Routine Exams

Question 1

Blood Type/Rh Factor

Answer 1

If mother: Rh (-) + baby: Rh (+) = considered a ‘set up’ + puts infant @ risk for erythroblastosis fetalis

Further testing needed if this is the case - after the baby is born:
- Direct Coombs test:
- Performed on newborn’s blood sample
- Indirect Coombs test:
- Performed on mother’s blood sample

Tx = Rhogam to mother only - stops blood from making antibodies
26 - 28 wks + then 3 days after delivery

Question 2

STI Testing

Question 3

Fetal Doppler Assessment

Answer 3

(10 - 12 wks)

Question 4

Glucose Challenge

Answer 4

Oral Glucose Tolerance Test (done @ 28 wks gest.)
- Mother drinks 50 g of glucose in oral soln. (does not need to fast)
- 1 hr later he blood sugar is checked
- If BG is >140, 3 hr glucose test is performed (if <140 then mother is ok)

3 hr Glucose Tolerance Test
- It is done FASTING; moms must not eat/drink for 8 hrs prior to test = fasting BG is checked
- Mother drinks 100g of glucose oral soln.
- BG checked @ 1 hr, 2nd hr, + 3rd hr
- A BG > 140 = gestational diabetes

Question 5

Urinalysis

Question 6

Ultrasound

Question 7

Nonstress Test (NST)

Answer 7

(far enough along, 28 wks)

Assesses babys HR, well-being, + placental oxygenation
Eval if there are any changes in fetal HR w/ movement
- Increase in FHR w/ movement = acceleration = GOOD
- Decrease in FHR w/ movement = deceleration = BAD = sign baby will not tolerate labor

Result:
- Reactive = there are @ least 2 accelerations of 15 bpm for 15 sec in a 20 min period
- Non-reactive = there are NOT @ least 2 accelerations of 15 bpm for 15 sec in a 20 min period
- Further testing req. if result is non-reactive

Contraction Stress Test - performed if NST is non-reactive:
- Oxytocin/pitocin admin. to uterus to induce contractions + baby is monitored to eval their response to contractions

Result:
- Negative: normal, baby did not have any decelerations in response to contractions
- Positive: BAD, baby had decelerations = distress in response to contractions

Question 8

Group B Strep

Question 9

Kick Counts

Question 10

GTPAL

Answer 10

G - gravidity - a pregnancy (twins only count once; count current pregnancy)
T - term - # of pregnancies carried to term (37 wks [twins count once])
P - preterm - # of preterm births carried to 20 - 36(+6 days) wks gestation
A - abortion - spontaneous, miscarriage, termination - occurs @ 19(+ 6 days) wks
L - living children - how many current living children (you can count twins etc.)

Question 11

Naegele’s Rule for EDD

Answer 11

1st day of LMP + 7 days - 3 month + 1 yr

Question 12

Chorionic Villus Sampling (CVS)

Answer 12

May be performed as early as 10 wks gest. if fetus has chromosomal abnormalities - uses ultrasound

• Aspiration of small samples of placenta
• Bladder needs to be full, pt can eat + drink