Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

OB/PEDs: Final > Antepartum Assessment & Assessing the Fetus: > Flashcards

Antepartum Assessment & Assessing the Fetus: Flashcards

1
Q

Antepartum

A

conception to labor- prenatal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Intrapartum

A

onset of labor until birth of infant and placenta (on L&D unit)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Postpartum

A

birth until woman’s body returns to prepregnant condition (after delivery)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Gravida

A

any pregnancy- regardless of duration- *including present pregnancy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Nulligravida

A

never been pregnant

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Primigravida

A

pregnant for the first time

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Multigravida

A

second or any subsequent pregnancy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Gestation

A

number of weeks since the first day of the last menstrual period (LMP)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Abortion

A

birth that occurs before the end of 20 weeks gestation (miscarriage)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Term

A

normal duration of pregnancy 40 weeks gestation or greater

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Preterm or premature labor

A

labor that occurs after 20 weeks but before the completion of 37 weeks (20-36.6 weeks)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Post term labor

A

after 42 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Para

A

birth after 20 weeks, regardless if born alive or dead (still birth)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Nullipara

A

woman who has not given birth at more than 20 weeks gestation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Primipara

A

one birth >20 weeks regardless of alive or dead

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Multipara

A

two or more births >20 wks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Stillbirth

A

fetus born dead after 20 wks gestation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Nageles rule

A

Determines the estimated date of delivery:
1.) determine the first day of the LMP
2.) subtract 3 months
3.) add 7 days
- need to know how many days are in each month

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Fundal Height: McDonald’s Method
Between what weeks?

A
  • Used as an indicator of uterine size.
  • Fundal height in cm is equal to weeks of gestation. (between 22-34 weeks)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Ultrasounds
Provide what information:

A
  • Maternal anatomy
  • Placental location
  • Amniotic fluid volume
  • Number of fetuses
  • Survey of fetal anatomy
  • Biometry-Fetal measurements for gestational age
  • Fetal cardiac activity
  • Fetal abnormalities
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Most common ultra sound

A

Transabdominal Ultrasound

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Transabdominal Ultrasound:

A
  • Drink 8 oz water- dont urinate
  • Pushes uterus to side so you can see better
  • 8 weeks gestation: determine if there is a pregnancy/ FHR/ fluid
  • 16 weeks gestation: can see the anatomy and sex of baby
23
Q

Measurement of the crown-rump length:

A
  • most accurate measurement for dating gestational age in 1st trimester
  • Measures crown to rump
  • Done using ultra sound
24
Q

Nuchal Translucency Testing

A
  • Nuchal fold testing- done at 11.1- 13.6 gestation (1st trimester) to test for trisomy 13, 18, 21 (Down’s syndrome).
  • If positive, the fetus will have an excess accumulation of fluid at the back of the neck
25
Q

Chorionic Villus Sampling (CVS)

A
  • 1st trimester: 9-11 weeks gestation
  • Sample from placenta- can be done in the first trimester- to diagnose genetic, metabolic and DNA studies.
  • Does not detect neural tube defects.
26
Q

Polyhydramnios

A

1% of all pregnancies Measured by AFI(Amniotic Fluid Index): 25 or > and 2,000ml or >

27
Q

What causes
Polyhydramnios: Fetal

A
  • Fetal Abnormalities such as: hydrocephaly, anencephaly, esophageal atresia (esophagus ends in a blind pouch. Reconnects itself into the trachea), spina bifida, diaphragmatic hernia
  • Fetal Anemia
  • Chromosomal Abnormalities
  • Fetal macrosomia (large fetus)
28
Q

What causes
Polyhydramnios: Placental

A
  • Twin-to-Twin Transfusion : one identical twin receives excessive amounts of amniotic fluid while the other has little
  • Placental Blood Vessel Abnormality
29
Q

What causes
Polyhydramnios: Maternal

A
  • Infectious Conditions: Toxoplasmosis, parvovirus, herpes simplex, rubella or cytomegalovirus infections
  • Maternal Diabetes Mellitus (gestational or pre-existing):
  • Maternal Rhesus Disease: Rhesus disease causes the mother’s antibodies to cross the placenta, often resulting in fetal anemia
  • Blood incompatibilities between the mother and the baby
  • Hypertension & Pre-eclampsia
30
Q

Symptoms of Polyhydramnios: maternal

A
  • Difficulty breathing & ambulating
  • Decreased urine production
  • Larger abdominal size for one’s gestational age
  • Swelling of abdomen, vulva, legs
  • Excessive weight gain
  • May be suspected if it’s difficult to assess the body contours and heart beat of the baby despite an enlarged size of the uterus.
31
Q

Polyhydramnios Effects: on Mother:

A

GI discomfort
- Indigestion
- Constipation
- Abdominal pain
- Heartburn
- Striae & varicose veins
- Premature labor, PROM, postpartum hemorrhage, placental abruption, umbilical cord prolapse

32
Q

Polyhydramnios Effects: on Newborn

A
  • Preterm Birth
  • Birth Defects: (Down’s syndrome, cleft palette)
  • Still birth: death of the baby in the uterus after the 20th week gestation
  • fetal malposition
33
Q

Treatment of Polyhydramnios

A

If harmful to fetus:
- Complete Bed rest
- Amnioreduction
- Indomethocin- Prostaglandin inhibitor-prior to 31 weeks only

