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OB > Chapter 26: Antepartal testing > Flashcards

Chapter 26: Antepartal testing Flashcards

1
Q

a ______ risk factor originates from the mother or fetus and impacts the development or function of the mother/ fetus

A

biophysical

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2
Q

maternal conditions that would require antepartum testing

A 
HTN
Renal disease
cardiac disease
diabetes
lupus
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3
Q

when does antepartum testing usually begin

A

32/34 weeks

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4
Q

a _______ is a noninvasive test that monitors fetal movement

A

daily fetal movement count

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5
Q

daily fetal movement count is commonly used to monitor the fetus in pregnancies that are ______

A

complicated by conditions that affect fetal oxygenation

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6
Q

during the third trimester the fetus makes about _____ gross motor movements in an hour. Mommy can recognize ______ % of these

A

30; 70-80%

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7
Q

a count of _____ fetal movements or less in an hour warrants further testing

A

3

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8
Q

what test is done if fetal movements are less than 3 in an hour

A

nonstress test or contraction test and a complete or modified biophysical profile.

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9
Q

______ is the use of high frequency sound waves to produce an image of organs or tissues

A

ultrasonography

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10
Q

Standard ultrasonography in second and third trimesters looks for: (5 major things)

A

AFV, cardiac activity, placental position, fetal growth, number of fetuses

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11
Q

______ ultrasonography are performed to determine a specific piece of information about the pregnancy such as AFV

A

limited

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12
Q

fetal heart activity can be heard at about six weeks when using ________ ultrasound

A

transvaginal

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13
Q

what do they measure with an ultrasound to determine gestational age in the first trimester

A

crown-rump length

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14
Q

what do they measure with an ultrasound to determine gestational age after the first trimester

A

biparietal diameter, head circumference, abdominal circumference, and femur length

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15
Q

a __________ screening uses ultrasound to measure the fluid in the nape of the fetal neck between 10-14 weeks to identify fetal abnormalities

A

nuchal translucency (NT)

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16
Q

a fluid collection of more than _____ mm on a nuchal translucency is abnormal

A

3mm

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17
Q

elevated NT (nuchal translucency) indicates:

A

chromosomal abnormalities including trisomy 13, 18, and 21

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18
Q

______ uses systolic/diastolic flow ratios and resistance to estimate blood flow in arteries

A

doppler blood flow analysis

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19
Q

a fundal height that is small for gestation and a fetus that is easily palpated suggests:

A

oligohydramnios (decreased AFV)

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20
Q

fundal height that is large for gestational age and a fetus that cannot be palpated or that is ballotable suggests:

A

polyhydramnios (hydraminos)

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21
Q

pockets of amniotic fluid less than 1 - 2 cm indicates:

A

oligohydramnios

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22
Q

pockets of amniotic fluid measuring more than 8 cm indicates:

A

polyhydramnios

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23
Q

how is amniotic fluid index measured

A

vertical depths in all four quadrants surrounding the maternal umbilicus get totaled together

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24
Q

An AFI of _____ is oligohydramnios

A

less than 5 cm

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25
Q

an AFI of ______ is polyhydramnios

A

25

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26
Q

oligohydramnios is associated with what conditions:

A

congenital defects and pre-labor ruptured membranes

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27
Q

polyhydramnios is associated with what conditions:

A

multiple fetuses, fetal hydrops,

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28
Q

________ is a noninvasive dynamic assessment of a fetus that is based on acute and chronic markers of fetal disease

A

biophysical profile

29
Q 
Biophysical profile (BPP) consists of: 
1.
2.
3.
4.
5.
A
  1. AFV
  2. FMB (fetal breath movements)
  3. fetal movements
  4. fetal tone
  5. FHR reactivity via non-stress test
30
Q

desired results of a modified biophysical profile

A

reactive non-stress test and a single deepest vertical pocket of amniotic fluid measuring more than 2 cm

31
Q

which score of biophysical profile suggests the fetus is at risk for chronic asphyxia

