antipardum exam Flashcards
adaptations of pregnancy - cardio - arteries and blood volume (not thicken)
Main uterine artery doubles in size
Increased blood volume by 40-50%
adaptations of pregnancy - skeletal
Shifting center of gravity
Increase lordosis
Loosening of the ligaments of the pubic symphysis and sacroiliac joints
Muscles of abd stretch and lose tone. Can lead to diastasis recti abdominis
adaptations of pregnancy - integumentary (melatropin in niagra)
Decreases in melanotropin- increase in areas of pigmentation (areolas and nipples)
Chloasma (melasma)
Striae gravidarum- stretch marks
Linea nigra (dark line down abdomen)
adaptations of pregnancy - GI (just relaxed)
Relaxed GI leads to constipation
Bleeding gums due to increase in vascularity
adaptations of pregnancy - GU - renal pelvis (hyper renal is relaxed)
Renal pelvis and ureters dilate: smooth muscle walls of the ureters undergo hyperplasia and hypertrophy (enlargement) and muscle tone relaxes.
adaptations of pregnancy - respiratory - increase or decrease?
Major change in shape to make room for growing uterus and fetus inside
Increased O2 consumption
Increased RR
adaptations of pregnancy - reproductive
Amenorrhea
Endometrium grows to support the embryo and fetus.
Increase in elastic properties
adaptations of pregnancy - reproductive - vagina (mucosa vault)
Vagina: increased mucosa, loosening of connective tissue, lengthening of the vaginal vault, increased vascularity,
What is GBS and when is screening done? (Diabetic in your 30s)
Group B Strep, a gram + organism that colonizes in the female genital tract and rectum; present in 10-30% of all healthy women, asymptomatic but can cause GBS disease of the newborn
Screening btw 36 - 38 weeks
Nonstress test (NST) (don’t stress the heart) - at what age is it recommended, and for who? (don’t stress 28 days later)
Nonstress test (NST) (lasts 20 minutes) is the most common method of prenatal testing used. Provides an indirect measurement of uteroplacental function. Recommended twice weekly, after 28 weeks gestation (3rd trimester), for clients with diabetes and other high-risk conditions. It measures the heart rate of the unborn baby (fetus) in response to its movements. In most cases, the heart rate of a healthy baby increases when the baby moves.
Nonstress test (NST) - results (stressed in 15 and 15)
Reactive = 2 accelerations in 20 minutes; accelerations are FHR equal or greater than 15 BPM over baseline lasting 15 seconds or more, occurs twice during NST (called acceleration)
Non-reactive = abnormal, does not meet criteria; indicates the need for more testing
What are good sources of iron?
Raisins! Red meat, chicken, fish, green leafy vegetable, soy products, nuts and dried fruit, dried beans, eggs, fortified grains
What are good sources of calcium?
Dairy products (milk, cheese, and yogurt), cereals; broccoli, spinach, and kale; salmon
What foods should the woman NOT eat while pregnant?
Artificial sweeteners: risk for higher newborn weight and childhood obesity
Mercury in fish: dangerous in high amounts; contribute to pregnancy complications and developmental problems in the infant
Listeriosis - raw dairy, fruit, fish
GDM/DM in pregnancy (Gestational diabetes mellitus) - fetus
macrosomia (large fetus) resulting from hyperinsulinemia stimulated by fetal hyperglycemia
Hypoglycemia
Childhood obesity
Hyperbilirubinemia
birth trauma due to shoulder dystocia (mechanical problems during delivery)
Congenital anomaly due to hyperglycemia in the 1st trimester (cardiac problems, neural tube defects, skeletal deformities, and genitourinary problems)
Premature birth secondary to polyhydramnios (too much amniotic fluid) and an aging placenta; places the fetus in jeopardy
Fetal asphyxia secondary to fetal hyperglycemia and hyperinsulinemia
Intrauterine growth restrictions secondary to maternal vascular impairment and decreased placental perfusion, which restricts growth
Perinatal death due to poor placental perfusion and hypoxia
Respiratory distress syndrome resulting from poor surfactant production
Polycythemia (a blood disorder) due to excessive RBC production in response to hypoxia
GDM/DM in pregnancy (Gestational diabetes mellitus) - maternal (the 2 big ones) (think of your pt)
preeclampsia and cesarean birth; greater risk of developing cardiovascular disease
Gestational hypertension of unknown etiology
Ketoacidosis due to uncontrolled hyperglycemia
Preterm labor secondary to premature membrane rupture
stillbirth in pregnancies
Hydramnios
Hypoglycemia as glucose is diverted to the fetus (in 1st trimester)
