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HMB2201 Complex Midwifery > Assessment of the unborn baby > Flashcards

Assessment of the unborn baby Flashcards

1
Q

What is the difference between a screening test and a diagnostic test?

A

A screening test shows you if you are at a higher risk.

A diagnostic test tells you if you have the condition.

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2
Q

Why would a mother have maternal serum screening?

A

To identify a person’s risk of the fetus having a chromosomal defect, such as trisomy 21, 18 13. It also can detect the risk of neural tube defects and early onset preeclampsia.

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3
Q

When would a woman have maternal serum screening?

A

1st trimester - 11-13+6 weeks

2nd trimester - 14-20+6

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4
Q

What is the difference between CFTS and 2TMSS?

A

CFTS is maternal serum screening done in the first trimester and 2TMSS is conducted in the second trimester.

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5
Q

What does CFTS measure?

A

Two chemicals called PAPP-A and free beta hCG.

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6
Q

What does 2TMSS measure?

A
  • Alpha-feto protein - unconjugated estriol
  • free beta hCG
  • dimeric inhibin A.
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7
Q

What is a Quadruple test?

A

It is a test that screens for Downs Syndrome.

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8
Q

When should a Quadruple test be done?

A

Between 14 and 20 weeks.

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9
Q

What does a first trimester ultrasound look for?

A

7-9 weeks.
Confirms the number of embryos, heartbeat, locate placenta, check for soft markers for chromosomal abnormalities and estimated due date.
Measures fetal head and abdominal circumference and femur length to measure growth.

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10
Q

Why are ultrasounds conducted throughout pregnancy?

A
  • First trimester - DD, confirm pregnancy.
  • Second trimester - detect anatomical anomalies, placenta size and location, and baby’s sex.
  • Third trimester - Only done if needed to check baby’s growth or to see if the placenta has migrated.
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11
Q

What is Chorionic Villi Sampling?

A

A diagnostic test done for those whose screening tests come back as high risk. It takes a sample of cells from the chorionic villi and has a 1% chance of miscarriage as it is invasive. 11-14 weeks. Carries risk of Rh sensitisation.

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12
Q

What is an amniocentesis?

A

A diagnostic test done for those whose screening tests come back as high risk. It has a 1 in 250 chance of miscarriage as it involves using a needle to take a sample of the amniotic fluid.
15+ weeks.
Risks such as infection, miscarriage, trauma to baby or placenta, bleeding, pre-term labour and Rh sensitisation.

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13
Q

How much do early pregnancy screening cost?

A

Maternal serum screening can cost $80-$100+

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14
Q

What are the benefits and risks associated with screening?

A

The benefits could be the parents are able to prepare themselves for the possibility of having a child who has chromosomal abnormalities.
The risks are, if a test screens as high and more invasive measures are used and things go badly the baby may be lost.

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15
Q

What are is trisomy 21?

A

Down’s syndrome.

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16
Q

What is trisomy 18?

A

Edward’s syndrome

17
Q

What is trisomy 13?

A

Patau’s syndrome.

18
Q

What are the categories of IUGR/FGR?

A

Symmetrical and Asymmetrical.

19
Q

What is symmetrical FGR?

A

CHRONIC. All parts of the body are a similar size. Occurs because the fetus is exposed to low blood flow for a long period of time which results in the baby having high cortisol levels. Babies generally do well.

20
Q

What is asymmetrical FGR?

A

ACUTE. The baby’s head and brain are the expected size but the rest of the body is small. Sunken abdomen. Large liver mass. Low subcutaneous fat. Baby is hyperactive and hungry. Often suffers from hypoglycaemia.

21
Q

When is a CTG able to be used in the antenatal period?

A

After 26 weeks

22
Q

What are the aspects of the CFTS?

A
  • blood test to test for chemicals (PAPP-A and free beta hCG)
  • Nuchal translucency ultrasound (11-13+6 weeks)
  • Maternal age, weight and gestation
  • some cases check for the presence of the nasal bone.
23
Q

What is low PAPP-A associated with?

A

IUGR and increased risk of stillbirth.

24
Q

TRUE/FALSE: CFTS can tell you the gender and the presence of spina bifida.

A

FALSE

25
Q

How many chemicals are measured in the 2TMSS?

A

4

26
Q

What does the 2TMSS involve?

A

A blood test and maternal age, weight and gestation.

27
Q

How much does the NIPT test cost?

A

$449

28
Q

What are the benefits of the NIPT test?

A

Can be done from 10 weeks on (ideally 11-16). It is highly sensitive and can also test for sex.

29
Q

What are USS markers for Down’s Syndrome?

A
  • Nuchal translucency (fluid measured at the back of baby’s neck)
  • Presence of cysts in choroid plexus of brain
  • Echogenic spots
30
Q

What is done to assess the fetus at each AN appointment?

A
  • fundal height
  • FHR
  • fetal movements
31
Q

What are doppler flow studies?

A

USS examination of placental function. Blood flow is measured in the systolic and diastolic phase.

32
Q

What is a Biophysical Profile test?

A

After 28 weeks. Non invasive USS. Assesses the fetal wellbeing and the fetal environment.
It measures body movement, muscle tone, breathing movement and amniotic fluid volume around the fetus.

33
Q

What are the 3 categories of causes of IUGR?

A

Maternal, fetal and placental causes.

34
Q

What are the maternal causes of IUGR?

A
  • PIH/Preeclampsia
  • chronic HTN
  • DM
  • Malnourishment/underweight
  • Smoking/alcohol/drug use
  • Renal disease/anaemia
  • young/older mother
35
Q

What are the Fetal causes of IUGR?

A
  • Multiple gestation
  • chromosomal abnormality
  • errors of metabolism
  • achondroplasia
  • Intra-uterine infection (TORCH)
36
Q

What are the placental causes of IUGR?

A
  • Abruptio placentae
  • placenta praevia
  • chorioamnionitis
  • abnormal cord insertion
  • Single umbilical artery
37
Q

What is the difference between intrinsic and extrinsic factors in regards to IUGR?

A

Intrinsic - within fetus

Extrinsic - intrauterine environment

HMB2201 Complex Midwifery (8 decks)

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