

Low fluid surround the fetus

oligohydramnios

Abnormally high level of circulating carbon dioxide

hypercapnia

Reduced blood oxygen levels

hypoxemia

Prenatal testing including only the NST and AFI

modified biophysical profile (mBPP)

Positive result when the state being tested is absent; example: nonreactive BPP owing to fetal sleep cycles

false positive

Intravenous injection of oxytocin causing the uterus to contract; monitoring of the fetal reaction to uterine contractions aims to determine how the fetus reacts to environmental stress

oxytocin challenge test (OCT)

Measure of alkalinity or acidity of the blood with neutral at 7; > is alkaline; and <7 is acidic

pH

Amount of fluid within the amniotic sac surrounding the fetus; the AFI is an estimate of this amount

amniotic fluid volume (AFV)

Rough estimate of the fluid surrounding the fetus obtained through the measurement of four pockets of amniotic fluid, one from each of the abdominal quadrants

amniotic fluid index (AFI)

Monitoring of fetal activity to include breathing movements, discrete movements, tone, and fluid surrounding the fetus accompanied by a NST

biophysical profile (BPP)

Blood pH <7 owing to an increase in hydrogen concentrations caused by impaired blood supply to the fetus

acidosis

Technique of concurrently recording the fetal heartbeat and contractions

cardiotocography (CTG)

Decrease in oxygen content of the blood accompanied by an increase in carbon dioxide

asphyxia

Recording of fetal heart rate accelerations (normal) or decelerations (abnormal) owing to blood oxygen level changes resulting from uterine contractions

nonstress test (NST)

US observance of fetal well-being is determined by all of the following except:

• body movements

• urine output

• spontaneous breathing

• heart decelerations

heart decelerations

Electronic fetal heat rate monitoring is performed by:

• calculating AFV

• OCT

• BPP testing

• calculating fetal growth ratios

OCT

A fetal biophysical profile in utero observation includes all except:

• NST

• fetal tone

• fetal breathing

• gross body movements

NST

In order to pass the fetal breathing portion of a BPP, the fetus must exhibit:

• breath to breath intervals of less than 6 seconds

• at least on episode of sustained fetal breathing of at least 30 seconds duration within a 30 minute span

• breathing episodes to include hiccups within a 30 minute interval

• spontaneous motions to include movement of the chest wall and of the abdominal wall

at least on episode of sustained fetal breathing of at least 30 seconds duration within a 30 minute span

Fetal movements in pregnancy imply normalcy of the fetal:

• respiratory system

• musculoskeletal system

• CNS

• cerebrospinal fluid volume

CNS

Fetal movements of the trunk, large limbs, swallowing, face, and hands are categorized as:

• motion mode

• AFV

• tone

• gross body movements

gross body movements

AFI is determined by:

• measuring the deepest pocket of amniotic fluid

• subjective analysis

• measuring four quadrants in the deepest vertical pocket and totaling the values

• four transverse depth measurements of amniotic fluid within the pregnant uterus, summed and totaled

measuring four quadrants in the deepest vertical pocket and totaling the values

The electronic feta heart monitoring method that has a low false positive, low false negative and usually requires several hours to complete is:

• OCT

• NST

• BPP

• AFI

OCT

Oligohydramnios is diagnosed when the amniotic fluid in four quadrants measures:

• 5.0 cm or less

• 19.0 cm or more

• less than 5.0 cm in a quadrant

• more than 9.0 cm in a quadrant

5.0 cm or less

A normal BPP score is 8 or 10. An equivocal score is

• 8 or less

• 6 or less

• 4 or less

• 2 or less

6 or less

A cardiotachometer records:

• fetal gross movement

• uterine and cervical contractions

• patterns of fetal heart rate including baseline and changes

• blood flow patterns and Doppler assessment of the fetal heart

patterns of fetal heart rate including baseline and changes

Acceleration is defined as:

• increased fetal gross body movement and ton involving more than six movements in 15 minutes

• sustained breathing beyond 60 seconds

• an AFI over 22 cm

• increase of the fetal heat rate over the baseline of at least 15 beats per minutes, and lasting at least 15 seconds associated with fetal movement

increase of the fetal heat rate over the baseline of at least 15 beats per minutes, and lasting at least 15 seconds associated with fetal movement