UTIs resulting from excess glucose in the urine
Chronic monilial vaginitis due to glucosuria (promotes yeast growth)
Difficult labor
tetarogens
Teratogens are substances that may produce physical or functional defects in the human embryo or fetus after a pregnant woman has been exposed. Can cause physical deformities, problems in the behavior or emotional development of the child, and decreased IQ. susceptibility depends on the timing of the exposure and the developmental state of the embryo or fetus
alcohol
Alcohol: spontaneous abortion, inadequate weight gain, IUGR (intrauterine growth restriction), FASD (fetal alcohol syndrome)
opiates (pre-opiates)
maternal and fetal withdrawal, placental abruption, preterm labor, premature rupture of membranes, perinatal asphyxia, newborn sepsis and death, malnutrition and intellectual impairment
meth
risk of preterm birth, low birth weight, placental abruption, fetal growth restrictions, and congenital abnormalities
cigarettes
nicotine causes vasoconstriction, and can transfer across the placenta reducing blood flow to the fetus and contributing to fetal hypoxia. Increases risk for spontaneous abortion, tubal ectopic pregnancy, preterm labor and birth, fetal growth restriction, stillbirth, premature rupture of membranes, low fetal iron stores, maternal hypertension, SIDS, cardiac arrhythmias, placenta previa, and placental abruption. Perinatal death rate is higher in infants of smokers. Increased risk of cleft lip and palate, clubfoot, asthma, middle ear infections, reduced head circumference, altered brain stem development, and cerebral palsy. Risk factor for low birth weight, cognitive deficits especially in language, reading, and vocabulary; poorer performances on tests of reasoning and memory; behavioral problems such as increased activity, ADHD, impulsivity, opposition and aggression
Toxoplasmosi
caused by a parasite; cats primary host; spread by contaminated soil, raw meats, and unwashed fruits and veg. Fetus is high risk for preterm labor and stillbirth; low birth weight, enlarged liver and spleen, visual problems, cerebral palsy, hearing loss, seizures, chorioretinitis, jaundice, IUGR, hydrocephalus, microcephaly, neurologic damage and anemia
STIs - effects on baby
depends on the type but effects include: eye infections, pneumonia; low birth weight, stilllbirth, preterm birth; intrauterine growth restrictions; intellectual disabilities, blindness, seizures, premature birth, death; skin ulcers, weakness or hoarse cry, deafness, swollen liver and spleen, amnesia, various deformations; HIV positive status; warts in throat; premature rupture of membranes
Rh factor incompatibility - where is it found? (R loves R)
Rh factor is a protein found on the surface of RBCs
ABO incompatibility - which blood type for mom?
Blood type incompatibility; when a mother with type O blood has become pregnant with a fetus with a different blood type (Type A, B, or AB). Mothers serum contains naturally occurring anti-A and Anti-B which can cross the placenta and hemolysis fetal RBCs
Teen pregnancy - nutritional needs
Nutritional needs
Mothers likely to have poor maternal weight gain, iron-deficiency anemia, poor eating habits and inadequate nutrition
Teen pregnancy - psych
Contributes to loss of self-esteem, societal discrimination, a destruction of life projects, and the prolonging of poverty
Faced with ethical dilemmas and decisions
They lack information, skills, and services necessary to make informed choices related to their sexual and reproductive health
Pregnancy can exacerbate their feeling of loss of control and helplessness
7/10 will drop out of school; more than 75% will receive public assistance within 5 years of having their 1st child
Babies are at greater risk of preterm birth, low birth weight, child abuse, neglect, poverty, and death
The younger the mother, the more likely she is to have another child in her teens; client is at risk for obstetric complications, STIs, poor maternal weight gain, preeclampsia, iron-deficiency anemia, poor eating habits and nutrition, and postpartum depression
teen pregnancy - psychological risk
Pregnant adolescents experience a higher rate of domestic violence and substance abuse (which contributes to low birth weight, fetal growth restrictions, preterm birth, newborn addiction, and sepsis)
More likely to abuse substances, receive inadequate prenatal care, and have lower pregnancy weight
Many clients are from minority backgrounds and live below the poverty line
teen pregnancy - what % want to be pregnant?
