3)maternity- antepartum screening/diagnostics

biophysical risk factors

genetics, nutrition, medical disorders

psychosocial risk factors

caffeine, smoking, alc use, drug use, mental health

testing is done for

high risk pregnancy

maternal screening

alpha-fetoprotein, multiple marker screen

alpha-fetoprotein: _________ only

screening

alpha-fetoprotein: need _________ to diagnose

amniocentesis

alpha-fetoprotein ideal levels

16-18

alpha-fetoprotein: low levels= risk for

down syndrome, hydatidiform mole

alpha-fetoprotein: high levels= risk for

neural tube defects (spina bifida)

multiple marker screen done at

15-16 w

multiple marker screen: serum biochemical markers

AFP, hCG, estriol

multiple marker screen test for

trisomy 21/18, neural tube defects

fetal diagnostic testing

amniocentesis, chroionic villus sampling, cordiocentesis

amniocentesis

use of needle to remove amniotic fluid

amniocentesis done after

14 w

amniocentesis requires

ultrasonography

amniocentesis tests for

genetic disorder, fetal lung maturity (lamellar body count), intrauterine infection

amniocentesis positioning

on back

amniocentesis post-op: monitor

contractions

amniocentesis: obtain _______ after procedure

NST

chroionic villus sampling tests for

chromosomal abnormality (down syndrome, cystic fibrosis)

chroionic villus sampeling

checks cells from placenta

chroionic villus sampling done at

10-12 w

chroionic villus sampling complications

preterm labor, infection, inury to baby

cordocentesis also called

percutaneous umbilical cord blood sampling

cordocentesis done after

18 w

cordocentesis tests for

anemia

fetal well being screening

fetal kick counts, nonstres test, contraction stress test, ultrasound, biophysical profile

fetal kick count done after

28 w

fetal kick count test for

conditions affect fetal oxygenation (preeclampsia, maternal heart disease)

fetal kick count: ____ movements in ___ hours

10, 2

if fetal kick count is dec, need to come in for

NST/CST and biophysical profile

NST

fetal heart rate patterns in response to fetal movement, contrations, or stimulation

reactive NST

2 15x15 accelerations in 20 min

NST done after

32 w

nonreactive NST

no accelerations in 40 min

nonreactive NST: follow up with ___ or _____

BPP, CST

most common reason for no accelerations

fetus sleeping

contraction stress test (CST): use of

oxytocin

negative CST

no late decelerations

positive CST

repetitive late decelerations

CST used for women at risk for

uteroplacental insufficiency (diabetes, hypertension)

CST: need ___ contractions in _____ min

3, 10

ultrasound allows for

ealier diagnosis

ultrasound can be done at

any trimester

ultrasound tests for

\# gestational sacs/fetuses, placental placement, fetal viability, fetal organs, growth pattern, anomalies, amniotic fluid volume

doppler evaluation tests for

flow in umbilical vessels, placental profusion, IUGR babies

anatomy scan done at

18 w

biophysical profile uses

real time ultrasound

biophysical profile done in

2/3 trimesters

biophysical profile is a reliable predictor of

fetal well being

biophysical profile: acute markers

current CNS status

biophysical profile: chronic markers

amniotic fluid indicator

biophysical score of ______ indicates normal/low risk for chronic asphyxia

8-10

normal amniotic fluid index

5-24