antepartum testing

Question 1

what tests are done in weeks 8-12

Answer 1

CBC, hub and hct, blood type, RH factor and antibody, UA, HIV, RPR/VDRL, Rubela, Hep B, TORCH, UDS, hCG, PAP
ultrasound

Question 2

if mother has RH ____ and baby has ____ then the mother could develop ______ against baby

Answer 2

negative; positive; antibodies

Question 3

what is RPR/VDRL tested for

Answer 3

syphilis

Question 4

what is important to know about the T in TORCH testing

Answer 4

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

Question 5

what should we expect hCG to do early in pregnancy

Answer 5

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)

Question 6

what does a positive pap smear indicate

Answer 6

the mother had or has HPV

Question 7

ultrasound is very accurate to _____ pregnancies but after __-__ wks its not as accurate

Answer 7

date; 8-12

Question 8

what tests are done in 12-24 wks

Answer 8

genetic screens; MSAFP
triple or quad
CVS/Amniocentesis
ultrasound

Question 9

low levels of MSAFP indicate

Answer 9

down syndrome

Question 10

high levels of MSAFP indicate

Answer 10

neural tube defects

Question 11

what test is done 24-28 wks

Answer 11

glucose screening

antibody screen

Question 12

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

Answer 12

gestational diabetes

Question 13

what is given to the mother if she is RH negative

Answer 13

RHo D immune globulin

Question 14

what tests are done at 28-40 wks

Answer 14

group B strep screening
CBC
RPR/VDRL
HIV
Hep B

Question 15

what is group B strep

Answer 15

normal vaginal flora but is deadly to the baby

Question 16

if mother is + for group B strep what should be done

Answer 16

she needs 2 doses of abx before labor (first dose needs to be given 4 hours before birth)

Question 17

what screening combines all three chemical markers AFP, hCG, and estriol levels with maternal age to detect some trisomies and neural tube defects

Answer 17

triple marker screening

Question 18

what does the quadruple screen for

Answer 18

the same chemical markers as the triple marker screen but adds in inhibin- A to increase detection of trisomy 21

Question 19

if you see ____ cardiac activity during an _______ you are 95% sure you will make it to the end of _______

Answer 19

fetal; ultrasound;pregnancy

Question 20

if there is too much amniotic fluid indicated during an ultrasound this could mean

Answer 20

soemthing is wrong with the baby

Question 21

if there is too little amniotic fluid indicated during an ultrasound this could mean

Answer 21

the baby’s kidneys are not working well

Question 22

when will the placenta begin to age and what “grade” is this

Answer 22

grade 4 expected at 40 wks

*the placenta will calcify and not help the baby anymore… the baby will be smaller

Question 23

what type of ultrasound is useful in obese pt
done in 1st trimmester
and does not require a full bladder

Answer 23

transvaginal ulstrasound

Question 24

what ultrasound requires a full bladder in first half of pregnancy

Answer 24

abdominal ultrasound

Question 25

why does the bladder have to be full during ultrasound

Answer 25

so it pushes up the uterus above the pubic bone to get a better look

Question 26

what is the advantage of chorionic villi sampling over amniocentesis

Answer 26

it can be done earlier

Question 27

what is the disadvantage of chorionic villi sampling

Answer 27

higher risk of spontaneous abortion, fetal limb loss, infection and ROM

Question 28

after a CVS what should we instruct the pt to report

Answer 28

bleeding, cramping, or leakage of fluid

Question 29

why should pt empty bladder before an amniocentesis

Answer 29

reduce risk of bladder puncture

Question 30

what is amniocentesis used for

Answer 30

genetic testing

assessment of fetal lung maturity, hemolytic disease in fetus, intrauterine infection

Question 31

post procedure of amneocentesis what should you monitor for

Answer 31

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

Question 32

when is a percutaneous umbilical blood sample done (PUBS)

Answer 32

this is done because baby is in grave danger and this is when we do this

Question 33

for a PUBS what is the kleihauer-betke test

Answer 33

to insure that fetal blood was obtained

Question 34

when testing fetal status what could indicate is wrong with the baby if it is not moving a lot

Answer 34

hypoxic fetus

Question 35

tool that uses auditory stimulation to assess fetal well-being with EFM when NST is nonreactive

Answer 35

vibroacoustic stimulation (VAS)

Question 36

VAS is ONLY used when

Answer 36

baseline rate is within normal limits

Question 37

what are other interventions you can do instead of using VAS

Answer 37

give mom something cold to drink, popsicle, or sugar to wake up baby

Question 38

oligohydramnios

Answer 38

not enough amniotic fluid

Question 39

polyhydramnios

Answer 39

too much amniotic fluid

Question 40

what are the 5 indicators of a biophysical profile

Answer 40

fetal breathing movements
fetal movement
fetal tone
amniotic fluid volume
non stress test