80% do not want to be pregnant, fragile body image, immaturity, conflict btw their own needs and the babies, limited knowledge of child development
teen pregnancy - physiologic - younger than 15 yrs old?
Cephalopelvic disproportion, increased nutrition needs for mom and baby, increased risk of preeclampsia, increased risk of anemia, increased risk of STIs, <15 has 60% greater mortality rate
teen pregnancy - sociological
Increased incarceration rates and health care costs; less likely to receive prenatal care or is late care; more likely to suffer domestic violence; higher infant mortality related to immaturity, may have less support
advanced age - risk
Female infertility, pregnancy loss, fetal abnormalities, stillbirth, and obstetric complications (gestational diabetes and hypertension, preeclampsia, small-for-gestational-age infants, spontaneous late preterm births, postpartum hemorrhage, genetic disorders and chromosomal abnormalities, placenta previa, fetal growth restrictions, low Apgar score, and cesarean section
What are the risk factors for developing pre-e?
Multifetal gestations, previous pregnancy w/ preeclampsia, renal disease, autoimmune disease, diabetes, first pregnancy, periodontal disease, chronic hypertension, and obesity
What is HELLP? (help Yolanda’s liver and platelets)
Hemolysis elevated liver enzymes low platelets
Variant of the pre/-eclampsia syndrome; development of an abnormal trophoblastic (abnormal cells) invasion due to inadequate maternal immune tolerance
What is Mag Sulfate given for?
Prevention and treatment of eclamptic seizures
What are the assessments of a patient on Mag Sulfate? (maggie, everything is going down)
Monitor for signs of toxicity including hypotension, areflexia (loss of deep tendon reflexes DTR), respiratory depression and arrest, oliguria, SOB, chest pain, slurred speech, hypothermia, confusion, circulatory collapse
What are the side effects of Mag Sulfate? (the usual, except…)
Allergic rxn (skin rash, itching, hives; swelling of face, lips, tongue or throat; confusion, drowsiness, facial flushing, redness, sweating, muscle weakness, fast or irregular heartbeat, trouble breathing, low BP
What is S&S of Mag Sulfate toxicity in babies (maggie doesn’t like milk for babies)
Newborn monitored for respiratory depression, muscle weakness, neurologic depression, loss of reflex, hypocalcemia, and hypotonia (decreased muscle tone); decreased fetal heart rate variability may occur
how to administer Mag Sulfate? (maggie is 4)
Nursing interventions:
Administer loading dose of 4-6 g by IV in 100 mL of fluid, over 15-30 minutes followed by a maintenance dose of 1-2 g as continuous IV infusion;
Spontaneous Abortions (spontaneous at 20)
Spontaneous Abortions: loss of fetus before 20 weeks. signs could be lower backpain
abortion management
bedrest, fluids (threatened); D & D or suction curettage; D & E (2nd trimester); antibiotics (missed, septic); misoprostol; pain medications; PhoGAM (RH-)
abortion s/s
vaginal bleeding. Abd pain, cramping, pelvic pressure, low back pain
Threatened abortions - s/s (NOT threatened by dilation or cervix)
S/S: early vaginal bleeding (often slight); no cervical dilation or change in cervical consistency; mild abd cramping; closed cervical os (?); no passage of fetal tissue. usually can’t keep the baby.
Inevitable abortion (everything is inevitably strong)
S/S: vaginal bleeding (greater than w/ threatened); rupture of membranes; cervical dilation; strong abd cramping; possible passage of products of conception
Incomplete abortion
S/S: intense abd cramping; heavy vaginal bleeding; cervical dilation; passage of some of the products of conception, but some still remains in uterus. pain and bleeding main reason women come to hospital
complete abortion - what decreases?
S/S: Hx of vaginal bleeding and abd pain; passage of tissue w/ subsequent decrease in pain and significant decrease in vaginal bleeding
missed abortion - definition and s/s (missed abortion is irregular)
(nonviable embryo retained in utero for at least 6 weeks)
S/S: absent uterine contractions; irregular spotting; possible progression to inevitable abortion
reccurent abortion (3 C’s in recccurent)
(habitual): will start treating early, could be a hormone issue. 3 consecutive pregnancy losses prior to 20 weeks from the last menstrual period. infection could be an issue.
