Antepartal Tests-6 Flashcards
Biophysical factors
originate from the mother or fetus and impact the development or function of the mother or fetus. They include genetic, nutritional, medical, and obstetric issues
Psychosocial factors
maternal behaviors or lifestyles that have a negative effect on the mother or fetus. Examples include smoking, caffeine use, alcohol/drug use, and psychological status.
Sociodemographic factors
variables pertaining to the woman and her family that place the mother and the fetus at increased risk. Examples include access to prenatal care, age, parity, marital status, income, and ethnicity.
Environmental factors
Various environmental substances can affect fetal development. Examples include exposure to chemicals, radiation, and pollutants.
fetal ultra sounding imaging
● Presence of a gestational sac.
● Gestational age.
● Fetal growth.
● Fetal anatomy and presentation when performed in the second and third trimesters.
● Placental location and possible abnormalities.
● Fetal activity.
● Number of fetuses.
● Viability.
● Amount of amniotic fluid.
● Visual assistance for some invasive procedures, such as amniocentesis.
Transvaginal ultrasound
● Generally performed in the first trimester for earlier visualization of the fetus
● Woman in a lithotomy position
● Sterile covered probe/transducer inserted into the vagina
Abdominal ultrasound
● A full bladder is necessary to elevate the uterus out of the pelvis for better visualization when performed during the first half of pregnancy.
● The woman is in a supine position.
● Transmission gel and transducer are placed on the maternal abdomen.
● The transducer is moved over the maternal abdomen to create an image of the structure being evaluated
Obstetric first-trimester ultrasound
Identification of number and measurement of yolk sac(s), gestational sac(s), embryo(s), and fetus(es)
Identification and confirmation of early fetal cardiac activity
Determination of uterine versus extrauterine pregnancy
Use as an aid for ultrasound-guided procedures
Obstetric second- and third-trimester ultrasound
Fetal number and location
Fetal cardiac activity
Fetal position and presentation
Placental location
Amniotic fluid volume assessment
Biometric measurements to estimate fetal age and weight
Cervical length measurement
Use as aid for ultrasound-guided procedures
Modified BPP (amniotic fluid index and nonstress test)
Biophysical profile including: fetal tone, fetal movement, fetal breathing, amniotic fluid, and nonstress test
Three-dimensional (3D) ultrasound
Determination of complications
used only as an adjunct to conventional ultrasonography
MRI
Tissue, organs, and vascular structures can be evaluated without the need to inject iodinated contrast
Doppler Flow Studies
Assesses placental perfusion
Used in combination with other diagnostic tests to assess fetal status in IUGR fetuses
not recommended to the general obstetric population
The middle cerebral artery (MCA) Doppler
important indicator of fetal anemia.
important obstetric ultrasound tool used as a predictor of adverse pregnancy outcome.
Chorionic villus sampling (CVS)
aspiration of a small amount of placental tissue (chorionic villi) for chromosomal, metabolic, or DNA testing.
● There is a 7% fetal loss rate due to bleeding, infection, and rupture of membranes.
● Ten percent of women experience some bleeding after the procedure.
Amniocentesis
a needle is inserted through the maternal abdominal wall into the uterine cavity to obtain amniotic fluid. It is commonly performed for genetic testing but can also be done for assessment of fetal lung maturity, assessment of hemolytic disease in the fetus, or intrauterine infection and therapy for polyhydramnios.
risks of Amniocentesis
● Studies suggest a loss rate as low as 1 in 300 to 500 (AAP & ACOG, 2012).
● Trauma to the fetus or placenta
● Bleeding or leaking of amniotic fluid
● Preterm labor
● Maternal infection
● Rh sensitization from fetal blood into maternal circulation
Fetal blood sampling/percutaneous umbilical blood sampling (PUBS)
A needle is inserted into the umbilical vein at or near placental origin and a small sample of fetal blood is aspirated
test for metabolic and hematological disorders, fetal infection, and fetal karyotyping.
Alpha-fetoprotein (AFP)
The AFP test is a maternal blood test that evaluates the levels of AFP in the maternal blood to screen for certain fetal abnormalities.
high false positive rate
Triple marker screening
This is a maternal blood test that assesses for the levels of chemicals in the maternal blood to screen for certain developmental abnormalities.
fetal movement counting (FMC)
counts fetal movements in a specified time period to identify potentially hypoxic fetuses
after 28 weeks’ gestation
The nonstress test (NST)
The NST uses EFM to assess fetal well-being.
____________________
uses fetal heart rate patterns and accelerations as an indicator of fetal well-being
monitored with the external FHR transducer
Vibroacoustic stimulation (VAS)
The test uses a buzzer (in auditory stimulation) to assess fetal well-being.
___________________
screening tool that uses auditory stimulation (with an artificial larynx) to assess fetal well-being with EFM when NST is nonreactive.
contraction stress test (CST)
The CST stimulates contractions to evaluate fetal reaction to the stress of contractions.
Amniotic Fluid Index
This test uses ultrasound to measure the amount of amniotic fluid to assess fetal well-being and how well the placenta is working.
Biophysical Profile
The BPP is an ultrasound evaluation of fetal status and involves observation of various fetal reflex activities.
Modified Biophysical Profile
A modified BPP is an NST and measurement of the amount of amniotic fluid.
