Chapter 26

Question 1

what are biophysical risk factors

Answer 1

Originates with the mother or the fetus
May affect development and functioning of both
Genetic disorders, nutritional and general health status, and medical or obstetric-related illnesses

Question 2

what are psychosocial risk factors

Answer 2

Maternal behaviors and adverse lifestyles that have a negative effect on health of mother or fetus
emotional distress
disturbed interpersonal relationships
Inadequate social support
Unsafe cultural practices

Question 3

sociodemographic risk factors

Answer 3

Arise from mother and her family
Lack of prenatal care
low income
marital status
ethnicity

Question 4

what is a daily fetal movement count test (DFMC)

Answer 4

Used to monitor fetus in pregnancies complicated by conditions that may affect oxygenation
A count of fewer than three kicks in 1 hour warrants further evaluation by a nonstress test (NST).
kick counts

Question 5

what are the types of ultrasounds

Answer 5

abdominal and transvaginal

Question 6

what are the indication for an ultrasound?

Answer 6

Fetal heart activity
Gestational age
Fetal growth
Fetal anatomy
Fetal genetic disorders and physical anomalies
Placental position and function

Question 7

information about abdominal ultrasound

Answer 7

done during 1st trimester to look at maternal abnormalities
Pts instructed to drink 1-2 liters before to keep bladder full and push everything up

Question 8

transvaginal ultrasound information

Answer 8

gives better detail of pelvis
used for placental location
probe inserted vaginally,
infection risk
contraindicated in cervical complications, placenta previa, preterm labor
can see more accurate cervical length

Question 9

what are tests to assess fetal well being

Answer 9

Doppler blood flow analysis
Amniotic fluid volume
Biophysical profile (BPP)
Modified biophysical profile

Question 10

what is included in a Biophysical profile (BPP) assessment

Answer 10

done via ultrasound
looks at fetal movement
muscle tone
HR
amniotic fluid index
non stress test

Question 11

How many total points in a BPP

Answer 11

10 total points, each section is 2 pts, 10 pts is fetal well being, anything above 8 is good, under a 4 means further investigation and possible immediate delivery

Question 12

what is a modified biophysical profile

Answer 12

just amniotic fluid index and nonstress test

Question 13

what is a doppler used for

Answer 13

used to look at placenta and cord to make sure perfusion is adequate

Question 14

How is placenta graded

Answer 14

1-4, 4 is the oldest placenta

Question 15

Info about aged placenta

Answer 15

the older the placenta is it will have calcium deposits and less efficacy
baby wont get nutrients , lack of oxygen , IUGR can occur

Question 16

what can be seen in an MRI ?

Answer 16

Fetal structure, overall growth
Placenta
Quantity of amniotic fluid
Maternal structures
Biochemical status of tissues and organs
Soft-tissue, metabolic, or functional anomalies

Question 17

what are the indications for an amniocentesis?

Answer 17

Genetic concerns
Fetal maturity
Fetal hemolytic disease

Used for:
preterm labor
diabetic mother
fetal lung maturity for induction

Question 18

what are potential complications with an amniocentesis ?

Answer 18

poke baby and placenta, rupture membrane, infection, hemorrhage
ultrasound guided is necessary

Question 19

Chorionic Villus sampling (CVS)

Answer 19

Technique for genetic studies
Earlier diagnosis, rapid results
Performed at 10 weeks gestation up to 13 wks
Involves removal of small tissue specimen from fetal portion of placenta
Transcervically or transabdominally
risk for infection and hemorrhage

Question 20

what is percutaneous umbilical blood sampling (PUBS) aka cordocentesis

Answer 20

Insertion of needle directly into fetal umbilical vessel under ultrasound guidance
Direct access to the fetal circulation during the second and third trimesters
Most widely used method for fetal blood sampling and transfusion
Used for fetal blood transfusions , if severe anemia

Question 21

what does the Maternal serum alpha-fetoprotein (MSAFP) test for ?

Answer 21

Maternal serum levels used as screening tool for neural tube defects (NTDs) in pregnancy
Detects 80% to 85% of all open NTDs and open abdominal wall defects early in pregnancy
Triple- and quad-screening to detect autosomal trisomies

Question 22

what are important considerations with the maternal assays test (MSAFP)

Answer 22

This test is not a requirement
Not accurate, This one has a lot of false positive and false negatives

Question 23

when is the maternal serum alpha fetoprotein test done (panorama test)

Answer 23

14-22 wks

Question 24

what is the cell free DNA screening in maternal blood?

Answer 24

Noninvasive prenatal genetic testing
Provides definitive diagnosis noninvasively for fetal Rh status, fetal gender, and certain paternally transmitted single gene disorders , Trisomy 21

Question 25

when is the panorama test performed

Answer 25

performed as early as 10 wks, results available in about 10 days, not covered by insurance

Question 26

What is the indication for electronic fetal monitoring ?

Answer 26

to assess if the intrauterine environment can support the fetus well being

Question 27

What is reactive nonstress test

Answer 27

20 min long , 2 fetal hr accelerations, 15 by 15, indicates fetal well being

Question 28

what is a nonreactive nonstress test

Answer 28

does not meet requirements, try things to get baby to respond, give juice, water, change positions, baby may be in sleep cycle

Question 29

what is vibroacoustic stimulation

Answer 29

put on outside of belly and stimulates baby, used when nonreactive stress test to stimulate baby

Question 30

what is a contraction stress test

Answer 30

stimulate contraction by giving iv oxytocin or nipple stimulation cuz it causes release of oxytocin, Look at how baby is responding to contractions

Question 31

what does a negative contractions stress test mean ?

Answer 31

baby is tolerating contractions, it is good

Question 32

what does a positive contraction stress test mean ?

Answer 32

baby is having a hard time with contractions

Question 33

how long does must a contraction last to be considered as one

Answer 33

40 seconds

Question 34

what is an acceleration

Answer 34

increase in fetal hr of 15 bpm above baseline that last more than 15 secs but less than 2 min