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RNC NIC > Maternal History And Risk > Flashcards

Maternal History And Risk Flashcards

1
Q

Maternal serum alpha fetoprotein (MSAFP)

A

16-18 weeks, neural tube defects if high, low can indicate T21

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2
Q

Glucose tolerance test

A

24-28 weeks, plus repeat H/H bc blood volume increases by 50%

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3
Q

RhoGham

A

Given at 28 weeks

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4
Q

Chorionic Villus Sampling

A

Chorionic tissue (inside layer of placenta) tests for fetal chromosomal anomalies, can test in 1st trimester. Can be transabdominal or transvaginal

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5
Q

Amniocentesis

A

Screen for chromosomal abnormalities, done in second trimester (have to wait for enough fluid). Uses fluorescence in situ hybridization (FISH)

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6
Q

Cordocentesis (Percutaneous Umbilical Blood Sampling - PUBS)

A

Takes blood from umbilical cord, guided by ultrasound. Test for blood disorders

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7
Q

Biophysical profile (BPP) variables

A

Fetal breathing movements, fetal movement, fetal tone, amniotic fluid volume, non-stress test

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8
Q

Fetal breathing movements (BPP)

A

Normal - one or more episodes lasting 30 seconds or more
Abnormal - absence of breathing movements or movements lasting less than 30 seconds

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9
Q

Fetal movement (BPP)

A

Normal- 3 or more body or limb movements
Abnormal - two or less

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10
Q

Fetal tone (BPP)

A

Normal - one or more episodes of active extension with return to flexion of limb or trunk, or opening and closing of hand
Abnormal - slow extension with return to partial flexion or absent movement

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11
Q

Amniotic fluid volume (BPP)

A

Normal - single vertical pocket >2cm
Abnormal - <2cm or no fluid

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12
Q

Non-stress test

A

Normal - reactive

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13
Q

BPP scoring

A

8-10 - normal
6 -10 - may be sleepy, watch and retest
4 or less - no reassuring, consider delivery

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14
Q

Preeclampsia

A

Hypertension with proteinuria (> 300mg/L)

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15
Q

HELLP

A

High blood pressure (hemolysis), elevated liver enzymes, low platelets

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16
Q

Superimposed PIH

A

Already had HTN, now worse due to pregnancy

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17
Q

CMV

A

Most common intrauterine infection, transmitted by exposure to infected blood or body fluids, most asymptomatic at birth.
Tx - gancyclovir

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18
Q

Oligohydramnios

A

AF <1 L at 36 weeks, < 800 ml at term
Potter sequence - renal agenesis, not urinating, no fluid, no lungs, can lead to hypoplastic lungs

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19
Q

Hydramnios (poly)

A

AF volume > 2L anytime
GI obstructions, tight nuchal cord (obstruction to swallowing), neuro defects, TE fistula

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20
Q

PROM

A

Premature rupture of membranes

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21
Q

PPROM

A

Preterm premature rupture of membranes (before 37 weeks)

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22
Q

Chorioamniotitis

A

Infection of placental membranes

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23
Q

Lectin/Sphigomyelin (L/S) ratio

A

Normal 2 or more
<2 indicates immature lungs, give steroids, try to stress baby, wait
>2 occurs when fetal lung surfactant is present in fluid (35 weeks)

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24
Q

Phosphatidylglycerol (PG)

A

If present in amniotic fluid, indicates lung maturity
More reliable than l/s ratio in diabetic moms

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25
Q

Fetal-lung maturity (TDx-FLM)

A

Measures mg of surfactant/g of albumin
>55 - probably maturity

26
Q

Variability

A

Short term- beat to beat changes, vagal stimulation
Long term- larger amplitude

27
Q

Early Decelerations

A

Head compression

28
Q

Variable decelerations

A

Cord compression

29
Q

Late decelerations

30
Q

Fetal tachycardia

A

> 160 for 10 or more minutes
Think infection if sustained

31
Q

Tocolytics

A

Stop labor

32
Q

Mag sulfate

A

Can cause neuromuscular or respiratory depression in baby

33
Q

Indomethacin (prostaglandin inhibitors)

A

Risk of premature ductal closure, pulmonary hypertension, and altered renal function

34
Q

Betamimetics (terbutaline)

A

Can cause hypoglycemia due to hyper insulin emit

35
Q

Procardia

A

Decrease heart muscle contractors which decreases uterine contractility

36
Q

Abruption

A

Abruptly pulling away from intrauterine wall, can be partial or total. Can bleed into pocket. Can cause hypoxia and hypoperfusion in baby

37
Q

Cord prolapse

A

Occult - covering cervical opening
1st or 2nd degrees - dangling
Risk of cord compression and fetal hypoxia

38
Q

Placenta previa

A

Low placental implantation, bright red bleeding because right by cervical opening, low placental implantation

39
Q

Vacuum

A

Consider hyperbili (RBC breakdown and bleeding)

40
Q

C/s risk

A

Extra fluid on lungs bc they aren’t squeezed
If c/s with no labor - RDS bc labor kicks out surfactant response

41
Q

Fetal fibronectins

A

Found in fetal membranes throughout pregnancy, no longer detected in fluid after 22 weeks until ~2 weeks before delivery

42
Q

Cervical ferritin

A

Inflammatory marker (think infection)

43
Q

Corticotropin releasing hormone

A

Component of labor, both term and preterm

44
Q

Placental a-microglobulin-1

A

Bio marker for rupture of membranes

45
Q

Last menstrual period (LMP) assessment of gestational age

A

EDD= first day of LMP- 3 months + 7 days + 1 year

46
Q

Fundal height gest age assessment

A

Uterus is at umbilicus at 20 weeks

47
Q

Quickening

A

First feeling of fetal movement
Primigravida - 18-20 weeks
Multigravida - 16-18

48
Q

Fetal heart tones detected when

A

as early as 9 weeks, commonly by 12 weeks

49
Q

Fetal femur length for gest age assess

A

Second trimester on, accurate +/- 7 days

50
Q

TORCH infections

A

Toxoplasmosis, others (parvo, syphilis), rubella, cytomegalovirus, herpes simplex
All cross placenta

51
Q

GBS

A

Screened at 35-37 weeks
Mom given prophylaxis abx during labor if positive

52
Q

Normal fetal baseline

A

110-160 - 2 minutes

53
Q

Fetal bradycardia

A

Less than 110 for 10 min or more

54
Q

Fetal tachycardia

A

Greater than 160 for 10 min or more

55
Q

Category 1

A

Normal FHR

56
Q

Category 2

A

Indeterminate FHR not predictive or abnormal fetal acid base balance
Reevaluation needed

57
Q

Category 3

A

Abnormal FHR, abnormal fetal acid base balance

58
Q

Mag sulfate

A

CNS depressant to prevent seizures
Decreases BP transiently

59
Q

GDM etiology

A

Secretion of human placental lactogen increases cellular resistance to insulin
Cortisol and glycogen levels increase
Pancreas can’t meet need for increased insulin demand, leads to hyperglycemia

60
Q

Kleihauer-Betke test

A

For placental abruption
Tests for fetal blood in maternal circulation

61
Q

Occult prolapse

A

Cord not visible or palpable but located between presenting part and pelvis or cervix

RNC NIC (6 decks)

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