antepartum testing Flashcards
what tests are done in weeks 8-12
CBC, hub and hct, blood type, RH factor and antibody, UA, HIV, RPR/VDRL, Rubela, Hep B, TORCH, UDS, hCG, PAP
ultrasound
if mother has RH ____ and baby has ____ then the mother could develop ______ against baby
negative; positive; antibodies
what is RPR/VDRL tested for
syphilis
what is important to know about the T in TORCH testing
its toxico something… but just know that if a mom is pregnant she should not be cleaning out a cats letterbox or planting in a garden
what should we expect hCG to do early in pregnancy
first off this is what indicates a women is pregnant but the levels should double early in pregnancy (if abnormally high there could be another baby)
what does a positive pap smear indicate
the mother had or has HPV
ultrasound is very accurate to _____ pregnancies but after __-__ wks its not as accurate
date; 8-12
what tests are done in 12-24 wks
genetic screens; MSAFP
triple or quad
CVS/Amniocentesis
ultrasound
low levels of MSAFP indicate
down syndrome
high levels of MSAFP indicate
neural tube defects
what test is done 24-28 wks
glucose screening
antibody screen
if glucose screen is abnormal (over 140) then we do an intolerance test and if this is abnormal too then what are they dx with
gestational diabetes
what is given to the mother if she is RH negative
RHo D immune globulin
what tests are done at 28-40 wks
group B strep screening CBC RPR/VDRL HIV Hep B
what is group B strep
normal vaginal flora but is deadly to the baby
if mother is + for group B strep what should be done
she needs 2 doses of abx before labor (first dose needs to be given 4 hours before birth)
what screening combines all three chemical markers AFP, hCG, and estriol levels with maternal age to detect some trisomies and neural tube defects
triple marker screening
what does the quadruple screen for
the same chemical markers as the triple marker screen but adds in inhibin- A to increase detection of trisomy 21
if you see ____ cardiac activity during an _______ you are 95% sure you will make it to the end of _______
fetal; ultrasound;pregnancy
if there is too much amniotic fluid indicated during an ultrasound this could mean
soemthing is wrong with the baby
if there is too little amniotic fluid indicated during an ultrasound this could mean
the baby’s kidneys are not working well
when will the placenta begin to age and what “grade” is this
grade 4 expected at 40 wks
*the placenta will calcify and not help the baby anymore… the baby will be smaller
what type of ultrasound is useful in obese pt
done in 1st trimmester
and does not require a full bladder
transvaginal ulstrasound
what ultrasound requires a full bladder in first half of pregnancy
abdominal ultrasound
why does the bladder have to be full during ultrasound
so it pushes up the uterus above the pubic bone to get a better look
what is the advantage of chorionic villi sampling over amniocentesis
it can be done earlier
what is the disadvantage of chorionic villi sampling
higher risk of spontaneous abortion, fetal limb loss, infection and ROM
after a CVS what should we instruct the pt to report
bleeding, cramping, or leakage of fluid
why should pt empty bladder before an amniocentesis
reduce risk of bladder puncture
what is amniocentesis used for
genetic testing
assessment of fetal lung maturity, hemolytic disease in fetus, intrauterine infection
post procedure of amneocentesis what should you monitor for
monitor v/s, FHR and uterine contractions for 30 min after
*instruct pt to report fever, chills, leakage of fluid, vaginal bleeding, decreased fetal movement, or uterine contractions
when is a percutaneous umbilical blood sample done (PUBS)
this is done because baby is in grave danger and this is when we do this
for a PUBS what is the kleihauer-betke test
to insure that fetal blood was obtained
when testing fetal status what could indicate is wrong with the baby if it is not moving a lot
hypoxic fetus
tool that uses auditory stimulation to assess fetal well-being with EFM when NST is nonreactive
vibroacoustic stimulation (VAS)
VAS is ONLY used when
baseline rate is within normal limits
what are other interventions you can do instead of using VAS
give mom something cold to drink, popsicle, or sugar to wake up baby
oligohydramnios
not enough amniotic fluid
polyhydramnios
too much amniotic fluid
what are the 5 indicators of a biophysical profile
fetal breathing movements fetal movement fetal tone amniotic fluid volume non stress test