34
Q

Oligohydramnios

A

not enough amniotic fluid

35
Q

What Causes:
Oligohydramnios:

A
  • PROM
  • Post term gestation
  • Placental Insufficiency
  • Antihypertensive medications: drys out amniotic fluid
  • Fetal urinary tract abnormalities
36
Q

Oligohydramnios Treatment

A

Amnioinfusion: sterile water
Increased fluid intake

37
Q

Amniocentesis

A
  • done with ultrasound
  • 35 years or older(geri pregnancy)= amniocentesis to check for abnormalities
  • preterm labor: check LS ratio
38
Q

Amniotic Fluid Tests

A
    • a-Fetoprotein (alpha-fetoprotein) (AFP)– fetal serum protein produced in the yolk sac for the first 6 weeks of gestation and then by the fetal liver- can diagnose genetic abnormalities
  • L/S Ratio- Lecithin/Sphingomyelin- 2 components of surfactant
  • 30-32 weeks the ratio=1:1
  • 35 weeks=2:1
39
Q

Percutaneous Umbilical Blood Sampling -PUBS

A
  • Aspiration of fetal blood from the umbilical cord to assess for Rh disease, clotting disease, acid- base status of fetus, fetal infection
40
Q

Prenatal Blood Tests

A
  • Blood type
  • CBC
  • Hepatitis
  • HIV
  • PAPP-A-Plasma pregnancy associated plasma protein A
  • Rh Factor
  • Rubella
  • Syphilis
41
Q

Group B Strep

A
  • Vaginal/rectal swab at 35-37 weeks
  • Leading cause of meningitis, sepsis, pneumonia in newborns
  • Treat with Penicillin or Ampicillin within 4 hours of labor
    — **If severe allergy to PCN- may use Clindamycin or Erythromycin
42
Q

Nonstress Test [NST]

A
  • Measure the ability of the fetal heart to accelerate in association with fetal movement
    — Reactive=good
    — Non-Reactive=no fetal movement.
43
Q

Reactive nonstress test.

A

At least 2 Accelerations of 15 bpm lasting 15 seconds with each fetal movement, over 20 minutes

44
Q

Nonreactive NST

A

Accelerations not present or do not meet normal criteria.

45
Q

Biophysical Profile

A
  • Noninvasive assessment of the fetus
  • It consists of Five Variables (4 by ultrasound; 1 by NST).
  • It is usually done when there is a sequella of nonreassuring findings on the nonstress test.
  • It provides a reflection of CNS activity because CNS is among the tissues sensitive to altered oxygen supply. Based on the gradual hypoxia principle, progressive fetal hypoxia* is manifested as loss of biophysical function.
46
Q

Biophysical Profile: Five Variables

A
  • Fetal breathing movements
  • Fetal movements of body or limbs
  • Fetal tone
  • Amniotic fluid volume
  • ## Reactive fetal heart rate with activity— Maximum score is 10; 10/10 or 8/10 norm.
    — Interventions vary with lower scores.
    —— 4 or below =immediate delivery & resuscitation of the newborn
47
Q

Contraction Stress Test (CST)

A

CST measures the response of the fetal heart to the stress of uterine contractions(caused by Oxytocin) .
It is indicated for pregnancies at risk for placental insufficiency or fetal compromise because of any of the following:
- IUGR (intrauterine growth restriction)
- Diabetes mellitus
- Postdates (42 or more weeks’ gestation)
- Nonreactive NST

48
Q

Interpretation of CST Results

A
  • Negative: Desired result. No decels with contraction. 3 contractions of good quality lasting 40 sec. in 10 minutes without decels. (fetus can handle hypoxia of contraction)
  • Positive: repetivitve late decels with more than 50% of contractions. Hypoxia causes decreased FHR
  • Equivocal or suspicious: nonpersistant decels
49
Q

Contraction Stress Test (CST): Negative CST:

A
  • good;
    The example shows: the baseline FHR is 130 with acceleration of FHR of at least 15 bpm lasting 15 seconds with each fetal movement. Uterine contractions indicate 3 in 8 minutes
  • May indicate the possibility of insufficient placental respiratory reserve
50
Q

Contraction Stress Test (CST): Positive CST

A
  • Positive contraction stress test: bad; Repetitive late decelerations occur with each contraction.
    This example shows: No accelerations of FHR with 3 fetal movements. Baseline FHR is 120 bpm. Uterine contractions occurred 4 times in 12 minutes
51
Q

Equivocal Suspicious Result

A
  • FHR decelerations in presence of contractions that are more frequent than every 2 minutes or last longer than 90 seconds
  • Often times c-section
52
Q

Fetal hypoxia: as it progresses

A
  • loss of fetal heart rate reactivity
  • Reduced, then absent, fetal breathing movements
  • Reduced then absent gross (large) fetal movement
  • Reduced fetal tone
  • Prolong hypoxemia: reduced amniotic fluid volume
53
Q

Umbilical Velocimetry:

A
  • Doppler measures the red blood cells from the umbilical artery.
  • How well the ambilical artery is perfusing
  • Highest peak is systolic and lowest is diastolic.
    — pic: normal- no gaps
  • abnormal: gaps

OB/PEDs: Final (18 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions