T4 - Assessment of High Risk Factors (Josh) Flashcards
What is a high risk pregnancy?
one in which the life or health of the mother or fetus is jeopardized by a disorder coincidental with or unique to the pregnancy
What risk factors are associated w/ Polyhydramnios?
Diabetes Milletus
Congenital Fetal Anomolies
- **GI obstruction
- **twin-twin transfusion
What risk factors are associated w/ Intrauterine Growth Restriction?
HTN Diabetes Chronic Renal Disease Collagen Vascular Disease Thrombophilia Cyanotic Heart Disease Poor Weight Gain Smoking, ETOH, Drug Use High Altitude
**pretty much anything that can affect perfusion of O2 and nutrients to fetus
What risk factors are associated w/ Oligohydramnios?
Renal Agenesis (Potter Syndrome)
Premature ROM
Prolonged Preg
Uteroplacental Insufficiency
Severe IUGR
Maternal HTN
What risk factors are associated w/ Chromosomal Abnormalities?
Advanced Maternal Age
Parental Chromosomal Rearrangements
Prev. Preg. w/ Autosomal Trisomy
Abnormal U/S Findings
Fetus should be — if not asleep.
active (kicking)
How often will a high risk mother need to do a kick count?
What about a low risk?
High Risk = 2-3 times/day for 30 mins to 1 hr
Low Risk = 1-2 times/day for 30 mins to 1 hr
Within each 30min-1hr kick count time frame, how many fetal movements should be felt?
5-6
How long of an absence in fetal movement is a cause for concern?
12 hrs
***Call doc
How long to count fetal movement during each time period?
30 mins - 1 hr
***book says 1 hr, but if she gets 2-3 kicks in 30 mins, she would not need to continue counting
How many levels of U/S are there?
Three:
- Level One
- Level Two
- Level Three
What is Level One U/S checking for?
Fetal viability
Fetal presentation
Gest. Age
Placental Location
Fetal Amniotic Structures
AF vol.
What is Level Two U/S checking for?
Fetal Presentation during labor
FHT (when unable to obtain other ways)
What is Level Three U/S checking for?
anatomically or physiologically abnormal fetus
When would a Level Two U/S be called for?
a specific reason
When would a Level Three U/S be called for?
Detailed or Targeted inspection of fetus
When is the U/S more accurate?
the earlier it is taken
What are major uses for U/S during First Trimester?
Confirm Preg and Viability
Determine Gest. Age
Rule out Ectopic Preg
Detect Multips
Determine cause of Vag bleeding
Visualization during Chorionic Villis Sampling
Detect maternal abnormalities like bicornuate uterus, ovarian cysts, fibroids
What are major uses for U/S during Second Trimester?
Confirm EDC and Viability
Detect Poly- or Oligohydramnios
Detect Congenital Abnormalities
Detect IUGR
Assess Placental Location
Visualization during Amniocentesis
What are major uses for U/S during Third Trimester?
Confirm Gest. Age and Viability
Detect Macrosomia
Detect congenital abnormalities
Detect IUGR
Determine Fetal Position
Detect Placental Previa or Abruption
Visualization during Amniocentesis
Biophysical Profile
AF Vol. Assessment
Doppler Flow studies
Detect Placental Maturity
In order to perform an Abdominal U/S, what must we tell client?
bladder must be full (especially during first and third trimesters)
Sitting or reclining w/ wedge under hip
Which position would client be in to perform a Transvaginal U/S?
Lithotomy
When would the Transvaginal U/S be used?
frequently in early weeks of pregnancy and also to determine cervical length
How is gestational age and EDC determined via U/S during first trimester?
crown-rump length
