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old Sophomore cards > Assessment of Fetal Well-being > Flashcards

Assessment of Fetal Well-being Flashcards

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0
Q

Low risk pregnancy

A

Evaluate normal growth and development

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1
Q

At risk pregnancy

A

Evaluate fetal status

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2
Q

What should be performed by all pregnant women

A

Maternal evaluation of fetal movement (kick counts 10 in 10)

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3
Q

When should mother perform evaluation of fetal movement

A

After 27 weeks

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4
Q

DFMC

A

Daily Fetal Movement Count

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5
Q

How should mother perform DFMC?

A

Lying sideways - 1 hour after meal

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6
Q

Number of times fetus should move in one hour

A

4

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7
Q

Number of times a fetus should moved in 2 hours

A

10

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8
Q

If a baby doesn’t moved much what are they usually?

A

Hypoxic

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9
Q

If baby doesn’t move in the morning time, what should mother do?

A

Call the doctor

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10
Q

Use of high frequency sound waves to create an image of the fetus

A

Ultrasound

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11
Q

Limited obestric ultrasound

A

Basic screening

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12
Q

Ultrasound for women suspected of caring an abnormal fetus

A

Comprehensive ultrasound

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13
Q

What color is bone on an ultrasound?

A

White

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14
Q

What color is soft tissue on an ultrasound?

A

Gray

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15
Q

What color is fluid on an ultrasound?

A

Black

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16
Q

If you see nuchal thickening and flattened nasal brindge on a baby in an ultrasound, what does the baby have?

A

Trisomy 21 or down syndrome

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17
Q

The amount of amnionic fluid in the uterus is an indicator for what?

A

Fetal well-being

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18
Q

Excess amniotic fluid

A

Polyhydramnios

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19
Q

Decreased amounts of amniotic fluid

A

Oligohydramnios

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20
Q

What is polyhydramnios associated with?

A

Diabetes or baby may have a neurological disorder and isn’t able to swallow

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21
Q

What is Oligohydramnios associated with?

A

The fetus may be swallowing but are not urinating - when baby is hypoxic, their kidneys shut off to support the heart and therefore - no urine

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22
Q

How much fluid should a mother drink before having the amniotic fluid assessed?

A

1 to 1 1/2 quarts of water

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23
Q

Amniotic fluid volume (AFV)

A

Measures only one pocket

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24
Q

Amniotic fluid index (AFI)

A

A measure of 4 quandrants or pockets

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25
Q

Biophysical Profile (BPP)

A 
Fetal breathing movements 
Gross body movements
Fetal tone 
Reactive fetal heart rate
Amniotic fluid
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26
Q

How many possible points can you get from a BPP?

A

10 (2 points each)

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27
Q

What is the normal BPP score?

A

8-10

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28
Q

What BPP score do you evaluated for possible delivery?

A

BPP score of 4 or less

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29
Q

If a mom is 32 weeks pregnant and the BPP score is 4 or less, what action takes place?

A

They induce labor

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30
Q

If baby is not flexed in the womb, what is wrong?

A

The baby is hypoxic and therefore has lack of muscle fetal tone

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31
Q

What are the 2 most important components of BPP?

A

Amniotic fluid index (AFI)

Reactivity of the fetal heart rate

32
Q

Observe for accelerations of fetal heart rate in response to fetal movement

A

Nonstress Test (NST)

33
Q

What indicates an intact nervous system, not effected by hypoxia?

A

Accelerations

34
Q

How and when is an NST given?

A

Can be performed after 30 weeks gestation - in semi-fowlers position with an empty bladder

35
Q

What does NST require?

A

The use of an electronic fetal monitor

36
Q

EFM

A

Electronic fetal monitor

37
Q

Two or more accelerations of fetal heart rate within 20 minutes

A

Reactive NST (good)

38
Q

Does not meet criteria for reactive NST

A

Nonreactive NST

39
Q

Acceleration of fetal heart rate

A

An increase in heart rate of 15 bpm or more lasting 15 seconds (15 by 15 rule)

40
Q

Fetal Acoustic Stimulation test (FAST)

A

Horn to wake up baby - sound stimulus

41
Q

Vibroacoustic stimulation test (VST)

A

Vibrator to wake up baby for NST

42
Q

When would you NOT buzz to wake up a baby?

