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maternity > prenatal diagnostic tests > Flashcards

prenatal diagnostic tests Flashcards

1
Q

how many weeks is in the FIRST trimester or pregnancy?

A

1-12 weeks

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2
Q

how many weeks is in the SECOND trimester or pregnancy?

A

13-26 weeks

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3
Q

how many weeks is in the THIRD trimester or pregnancy?

A

27-delivery

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4
Q

who gets consent for a prenatal test?

A

diagnostician

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5
Q

is the mom REQUIRED to complete a diagnostic test or screening, or is it OPTIONAL?

A

optional

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6
Q

what are some fetal & placental conditions ULTRASOUNDS determine?

A

presence & location of pregnancy, multifetal gestation, gestational age (how far along pregnancy is), viability confirmation (confirmed by FHR), identifying fetal abnormalities

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7
Q

can you determine fetal sex with an ultrasound?

A

yes, but not always

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8
Q

why should the mom (at 18 weeks/2nd trimester) drink 1-2 quarts of water and hold her bladder before an ultrasound?

A

because in the 2nd trimester, the fundus is below the umbilicus & holding the bladder will move the fundus up

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9
Q

what is used to perform the doppler ultrasound blood flow assessment?

A

ultrasound

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10
Q

indicates forward movement of blood in a vessel that is above baseline

A

doppler shift

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11
Q

in what pregnancies would a doppler ultrasound blood flow assessment be used?

A

in pregnancies complicated by hypertension & fetal growth restriction caused by placental insufficiency

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12
Q

what organs are affected in pregnancies complicated by hypertension?

A

placenta & umbilical cord

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13
Q

what ratio does the doppler ultrasound blood flow assessment use to measure blood flow?

A

systolic to diastolic ratio

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14
Q

what does color doppler imaging help you see?

A

the umbilical vein and the 2 umbilical arteries

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15
Q

how is the alpha-fetoprotein (AFP) SCREENING assessment performed?

A

by collecting maternal serum or amniotic fluid

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16
Q

what does alpha-fetoprotein (AFP) SCREENING assessment identify?

A

open body wall defects (neural tube defects) & chromosomal anomalies (trisomy 21/down syndrome)

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17
Q

low levels of amniotic fluid indicates ….

A

chromosomal anomalies (ex. down syndrome)

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18
Q

how many weeks of gestation is the AFP SCREENING assessment performed?

A

between 16 & 18 weeks of gestation

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19
Q

must be viewed as a first step in screening

A

AFP screening assessment

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20
Q

main protein in fetal plasma that diffuses from fetal plasma into fetal urine & gets excreted into amniotic fluid or to mom’s blood as waste product

A

alpha feto protein

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21
Q

is AFP screening assessment able to diagnose (diagnostic) or a screening tool & requires follow up?

A

screening

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22
Q

what does elevated AFP levels indicate?

A

failure of embryo neural tube or anterior body wall to close properly (ex. ancephaly or spina bifida)

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23
Q

another term for AFP screening assessment

A

MSAFP (maternal serum AFP)

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24
Q

what are the two additional markers (multiple marker SCREENING) added to the MSAFP/AFP SCREENING?

A

HCG & unconjugated estriol (estrogen)

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25
Q

increases detection of trisomy 18 & 21

A

multiple marker screening

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26
Q

what indicates a positive test in multiple marker screening?

A

if MSAFP & estriol are low but HCG is high

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27
Q

if testing is positive in multiple marker screening what DIAGNOSTIC test is recommended?

A

amniocentesis

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28
Q

uses transcervical or transabdominal sampling to obtain villi & performed much earlier than amniocentesis

A

chorionic villus sampling

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29
Q

how many weeks of gestation is the chorionic villus sampling done in?

A

between 10 & 13 weeks gestation

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30
Q

provides information about chromosomal defects, metabolic & DNA abnormalities

A

chorionic villi cells

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31
Q

what is the advantage with chorionic villus sampling?

A

it’s performed early and can lead to earlier decision of elective abortion

32
Q

what are the risks associated with chorionic villus sampling?

A

infection, bleeding, fetal injury, fetal loss

33
Q

aspiration of amniotic fluid from sac for further examination (by going through the abd)

A

amniocentesis

34
Q

when is the SECOND trimester amniocentesis perfomed & what does it detect?

A

between 15 & 20 weeks, detects chromosomal or biochemical abnormalities

35
Q

when is the THIRD trimester amniocentesis performed & what does it determine?

A

during the third trimester, determines fetal lung maturity or hemolytic disease

36
Q

what does it mean when the fetal lungs are mature?

