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33 terms

Assessment of fetal well-being

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mother measures the fetal movements within one hour
sandovsky method
mother records the time interval it takes to feel ten fetal movements
count to ten/ cardiff method
what is the normal fetal heart rate?
- can be heard as early as 12 wks with doppler
120-160
<110 bpm for 10 minutes
bradycardia
>160 bpm for 10 minutes
tachycardia
irregularity or fluctuations of fetal heart rate
variability
increase of FHR by 15 bpm above the baseline lasting 15 seconds or longer
acceleration
decrease of FHR by 15 bpm below the baseline lasting 15 seconds or longer
deceleration
done just to assess FHR baseline, looking for long and short-term variability
rhythm strip testing
FHR measured in response to fetal movement
- non-invasive, generally done @ 28 wks, similar to fetal heart monitoring
non stress test (NST)
two accelerations of FHR lasting 15 sec occurring after movement - good
reactive NST
no accelerations of the FHR with movement of fetus - not good
non-reactive NST
usually done after NST, invasive
- assess ability of fetus to withstand the stress of uterine contractions, how will the fetus withstand labor?
- performed if NST is abnormal, also if PIH is worsening, only do if ready to deliver the baby
- gain c-section consent forms before
contraction stress test (CST) or oxytocin challenge test (OCT)
represented with no late decelerations of FHR, FHR stays within baseline during test, good sign
negative CST
late decelerations/invariabilities of the FHR for more than half of the contractions, will do c-section, baby would not be able to withstand labor, bad sign
positive CST
suspicious, not quite sure, some decelerations, less than 50%, not often
equivocal CST
inadequate FHR, and less than 3 contractions in 10 minutes
unsatisfactory CST
________ CST indicates that the fetus can survive labor
negative
________ CST indicated that the fetus is unlikely to tolerate labor
positive
Used to determine:
- diagnosis of pregnancy
- confirm presence, size and location of placenta
- presentation and position of fetus
- fetal gross defects
ultrasound
physician inserts a needle into amniotic sac and removes amniotic fluid
- patient has to sign consent form, needs to void before procedure, RhoGAM (if indicated) should be given before procedure
- risks: hemorrhage, infection, puncture of fetus
amniocentesis
amniotic fluid should be what color?
clear/ like water
yellow amniotic fluid may indicated what?
blood incompatibility
green amniotic fluid may indicate what?
meconium
measures lung maturity of the infant, ratio should be 2:1 or greater
lecithin/sphingomyelin ratio (L/S ratio)
genetic testing for various abnormalities
chromosome analysis
blood test done prenatally (16-18 wks), some Dr's do and some don't, good way to begin to rule out genetic abnormalities, need to have a value somewhere in the middle, may or may not be accurate, serum test
alpha-fetoprotein test (AFP)
____ levels of AFP indicate open spinal (spina bifida) or abdominal defects
high
___ levels of AFP indicate chromosomal defects
downs syndrome
What are the five parameters of biophysical profile?
- test for preterm delivery
fetal breathing movements
fetal movements
fetal tone
amniotic fluid volume
fetal heart reactivity
biophysical profile score of 8-10 means?
good/normal
biophysical profile score of 6 means?
satisfactory but be aware
biophysical profile score of 4 or less means?
fetus is compromised