Genetics & Prenatal Assessment Flashcards
What does a Biophysical risk factor mean ?
originates within the mother or fetus
- endometriosis
- ectopic pregnancy
- sickle cell anemia
- low/high BMI
- genetics, nutrition, illness
- chronic illnesses, HTN, poorly controlled diabetes
What does a Psychosocial risk factor mean ?
maternal behaviors/adverse lifestyle
- smoker
- alcohol and drug use
- interpersonal violence
- emotional distress
- social support
- relationships
What does a Sociodemographic risk factor mean ?
mother/family characteristics
- age (teen or over age 35)
- access to care (ability to pay for adequate foods, health check-ups)
- income
- parity
- ethnicity (some genetic disorders are more common in certain ethnicities)
What does Environmental risk factors mean ?
exposure to hazards
- occupational hazard (work in factory where exposed to chemicals, cashier who stands all day)
- infection
- drugs
- pollutants
At how many weeks do we start to count fetal kicks ?
begins at 28 wks gestation
What is a fetal kick count ?
simple yet variable method to evaluate the condition of the fetus
- non invasive
- baby who kicks is well oxygenated and has a good nervous system
- count # of movements in 1 hour
- 10 movements per hour is normal
When should we be concerned about fetal kick counts ?
if they have fewer than 10 movements in 2 hours
- needs further investigation and need to call provider
What is a Non-Stress Test (NST) ?
where accelerations and moderate variability will occur in response to fetal movement
- indicates normoxic fetus with a functioning CNS
When is a Non-Stress test performed ?
performed after 28 weeks
What is a Reactive (expected value) result of a Non-Stress test (NST) ?
2 accelerations within 20 mins
- 28 wks to 32: acceleration of 10 bpm from baseline lasting 10 secs with each fetal movement
- >32 week: increase in 15 bpm from baseline every 15 secs with fetal movement
What is a Non-Reactive NST mean ?
did not meet criteria within 40 mins
- needs further testing
What is a Biophysical Profile (BPP) ?
real-time assessment of fetus using ultrasound
- non-invasive
- 30 to 120 mins
When is a Biophysical Profile (BPP) performed ?
after 28 weeks after non-reactive NST or routine testing with risk factors
What are the 5 categories scored in for a Biophysical Profile ?
- breathing movements
- movements
- tone
- amniotic fluid
- NST
What is a Contraction Stress Test (CST) ?
determining fetal heart rate response to contractions (stressor) to see respiratory functioning during stress
- invasive and time consuming
- oxytocin stimulated
When is a contraction stress test (CST) performed ?
after 34 weeks
What are some contraindications for a contraction stress test ?
if pt shouldn’t be delivering baby vaginally because of:
- placenta previa (placenta is against the cervix and can cause increased risk of bleeding)
- previous classical c-section
- high risk for preterm labor (multiple gestation)
- PPROM (preterm premature rupture of membranes)
What are we looking for in a contraction stress test ?
the fetal heart rate (FHR) for decelerations (late or variable) with 3 contractions within 10 minutes
What does a negative, positive, or equivocal contraction stress test result mean ?
- Negative: no decels with contractions
- Positive: late decels with 50% or more contractions
- Equivocal: decels are intermittent
How does an ultrasound work ?
sound waves are sent through the amniotic fluid and bounce back to reflect a picture
- abdominal or transvaginal (good for early pregnancy)
What do we look for in a first trimester ultrasound ?
- confirm pregnancy and viability (heart beat at 8 wks)
- determine uterine abnormalities
What do we look for in a second trimester ultrasound ?
- confirm due date
- anatomy scan (map out the measurements to see where baby falls)
- detect anomalies
- measure growth
- determine placental location
At how many weeks gestation is the anatomy fetus scan ?
at 20 wks
- look for placenta placement too
What do we look for in the third trimester ultrasound ?
- measure fetal growth
- assess placental functioning
- determine fetal presenting part
- determine placental location
- perform doppler flow studies
