Chapter 15 Fetal Monitoring Flashcards
2nd and 3rd trimester ultrasound indication
Transabdominal
Fetal viability, evaluate fetal anatomy
Estimate GA
Assess progress of fetal growth over series of scans
Evaluate amniotic fluid
Determine location and relation of the placenta and umbilical cord
Determine fetal position/presentation
Guide needle placement for amniocentesis
Umbilical cord sampling
Indication for ultra sound in first trimester
Transvaginal ultrasound Presence and location of pregnancy Detect multifetal gestation Estimate GA Confirm fetal viability Identify need for follow up testing
Alpha fetal protein
Main protein in fetal plasma
Measured at 16-18 weeks to SCREEN for fetal defects
Not a diagnostic
What is an amniocentesis?
Aspiration of amniotic fluid from amniotic for exam
Indications for amniocentisis
Age 35 or older
Chromosomal abnormalities in close family members
Gender determination for maternal carrier of x linked disorder
Birth of previous infant with abnormality
Elevated afp
Purpose of amniocentesis during 2nd trimester
Examine fetal cells to identify chromosomal or biochemical abnormalities
Evaluate fetal condition when the women is sensitized to rh- blood
Purpose of amniocentesis during 3rd trimester
Determine fetal lung maturity
Evaluate fetal hemolytic disease caused by rh incompatibility
Advantages of amniocentesis
Simple relatively safe
Brief and painless
Few complications
Multiple marker screen
Positive next step
Detects hcg and unconjugated estridol
Increases detection of tirstomy 18-21. Taken between 16-18 weeks
If positive amniocentesis should be offered for karyotyping or an ultrasound to look for physical abnormalities
Non stress test
Increase in heart rate adequate oxygenation, healthy neural pathway
False positive may occur
Non invasive
Reactive: at least 2 accelerations increase in 15 bpm for 15 seconds in 20 minutes