A

a score 6 or below

32
Q

which score of biophysical profile STRONGLY suggests chronic asphyxia

A

0-2- deliver fetus regardless of gestational age

33
Q

3D ultrasonography sometimes ordered for:

A

visualization of placental blood flow

34
Q

4D ultrasonography sometimes ordered for:

A

evaluation of fetal brain morphology and brain lesions

35
Q

_______ is used to assess placental perfusion and vasculature of the cord

A

artery doppler flow

36
Q

_________ is a radiography used to scan tissues and organs

A

MRI

37
Q

MRI is good for looking at:

A

fetal anatomy and abnormalities

38
Q

amniocenteses is possible after _______ weeks of pregnancy

A

14

39
Q 
indications for amniocentesis include: 
1.
2.
3.
4.
A
  1. prenatal diagnosis of genetic disorders
  2. congenital abnormalities
  3. assessment of pulmonary maturity
  4. sometimes diagnosis of fetal hemolytic disease
40
Q

chorionic villus sampling is done at ______ weeks

A

10-12 or 13 weeks

41
Q

__ % chance of fetal loss with CVS

A

7

42
Q

__ % of women experience bleeding after CVS

A

10

43
Q

__ % of fetal loss with Amniocentesis

A

1% when done after 15 weeks and 2-5% if done before 15 weeks

44
Q

high a-fetoprotein levels in amniotic fluid confirms the diagnosis of:

A

neural tube defects

45
Q

______ involves the insertion of a needle directly into a fetal umbilical vessel

A

percutaneous umbilical blood sampling

46
Q

______ involves the insertion of a needle directly into a fetal umbilical vessel at ______ weeks

A

percutaneous umbilical blood sampling; 11

47
Q

when is PUBS usually indicated

A

when something abnormal shows up on amniocentesis or CVS

48
Q

increasing levels of alpha fetoprotein are detectable at ___ weeks gestation

A

7

49
Q

what is diagnostic of NTD

A

amniocentesis

50
Q

what is screening for NTD

A

maternal alpha fetoprotein levels

51
Q

if maternal levels of serum alpha fetoprotein are elevated, what is the next step?

A

ultra sound to determine number of fetuses and confirm gestational age

52
Q

in Trisomy 21, _____ and _____ are elevated while ______ is lower than normal

A

hCG; Nuchal Translucency measurement; pregnancy-associated plasma protein A (PAPP-A)

53
Q

in trisomy 13 and 18 _____ and ______ are lower than normal in the first trimester

A

hCG; PAPP-A

54
Q

decreased ADAM 12 in the first trimester is indicative of __________

A

trisomy 21

55
Q

what does the quad test screen for

A

trisomy 21 and trisomy 18

56
Q

when is QUAD test performed

A

15-21 weeks

57
Q

low maternal AFP and estriol during quad test indicates:

A

trisomy 21

58
Q

increased hCG and inhibin A in quad test indicates:

A

trisomy 21

59
Q

what is the triple marker

A

AFP, hCG, and estriol calculated with maternal age to detect trisomy and NTD

60
Q

________ is a NTD in which the infants intestines’ or other abdominal organs are outside of the body

A

omphalocele

61
Q

during a _______ test, fetal heart rate is monitored in response to fetal movement, uterine contractions, or stimulation

A

non stress test

62
Q

in a normal fetus _______ is associated with movement during a non-stress test

A

accelerations

63
Q

for a reactive non-stress test:

A

fetal HR increases at least 15 beats per minute above the fetal heart rate baseline twice within 20 minute period

64
Q

what is a tocodynometer

A

measures uterine activity

65
Q

what is a fetal transducer

A

measures fetal HR

66
Q

next steps if there is a nonreactive non-stress test

A

try to wake baby up and retest (cold, Leopold maneuvers, drink juice), and perform further testing such as biophysical profile

67
Q

the desired contraction stress test is:

A

negative

68
Q

_________ uses auditory stimulation to assess fetal wellbeing using EFM after a nonreactive non stress test

A

Vibroacoustic Stimulation

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