Module 4
When is transabdominal ultrasound used?
Used in 2nd and 3rd trimester
Need full bladder in 2nd semester
How can you tell if a non-stress test is reactive?
At least two FHR accelerations
Occurring within any 20 minute period
Peaking at least 15 bpm above baseline and lasting 15 seconds
What are the risks with amniocentesis?
Infection
Bleeding
Trauma to baby
Puncturing the cord
Can develop preterm labor
When would contraction stress be contraindicated?
If they are preterm (less than 32 weeks)
Placenta previa
Previous c-section
If vaginal birth is not an option
Why is contraction stress test given?
To see how well the baby will tolerate labor
What does the alpha-fetoprotein screening do?
Low levels associated with down syndrome
Elevated AFP associated with neural tube defects
What do ultrasounds check for?
Structural abnormalities
Gestational age
Multifetal
Viability
Presence and location of pregnancy
What should you teach expecting moms who have amniocentesis?
Signs of labor (abdominal cramping, tightening of the stomach, bleeding/water leaking)
Signs of infection
What equipment do you need for a contraction stress test?
Fetal monitor
Heart monitor
Oxytocin/nipple stimulation
What is happening during contraction stress test?
Give oxytocin to cause contractions
Monitoring if there is any deceleration
When is the alpha-fetoprotein screening done?
Between 16-18 weeks
Is an amniocentesis done in the first trimester and why?
No because there is not enough amniotic fluid
What needs to happen to an RH- mom during any procedure with pregnancy?
Give roghan shot
What is a normal fetal HR?
110-160
What would indicate a positive contraction stress test?
Heart rate with 50% of more decelerations
When is the multi-marker screen done and what for?
16-18 weeks
the check for chromosomal abnormalities
When and why would an amniocentesis be done in the second trimester?
15-20 weeks
Check for chromosomal abnormalities
When is a chronic villus sampling done and what for?
10-13 weeks gestation
Provides information about numerous chromosomal defects
Metabolic or DNA abnormalities
What does the antepartum fetal surveillance consist of?
Nonstress test
Contraction stress test
Biophysical profile
When is a biophysical profile done?
When the baby HR is non-reactive
If the multi marker screening is positive then what?
Amniocentesis
Why would an amniocentesis be done in the third trimester?
Used to determine fetal lung maturity or hemolytic disease
Remove excess amniotic fluid
What are late deceleration caused?
Placental insufficiency
How is the biophysical scored?
Each subject either gets two point or 0 points