sexuality in pregnancy = What are the contraindications? (push, pid, hemorrage)
Complications of sex during pregnancy include preterm labor, pelvic inflammatory disease, antepartum hemorrhage in placenta previa, and venous air embolism. Generally sexual relations are concidered safe, abstinence is recommended for high-risk patients (risk for preterm labor or for antepartum hemorrhage due to placenta previa)
Hyperemesis Gravidarum - when does it begin? linked to what hormone? (you know this)
Hyperemesis Gravidarum is a severe form of N/V during pregnancy that begins 9 weeks gestation,which could lead to hospitalization; could be linked to higher and extended levels of hCG
morning sickness - how to treat
are the relatively mild symptoms of pregnancy
During 1st trimester, cause is unknown but may be hormonal; treatment involves eating dry carbs in the AM, avoid empty stomach and fatty/fried foods, do frequent small meals, eat ginger; PNV (?), Vit B6, doxylamine
Hyperemesis Gravidarum:
s/s - how much weight loss?
Hyperemesis Gravidarum:
severe, persistent, and uncontrolled N/V, dehydration, weight loss (> 5% of pre pregnancy body weight), electrolyte imbalance and nutritional imbalances and ketosis
Morning Sickness:
s/s
Morning Sickness:
mild N/V, only in 1st trimester
How is Hyperemesis Gravidarum diagnosed?
Diagnosis of exclusion, associated with symptoms. Looks for fluid and electrolyte imbalances, weight loss, uncontrolled N/V that extends passed the 1st trimester; multiple theories so look for Vitamin B6 deficiency (metabolic theory), genetic predisposition (genetic factors), and high levels of hCG and estrogen (endocrine theory)
From lecture slides: look to exclude → is V from other causes?
What are the nursing assessments and interventions for Hyperemesis Gravidarum?
Health history *R/O other causes ex. Gastroenteritis, pyelonephritis, pancreatitis, cholecystitis, hepatitis, thyroid
Onset, duration and course of N/V
Hyperemesis Gravidarum - nursing assessment (anything related to dehydration)
Weight loss
Inspect mucus membranes for dryness, check skin turgor, BP changes (hypotension that may suggest fluid volume deficit)
Complaints of weakness, fatigue, activity intolerance, dizziness, mood changes, and decreased ability to concentrate
From lecture slides: assess for dehydration [hypotension, I/O, U/A (specific gravity); skin turgor, mucous membranes, electrolyte imbalances (labs, S/s of hypokalemia), Bit B1, B6 and B12 deficiencies (Wernicke-Korsakoff syndrome)]; IV fluids and electrolyte replacement, NPO
Hyperemesis Gravidarum - tests (and what for specific gravity?)
Liver enzymes: rule out hepatitis, pancreatitis, and cholestasis; elevation of aspartate aminotransferase (AST) and alanine aminotransferase (ALT) usually present
CBC: elevated RBC and hematocrit, indicates dehydration
Urine ketones: + when body breaks down fat to provide energy in the absence of adequate intake
TSH and T4: rule out thyroid disease
BUN: increased in the presence of salt and water depletion
Urine specific gravity: > 1.025, could indicate concentrated urine; ketonuria
Serum electrolytes: decreased levels of potassium, sodium, and chloride resulting from excessive vomiting and loss of hydrochloric acid in stomach
ultrasound
Hyperemesis Gravidarum - nursing management
Promote comfort and nutrition; initially withhold oral flood and fluids, maintain NPO status to allow GI tract to rest
Antiemetics
IV fluids and electrolyte replacement therapy
Monitor I/O
Provide support and education, reduce stress
ectopic pregnancy
Any pregnancy in which the fertilized ovum implants outside the uterine cavity (includes the fallopian tubes, cervix, intestine, and abd cavity). The embryo grows and draws its blood supply from the site of abnormal implantation. As it gets bigger it creates the potential for organ rupture because only the uterus is designed to expand to accommodate a growing fetus. Can lead to massive hemorrhage, infertility and death
What are the signs and symptoms of an Ectopic Pregnancy - triad
Triad of symptoms are abdominal pain, amenorrhea, and vaginal bleeding. Only half of women present with all three symptoms
ectopic pregnancy - How is it diagnosed? (Hugs for ectopic)
Urine pregnancy test to confirm pregnancy, beta-hCG concentration to exclude a false-negative urine test, and a transvaginal ultrasound to visualize the misplaced pregnancy
ectopic pregnancy - when do symptoms begin? (Ectoplasm is unlucky number 7)
Physical exam
Assess for S/S of ectopic pregnancy, usually begin ~7th week of gestation
ectopic pregnancy - health hx
Previous ectopic pregnancy, history of STIs, fallopian tube scarring from PID, in utero exposure to DES, endometriosis, previous tubal or pelvic surgery, infertility and treatments, uterine abnormalities such as fibroids, presence of intrauterine contraception, use of progestin-only mini pill, postpartum or post abortion infection, altered estrogen and progesterone levels (interferes w/ tubal motility), age > 35 years, cigarette smoking
From slides: Hx of STIs or PID, previous ectopic pregnancies, endometriosis, IUDs, assisted reproduction (in vitro)
ectopic pregnancy - lab tests
Transvaginal ultrasound to visualize misplaced pregnancy
ectopic pregnancy - nursing management - how long to use contraceptives?