Startle means:

• slow and small shifting of the fetal contour

• quick, generalized movement always initiated in limbs and sometimes spreading to neck and trunk

• regular in rate and amplitude

• irregular, intermittent, large-amplitude breaths; short duration of individual breaths

quick, generalized movement always initiated in limbs and sometimes spreading to neck and trunk

Normal fetal tone is:

• three flexion to extension movements with full return in a 30 minute span

• seen with movement of the extremities in a longitudinal fashion

• at least one episode of extension of extremities with return to position of flexion, or extension of spine with return to position of flexion is visualized in the 30 minute observation period

• three rolling movements of the trunk or long bones in a 30 minute observation period

at least one episode of extension of extremities with return to position of flexion, or extension of spine with return to position of flexion is visualized in the 30 minute observation period

An AFI plus an NST is known as:

• partial BPP

• modified BPP

• BPP-NST

• BPP

modified BPP

Regular patterns of fetal breathing are defined as:

• crescendo-decrescendo changes in rate and amplitude

• 40-60 breaths per minute

• intermittent, large-amplitude breaths

• observed in the 20-26 week fetus

40-60 breaths per minute

BPP, AFI, and NST testing typically occurs:

• daily

• every other day

• twice weekly

• once weekly

once weekly

Independent limb movements occur at:

• the 8th week

• the 9th week

• weeks 10-12

• the 14th week

weeks 10-12

Fetal movement I mostly related to:

• placental location

• AFV

• fetal individuality

• maturation of the CNS

maturation of the CNS

Fetal breathing can be gauged with a real-time scanner by viewing the fetal abdomen in a longitudinal fashion, as well as by observing:

• abdominal contractions

• caudal-cephalad kidney movement

• sustained lower extremity flexion extension with pressure onto the anterior abdomen

• prolonged wide opening of jaws, followed by quick closure

caudal-cephalad kidney movement

Monitoring the fetus in the second and third trimesters can be performed by the mother in the way of ________ _________.

kick counts

________ __________, a decrease in oxygen content of the blood accompanied by an increase in carbon dioxide, can be evaluated by antepartum testing.

Fetal asphyxia

Two electronic fetal monitoring tests involving heart rate are ____________ _____ and _____________ ___________ ________.

nonstress test (NT) and oxytocin challenge test (OCT)

The first maternal perception of fetal movement is known as _____________.

quickening

AFI is determined by measuring depth of fluid of ___ quadrants.

4

Amniotic fluid cannot be measured in a pocket that contains __________ ______.

umbilical cord

The biophysical profile variables can earn a score of ___ if normal and a score of ___ if abnormal or do not meet the criteria.

2; 0

Breathing movements increase during periods of __________, but decrease with maternal ____________________.

hypercapnia; hyperventilation

Fetal movement is usually noted by the mother at ________ weeks.

16-20

A fetal reactive NST is defined as ___ accelerations with a ___minute span.

2; 20

An increase of the fetal heat rate over the baseline of at least 10 BPM and lasting at least 10 seconds is considered normal for fetuses below ___ weeks gestation.

32

The term ___________ _____ is applied to an NST that did not respond as expected in the allotted time span.

nonreactive NST

Jerky contractions of the diaphragm or abrupt consistent displacement of the diaphragm, thorax, and abdomen are _________.

hiccups

The __________ plane through the fetal chest best demonstrates fetal breathing.

sagittal

______________ stimulation reslust in a significant reduction in the number of nonreactive NSTs and a decrease in the time required for a reactive test to occur.

Vibroacoustic

A nonreactive fetus may respond to maternal ___________, _______________ stimulation, __________ manipulation of the maternal abdomen, and _______ ingestion to stimulate or awaken them.

movement; vibroacoustic; manual; juice

It has been noted that at 20 weeks the fetal heart rate increases with fetal ____________.

movement

Hiccups are caused by a contraction of the ___________.

diaphragm

During maternal hypoxemia, cessation of fetal _____________ occurs.

respirations

Rhythmic bursts of regular jaw opening and closing at a rate of about one per second suggests ___________ activity.

swallowing