Weeks Three And Four Material

Question 0

What is a multiple marker screening for, what does the test consist of and when is it done?

Answer 0

Maternal blood samples are taken between 16 and 18 weeks of gestation to screen for chromosomal abnormalities.

Question 1

What is the purpose of intrapartum fetal surveillance?

Answer 1

To monitor the fetus for any anomalies -fetal heart

-Mothers contractions

Question 2

What are some important things that estrogen is responsible for and pregnancy?

Answer 2

• to maintain a pregnancy
• to have the uterus grow
• to maintain the uterine lining
• to increase blood circulation
• to trigger the development of the fetus’s organs and to regulate bone density in the arms and legs of the fetus
• helps the breast to prepare for milk production

Question 3

What is amniocentesis and when is it done?

Answer 3

When a trained professional aspirates amniotic fluid from the amniotic sac by using a needle and go through the woman’s abdomen, it is done in the second trimester around week 15 to 20(can be done around week 11 to 14 but there is the risk of fetal loss and foot deformity) in the third trimester it is used to determine fetal lung maturity.

Question 4

What do you need to know about blood volume in pregnancy?

Answer 4

• blood volume goes up by as much as 45%
• plasma volume increases by 40 to 60% or 1200 to 1600 ML’s
• this happens to provide for the excess blood loss at childbirth
• cardiac output is increased
• lying laterally allows the heart output to be more efficient rather than lying in a supine position

Question 5

What does a trans abdominal ultrasound consist of?

Answer 5

• it’s done in the second and third trimester
• pillow under the head knee and hip and mom should be lying slightly on her side (avoiding pressured to the vena cava and the aorta-this avoids supine hypotension) Head elevated
• Second trimester patients should drink several glasses of water prior to the procedure and the delay urination until it is complete

Question 6

What does L/S ratio stand for? What does it pertain to?

Answer 6

Lecithin/ sphingomyelin ratio,The lipoproteins that make up surfactant this is checked in the third trimester through amniocentesis..if a baby needs to be delivered before 38 weeks

Question 7

What does a biophysical profile consists of?

Answer 7

-The nonstress test
-Fetal breathing movement
-Gross fetal movement
-Fetal tone or smaller movements like sucking or limb extension
-amniotic fluid
There is a score of 0 to 2 given for each one of these…normal or reassuring is an 8 to 10,equivocal is 6,abnormal is less than 4

Question 8

What is a nonstress test?

Answer 8

Evaluates fetal stress during the antepartum. By observing acceleration of the fetal heart rate during movement,which indicates adequate Oxygenation(if the heart rate does not accelerate with movement fetal hypoxemia and acidosis are concerns)if this is a CST or contraction stress test or biophysical profile is necessary
Semi fowler position to prevent supine hypotension

Question 9

How is a nonstress test done?

Answer 9

An electronic fetal monitoring device is applied to the woman’s abdomen woman may be given a remote event marker to press every time she feels movement
+noninvasive because it is only monitoring

Question 10

Nonstress test is considered reactive when?

Answer 10

At least two fetal heart rate accelerations occur with or without fetal movement occurring at least 15 bpm above the baseline and lasting 15 seconds from baseline to baseline

Question 11

What is the main protein in fetal plasma?

Answer 11

AFP or alpha-feto protein

Question 12

How is AFP excreted into the amniotic fluid?

Answer 12

It moves through the fetus into Fetal urine and is then excreted into the amniotic fluid

Question 13

What are the ways that AFP can be measured?

Answer 13

Maternal serum/ blood….and amniotic fluid

Question 14

What are abnormally low concentrations of maternal serum AFP associated with?

Answer 14

Chromosomal anomalies such as down syndrome

Question 15

What is a common reason for elevated levels of AFP in the maternal serum?

Answer 15

Failure of the embryonic neural tube or anterior body wall to close properly(abdominal cavities are either open or only covered by a thin layer of tissue)ex. Anencephaly or spina bifida

Question 16

When is The AFP screening usually done?

Answer 16

Between 16 and 18 weeks of gestation

Question 17

What are some roles progesterone in pregnancy?

Answer 17

Growth of cells of the fallopian tubes and endometrial lining to nourish the embryo,it relaxes the smooth muscle of the uterus and prevents it from contracting(prevents spontaneous abortion and rejection of the fetal tissue)simulates the development of lobules in the breast to prepare for lactation

Question 18

What hormone is produced by the ovary the corpus luteum and the placenta and is used to sustain and maintain a viable pregnancy?

Answer 18

Progesterone

Question 19

What gland produces Oxytocin?

Answer 19

The pituitary gland

Question 20

What is the function of oxytocin?

Answer 20

Stimulates uterine smooth muscle causing contractions and birth and after to get the uterus back to the prepregnancy state and control bleeding and it also stimulates the let down mechanism known as the milk ejection reflex during breast-feeding

Question 21

What is the synthetic form of oxytocin called?

Answer 21

Pitocin

Question 22

What are some presumptive signs of pregnancy?

Answer 22

Amenorrhea, fatigue, nausea and vomiting, frequent urination, changes in the feel or appearance of the breasts, quickening movement of a fetus, abdominal enlargement

Question 23

What are some probable signs of pregnancy?

Answer 23

Chadwicks sign, Goodelle sign, ballottement and the size shape and feeling of the uterus,

Question 24

What are the positive signs of pregnancy?

Answer 24

Auscultation of fetal heart sounds and fetal movement felt by an examiner and visualization of the fetus on in ultrasound

Question 25

After what trimester of pregnancy may you feel and increased sexual desire?

Answer 25

The second trimester

Question 26

During the third trimester what should the fetal heart rate be?

Answer 26

Between 110 and 160 bpm

Question 27

What is the normal weight gain for a woman with a normal prepregnancy BMI?

Answer 27

25 to 35 pounds

Question 28

Overweight and obese women’s recommended weight gain with pregnancy is how much?

Answer 28

11 - 20 lbs

Question 29

What is folic acid found in?

Answer 29

in dark green leafy vegetables, lagumes, Orange juice and fortified cereal and pasta

Question 30

What neural tube defect’s can be prevented with a sufficient intake of folic acid?

Answer 30

Spina bifida and ancephaly