A

they have enough surfactant

37
Q

the two substances that create surfactant

A

lecithin & sphingomyelin

38
Q

decreases surface tension in alveoli to make breathing easier & prevent atelectasis

A

surfactant

39
Q

when mom is RH negative, has been exposed to RH antigen, developed antibodies against RH-positive fetal RBC and destroys them

A

hemolytic disease

40
Q

what are the indications for second trimester amniocentesis?

A

maternal age of 35 yrs or older, chromosomal d/o in close family members, gender determination for maternal carrier of x-linked disorders (ex. hemophilia or duchenne muscular dystrophy), birth of previous infant with chromosomal d/o or neural tube/body wall defect, pregnancy after multiple spontaneous abortions (miscarriages), unexplained elevated levels of maternal serum afp, maternal rh sensitization of maternal rh-neg blood to fetal rh-positive blood

41
Q

what are the risks associated with amniocentesis?

A

infection, bleeding, fetal injury, fetal loss

42
Q

aspiration of fetal blood from umbilical cord near placenta where it’s inserted for prenatal diagnosis or therapy

A

percutaneous umbilical blood sampling/ cordocentesis

43
Q

what does PUBS/cordocentesis detect?

A

blood disorders, acid-base imbalance, infection, or fetal genetic dz

44
Q

what are the risks associated with pubs?

A

infection, bleeding, fetal injury, fetal loss

45
Q

what are the different types of antepartum fetal surveillance tests?

A

nst, cst, bpp

46
Q

a prenatal diagnostic test which evaluates FHR accelerations WITH or WITHOUT fetal movement

47
Q

The fetal heart rate should increase as the baby moves. What indicates a reactive/reassuring result in NST testing?

A

if FHR increases for 15bpm for 15 seconds , two times, in the twenty minute long NST test

48
Q

what is reactivity in the NST test associated with?

A

adequate fetal oxygenation & intact neural pathways

49
Q

fetal reactivity may not develop until __________ weeks

50
Q

uses sound to confirm if NST findings are reactive/reassuring

A

vibroacoustic stimulation

51
Q

adds a stressful situation to the baby/contraction

52
Q

contractions cause a temporary _________ in blood flow that the baby can tolerate and adjust to

53
Q

used to cause a contraction in the CST testing

A

nipple stimulation or low dose oxytocin

54
Q

what does the CST testing determine?

A

if fetal heart responds to uterine contractions that temporarily decrease placental blood flow

55
Q

if stimulated uterine contractions are contraindicated, can an CST testing be perfomed?

56
Q

negative/reassuring result in CST

A

is a good sign

57
Q

late/positive/nonreassuring result in CST

A

means the FHR has dropped & baby is not ok

58
Q

what are the five parameters included in the Biophysical Profile (BPP)?

A

NST, fetal breathing/chest movements, gross fetal movements, fetal tone, & amniotic fluid volume

59
Q

if the five parameters are present in a BPP, how many points does each parameter receive?

60
Q

method used to quantify the amount of amniotic fluid visualized by ultrasound in a BPP

A

amniotic fluid index

61
Q

if NST is NOT done in a BPP but the rest of the five parameters are present, what is the result?

62
Q

if NST IS done in a BPP, is reactive, & the rest of the five parameters are present, what is the result?

63
Q

score below 8 in a BPP could indicate

64
Q

FIRST sign of fetal hypoxemia & acidosis

A

late decelerations appear

65
Q

SECOND sign of fetal hypoxemia & acidosis

A

accelerations disappear

66
Q

THIRD sign of fetal hypoxemia & acidosis

A

fetal breathing movement stops

67
Q

LATE sign of fetal hypoxemia & acidosis

A

fetal movement ceases

68
Q

LAST sign of fetal hypoxemia & acidosis

A

fetal tone absent & fetus is already compromised

69
Q

fetal movements assessed by the mother

A

kick counts

70
Q

how many fetal movements should be in 1-2 hours?

71
Q

how many fetal movements should be per hour?

72
Q

purpose of the AFP screening

A

to detect pregnancies at high risk for neural tube defects

73
Q

Normally, a 2:1 ratio lecithin/sphingomyelin indicates lung maturity in a 3rd trimester amniocentesis. A 3:1 lecithin/sphingomyelin ratio would reveal lung
maturity in a fetus of a pregnancy complicated by
______________________

74
Q

should the mother empty her bladder before NST testing?

75
Q

when should a mother notify the provider about fetal movements?

A

if movement suddenly changes and/or decreases

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