Antepartum fetal evaluation Flashcards
How should you instruct patients to do fetal kick counts?
3 movements in 1 hour
When does fetal movement peak throughout the day?
9 pm - 1 am
True or false: Mild hypoglycemia increases fetal movement
True
What is the contraction requirement for a contraction Stress Test?
3 contractions in 10 minutes lasting 40 - 60 seconds
What is the definition of a negative CST?
No late deceleration present
What is the definition of a positive CST?
late deceleration present with > 50% of contractions
What is the definition of an equivocal CTS?
late deceleration present with < 50% of contractions
CSTs have a _____ false positive rate and _____ false negative rates.
High, low
A negative CST assures fetal well being for how long?
1 week following test
A reassuring and reactive NST assures fetal well being or how long?
1 week following test
A non reactive NST is associated with what perinatal mortality rate?
30 - 40/1000
What is the most common cause of a non reactive NST?
Fetal sleep cycle
When you increase NST frequency to twice weekly how much do you decrease the mortality rate in high risk populations?
6.1/1000 (once weekly) –> 1.9/1000 (twice weekly)
What are the components of a BPP?
NST, Fetal breathing, fetal movement, fetal tone, amniotic fluid volume
What is the management of a BPP of 6/10 in a term patient?
Delivery
What is the management of a BPP of 6/10 in a preterm patient
repeat in 24 hrs
What is the management of a BPP of 4 or less regardless of gestational age?
Delivery
What is the false positive rate of a BPP of 6/10
75%, meaning 75% of babies with a BPP of 6/10 will be fine
What are the components of a modified BPP?
NST and AFI
What type of antenatal testing has the lowest false negative rate?
CST
When should fetal testing start for GDMA2?
32 wks - 36 wks
When should fetal testing start for pregestational diabetes?
32 wga or earlier
When should fetal testing start for previous stillbirth?
At gestational age of previous still birth
When should fetal testing start for Lupus?
28wga
When should fetal testing start for FGR?
at diagnosis and when delivery is feasible
When should fetal testing start for oligohydramnios?
at diagnosis and when delivery is feasible
When should fetal testing start for PreEclampsia?
When should fetal testing start for oligohydramnios?