Nursing management - Analgesics for pain
Teach about S/S of rupture is outpatient care (sever, sharp, stabbing, unilateral abd pain; vertigo/fainting; hypotension; and increased pulse). Advice to seek medical care immediately
Emotional support
Use of contraceptives for at least 3 menstrual cycles to allow for healing and repair
What is the usual treatment of women with HIV who are pregnant?
The standard treatment is oral antiretroviral drugs given daily until giving birth, IV administration during labor, and oral zidovudine (AZT) for the newborn within 6 to 12 hours of birth. Some reports suggest that cesarean birth may reduce the risk of HIV infection (King et al., 2019). Efforts to reduce instrumentation, such as avoiding the use of an episiotomy, fetal scalp electrodes, and fetal scalp sampling, will reduce the newborn’s exposure to body fluids
HIV behavioral (fluids, rest)
getting adequate sleep each night (7 to 9 hours)
avoiding infections (e.g., staying out of crowds, practicing good hand hygiene)
decreasing stress
consuming adequate protein and vitamins
increasing her fluid intake to 2 L daily to stay hydrated
planning rest periods throughout the day to prevent fatigue
HIV - How is it transmitted from mother to fetus/baby?
from mother to fetus during pregnancy or breast-feeding and amniotic fluid during childbirth.
- 1st trimester:*Urinary frequency - treatment (you know this)
Urinary frequency or incontinence: woman decrease her fluid intake 2 to 3 hours before bedtime and limit her intake of caffeinated beverages. Increased voiding is normal, but encourage the client to report any pain or burning during urination. Kegel exercises.
1st trimester - fatigue
arrange work, child care, and other demands in her life to permit additional rest periods. Using pillows for support in the left-side–lying position relieves pressure on major blood vessels that supply oxygen and nutrients to the fetus when resting. Relaxation techinques.
1st trimester - N/V - what to eat? (n/v loves B6)
eat small, frequent meals that are bland and low in fat. Eat dry crackers, Cheerios, or cheese or drinking lemonade before getting out of bed in the morning and increasing her intake of foods high in vitamin B6, such as meat, poultry, bananas, fish, green leafy vegetables, peanuts, raisins, walnuts, and whole grains, or making sure she is receiving enough vitamin B6.
1st trimester - breast tenderness
wear a larger bra with good support can help alleviate this discomfort. Advise her to wear a supportive bra, even while s1leeping.
1st trimester - constipation
● Eat fresh or dried fruit daily.
● Eat more raw fruits and vegetables, including their skins.
● Eat whole-grain cereals and breads such as raisin bran or bran flakes.
● Participate in physical activity every day.
● Engage in pelvic floor exercises, stretching exercises, and yoga daily.
● Eat meals at regular intervals.
● Establish a time of day to defecate, and elevate feet on a stool to avoid straining.
● Drink six to eight glasses of water daily.
● Decrease intake of refined carbohydrates.
● Drink warm fluids upon arising to stimulate bowel motility.
● Decrease consumption of sugary sodas.
● Avoid eating large amounts of cheese.
1st trimester - Leukorrhea (increased vaginal discharge):
keep the perineal area clean and dry, washing the area with mild soap and water during her daily shower. Cotton underwear. Wear nightgown. Avoid tampons and douching.
2nd trimester - Backache:
heat and ice, acetaminophen, massage, proper posturing, good support shoes, and a good exercise program for strength and conditioning. Pillow between legs when sleeping. Maintain correct posture with head up and shoulders back.
