Nur 263 - OB Skills Lab - Antepartal
|Amniocentesis||A procedure in which a needle is inserted through the abdominal and uterine walls into the amniotic fluid; fluid is withdrawn; used for assessment of fetal health and maturity. |
• Possible after 14 weeks
• Performed to obtain amniotic fluid (which contain fetal cells) for the purpose of a biochemical assessment/analysis of the amniotic fluid.
• Clinical significance: to evaluate for genetic disorders or congenital anomalies, assessment of pulmonary maturity, and diagnosis of fetal hemolytic disease
• Properly drape and position.
• Have necessary supplies close by. Assist physician as well as woman.
• Assist with positioning for ultrasonography, locating fetus, placenta, and pockets of amniotic fluid for sampling.
• Once pocket is located and confirmed by physician, remove gel and prepare woman with antiseptic solution.
• Prepare woman if physician determines to inject a small amount of .
• On a tray have a 3 inch 20 gauge spinal needle and a 20 ml syringe ready for physician.
• Under direct ultrasonography visualization, physician inserts needle trans abdominally into uterus. The physician removes and discards 1 to 2 ml of amniotic fluid then obtains 20ml for analysis.
• Amount withdrawn depends on gestational age and reason for testing. RN prepares sample and sends to lab
• After procedure, give woman injection of Rh immunoglobulin if ordered to prevent sensitization (observe closely).
• Reassess fetal heart rate while woman recovers for a couple of hours.
• To Mother: hemorrhage, fetomaternal hemorrhage with possible maternal Rh isoimmunization, infection, labor, placental abruption, inadvertent damage to intestinal bladder
• To Fetus: death, hemorrhage, infection, direct injury from needle, miscarriage or preterm labor, leakage of amniotic fluid.
• Because of the possibility of fetomaternal hemorrhage, administering RhoD immune globulin to the woman who is Rh negative is standard practice after an amniocentesis.
|Abortion||Termination of pregnancy before the fetus is viable and capable of ectrauterine existence, usually less than 20 weeks of gestation. (or when the fetus wheighs less than 500 grams)|
|Complete abortion||In which fetus and all related tissue have been expelled from uterus|
|Elective Abortion||Termination of pregnancy chosen by the woman that is not required for her physical safety|
|Habitual Abortion (recurrent)||Loss of 3 or more successive pregnancies for no known cause|
|Incomplete Abortion||Loss of pregnancy in which some but not all the products of conception have been expelled from the uterus|
|Induced Abortion||Purposeful interruption of a pregnancy before 20 weeks of gestation|
|Inevitable Abortion||Threatened loss of pregnancy that con not be prevented or stopped or is imminent|
|Missed Abortion||Loss of pregnancy in which the products of conception remain in the uterus after fetal death|
|Septic Abortion||Loss of pregnancy in which there is an infection in the products of conception and the uterine endometrial lining, usually resulting from attempted termination of early pregnancy|
|Spontaneous Abortion||A pregnancy that ends as a result of natural causes before 20 weeks of gestation; preferred term is miscarriage|
|Therapeutic Abortion||Pregnancy intentionally terminated related to medical reasons|
|Threatened Abortion||Possible loss of pregnancy, early symptoms present (i.e. cervix begins to dilate)|
|Amniocentesis||A procedure in which a needle is inserted through the abdominal and uterine walls into the amniotic fluid; fluid is withdrawn; used for assessment of fetal health and maturity. • Possible after 14 weeks|
|Nagele's rule|| Method for calculating the estimated date of birth or "due date". |
• After determining the first day of the last menstrual period subtract 3 calendar months and add 7 days;
• Or add 7days to the LMP and count forward 9 calendar months
|NST- Non Stress Test||Evaluation of fetal response (fetal heart rate) to natural contractile uterine activity or to an increase in fetal activity.|
|EDC||Estimated date of confinement, ,|
|EDD||Estimated date of delivery|
|EDB||Estimated Date of Birth|
|Fundus||Dome shaped upper portion of the uterus between the points of insertion of the uterine tubes|
|Gestation||Period of intrauterine fetal development from conception through birth; the period of pregnancy|
|Gravida||A woman who is pregnant|
|GTPAL||System for summarizing the womans obstetric history. |
• Acronym stands for Gavidity, Term, Preterm, Abortions, Living children.
- Gravidity = number of pregnancies,
- Term = number of deliveries after 37 completed weeks gestation',
- Preterm = number of deliveries after 20 weeks but before 37 weeks gestation,
- Abortion = number of pregnancies ending before 20 weeks,
- Living children = number of currently living children
|Leopold's Maneuvers||Four maneuvers for diagnosing the fetal position by external palpation of the mothers abdomen while lying on her back. |
• Prep: empty bladder, supine with one pillow under head and knees slightly flexed.
- Small rolled towel right or left hip to displace uterus off major blood vessels (prevents supine hypotensive syndrome
- Number of fetus's
- Presenting part, fetal lie/attitude
- Degree of (presenting parts) descent into pelvis
- Expected location of the PMI of the FHR
|Lightening||Sensation of decreased abdominal distention produced by uterine descent into the pelvic cavity as the fetal presenting part settles into the pelvis, |
• It usually occurs 2 weeks before the onset of labor in nulliparas.
• After the woman breaths easier and feels less congested.
• Usually bladder pressure results from the shift.
• In multipara woman this may not occur until after contact ions start
|LMP||Last menstrual period|
|Multigravida||A woman who has had 2 or more pregnancies|
|Nulligravida|| A woman who has never been pregnant|
|Para (parity)|| Number of pregnancies ending after 20 weeks counted as para whether baby is born living or dead|
• Counts the pregnancy not the number of babies
|Physiologic Anemia (Pseudoanemia)||A modest decrease in the hemoglobin concentration and hematocrit in pregnancy, caused by the relative excess of plasma|
|Primigravida||A woman who is pregnant for the first time|
|Quickening||Maternal perception of fetal movement (feeling of life) usually occurs between weeks 16 and 20 of gestation, but may be felt earlier by multiparous woman.|
|Stillbirth||The birth of a baby after 20 weeks of gestation and 1 day or weighing 350g (depending on the state code) that does not show any signs of life.|
|Supine Hypotension Syndrome (Shock)|| Fall in blood pressure caused by impairedvenous return when gravida uterus presses on ascending vena cava, |
• Occurs when woman is lying flat on her back
• Vena Cava Syndrome
|Trimester||- one of three periods of about 3 months each into which pregnancy is divided|