A

When baby is nonreactive - when their heart rate keeps dropping

43
Q

This test is to observe the response of the fetal heart rate to contractions

A

Contraction stress test (CST)

44
Q

What do they give mothers in a contraction stress test (CST)?

A

Oxytocin or Pitacin

45
Q

What does the CST evaluate?

A

Uteroplacental sufficiency

46
Q

When is the CST used?

A

In at risk pregnancies

  • non reactive NST
  • post dates
47
Q

What does the CST require?

A

Three contractions of 40 seconds duration in a 10 minute period

48
Q

How are contractions induced?

A

By IV oxytocin or breast nipple) stimulations

49
Q

No late decelerations occur after any contraction

A

Negative CST (good)

50
Q

Late decelerations occur with at least 2 out of the 3 contractions

A

Positive CST (bad)

51
Q

Late decelerations with a single contractions or late decelerations occur with hyperstimulation pattern

A

Equivocal CST (don’t know, keep watching)

52
Q

Needle is inserted into uterine cavity through the abdomen

A

Amniocentesis

53
Q

When giving an amniocentesis, what do you do with it?

A

An Ultrasound is used to identify locations of placental, fetal parts

54
Q

What is amniocentesis determining?

A

Karyotype (DNA)

55
Q

What is amniocentesis used to determine in early pregnancy?

A

Chromosomal abnormalities

56
Q

What is amniocentesis used to determine in late pregnancy?

A

Fetal lung maturity or intrauterine infections

57
Q

This is necessary for normal respirator functioning of the newborn - to prevent RDS

A

Surfactant

58
Q

What should the L/S ration be at 35 weeks to indicate lung maturity?

A

2:1 (even 1.7:1 is bad)

59
Q

What appears in amniotic fluid at about 36 weeks gestation and indicates fetal lung maturity?

A

Phosphatidylglycerol (PG +)

60
Q

Test for neural tube defects

A

AFP

61
Q

This is present in maternal serum and amniotic fluid

A

Alpha-fetoprotein (AFP)

62
Q

This rises throughout pregnancy and peaks at 30 weeks gestation

A

Maternal serum AFP (MSAFP)

63
Q

When does amniotic fluid AFP (AFAFP) peak?

A

At 15 weeks

64
Q

What is AFP produced by in the first 6 weeks?

A

Fetal Yoke

65
Q

What is AFP produced by after the first 6 weeks?

A

Fetal Liver

66
Q

When is MSAFP most accurate?

A

Between 16-18 weeks

67
Q

What does increased levels of AFP indicate?

A

Open neural tube defect (anencephaly or spina bifida)

Abdominal wall defect

68
Q

Anencephaly

A

Lacking upper part of brain

69
Q

Increased AFP

A

Fetal death

Multiple gestation

70
Q

Decreased levels of AFP

A

Down’s syndrome

71
Q

Components of Penta screen

A 
AFP 
Unconjugated estriol
HcG
H-HcG 
Inhibin A (a hormone)
72
Q

H-HcG (what is added to the Quad screen to make it Penta screen)

A

Hyperglyosated human chorionic gonadotropin

73
Q

Sample of the chorionic villi from the edge of the placenta is obtained

A

Chorionic Villus Sampling (CVS)

74
Q

When is CVS done?

A

Between 8 and 12 weeks gestation

75
Q

Glue that holds the placenta down

A

Fetal fibronectin

76
Q

The presence of vaginal fibronectin between 20-34 weeks is a strong indicator of what?

A

Preterm delivery

77
Q

What protein is produced by fetal tissues that is the glue that holds the placenta down?

A

Glycoprotein

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