2nd trimester - leg cramps
gently stretch the muscle by dorsiflexing the foot up toward the body. Wrapping a warm, moist towel around the leg muscle can also help the muscle relax. Advise the client to avoid stretching her legs, pointing her toes, and walking excessively. Stress the importance of wearing low-heeled shoes and support hose and arising slowly from a sitting position. Elevate legs.
2nd trimester - varicose veins
supportive hose, elevate her legs above her heart while lying on her back for 10 minutes before she gets out of bed in the morning, elevate both legs above the level of the heart for 5 to 10 minutes at least twice a day.
2nd trimester - hemmroids
increasing fiber intake and drinking at least 2 L of fluid per day. warm sitz baths, witch hazel compresses, or cold compresses. Elevate feet on stool when deficating.
2nd trimester - bloating
avoid gas-forming foods, such as beans, cabbage, and onions, as well as foods that have a high content of white sugar. Adding more fiber to the diet, increasing fluid intake, and increasing physical exercise. Don’t chew gum
3rd trimester - dypnea
adjust her body position to allow for maximum expansion of the chest and to avoid large meals. emphasize that lying on the left side will displace the uterus off the vena cava and improve breathing. avoid exercise that precipitates dyspnea, to rest after exercise, and to avoid overheating in warm climate.
3rd trimester - heartburn
imit or avoid gas-producing or fatty foods and large meals. maintain proper posture and remain in the sitting position for 1 to 3 hours after eating to prevent reflux. maintain proper posture and remain in the sitting position for 1 to 3 hours after eating to prevent reflux. avoid foods that act as triggers such as caffeinated drinks; greasy, gas-forming foods; citrus; spiced foods; chocolate; coffee; alcohol; and spearmint or peppermint. avoid late-night or large meals and gum chewing and avoid lying down within 3 hours after eating. Elevate HOB to 10 - 30 degrees while sleeping.
3rd trimester - edema (walking? and avoid what foods?)
● Elevate your feet and legs above the level of the heart periodically throughout the day.
● Wear compression stockings when standing or sitting for long periods.
● Change position frequently throughout the day.
● Walk at a sensible pace to help contract leg muscles to promote venous return.
● Avoid foods high in sodium, such as lunch meats, potato chips, and bacon.
● Avoid wearing knee-high stockings.
● Drink six to eight glasses of water daily to replace fluids lost through perspiration.
● Avoid high intake of sugar and fats because they cause water retention
3rd trimester - braxton hicks - how to lay?
typically in the 3rd trimester. keep herself well hydrated and to rest in a left-side–lying position to help relieve the discomfort. Breathing techniques. (brax is false)
GBS - baby - most common cause of what? (Don has gbs)
(strep) Although GBS is rarely serious in adults, it can be life-threatening to newborns. GBS is the most common cause of sepsis and meningitis in newborns and is a frequent cause of newborn pneumonia.
GBS - mom
GBS colonization in the mother is thought to cause chorioamnionitis, endometritis, and postpartum wound infection
BPP - Biophysical Profile (BPP) (my bio is a o2 ultrasound)
uses a real-time ultrasound and NST to allow
assessment of various parameters of fetal well-being that are sensitive to hypoxia. measures health of fetus. HR, muscle tone, breathing action, and how much amniotic fluid. also a non-stress test.
BPP - (TB MAN)
h) Body movements: three or more discrete limb or trunk movements
i) Fetal tone: one or more instances of full extension and flexion of a limb or trunk
j) Fetal breathing: one or more fetal breathing movements of more than 30 seconds
k) Amniotic fluid volume: one or more pockets of fluid measuring 2 cm
l) NST: normal NST = 2 points; abnormal NST = 0 points
AFI - normal fluid amount? (AFI is 25 yrs old)
AFI - (amniotic fluid index) measures the vertical depths of the largest pocket of amniotic fluid in all four quadranultts surrounding the maternal umbilicus and totaled. 5 - 25 cm is normal fluid amount.
utrasound
ultrasound technician or doctor will introduce a probe into the vagina. It may be mildly uncomfortable, but will not hurt. The probe is covered with a condom and a gel. The probe transmits sound waves and records the reflections of those waves off body structures. Abdominal - also soundwaves.
NST
provider will move the device over your abdomen until the baby’s heartbeat is found. The baby’s heart rate will be recorded on a monitor, while your contractions are recorded on paper. You may be asked to press a button on the device each time you feel your baby move.
