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Flashcards in Assessment of Antenatal Risks Deck (37)
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1
Q

When is Nuchal Translucent Screening done during pregnancy?

A

11-14 wks of prego

2
Q

What is Nuchal Translucent Screening?

A
  • US that checks the thickness of the nuchal fold
  • done at 11-14 wks of prego
  • thicker fold = increased risk of genetic anomalies
3
Q

Reasons for an early US?

A

Nuchal Transulency Screening, early prego confirmation and accurate dating of pregnancy (date of delivery)

4
Q

The sex of the child can be determined at how many wks?

A

18-20 wks

5
Q

Why are late prego US usually done?

A

to monitor high-risk preggos

6
Q

What does Quad testing screen for?

A

risks of down syndrome (trisomy 21)

7
Q

What substances does Quad testing measure?

A

AFP, hCG, estriol and inhibin A

8
Q

What is alpha-fetoprotein (AFP) and where is it produced?

A

is a protein that is produced by the fetus

9
Q

What is estriol and where is it produced?

A

an estrogen produced by both the fetus and the placenta

10
Q

What is hCG and where is it produced?

A

a hormone produced within the placenta

11
Q

What is inhibin A and where is it produced?

A

a protein produced by the placenta and ovaries

12
Q

When is the Quad Screen done during pregnancy?

A

1st (1-13 wks) or 2nd trimester (13-28 wks)

13
Q

High levels of AFP suggests what about the developing fetus?

A

may have a neural tube defect

14
Q

When in the pregnancy are fetal kick counts begun?

A

28-30 wks

15
Q

Explain the fetal kick count.

A
  • measures how long it takes the baby to kick 10x, want within 2
16
Q

When is Amniocentesis done during pregnancy?

A

15-20 wks

17
Q

Where are the cells for CVS taken from?

A

the cells are taken from the placenta

18
Q

When is CVS done during pregnancy?

A

10-14 wks

19
Q

What should a woman do if she feels < 10 movements within 2 hrs of fetal kick counting?

A

take a walk, drink something sweet and make sure to be in a quiet environment

20
Q

When should a woman see her provider after when performing fetal kick counts?

A

if < 10 fetal movements within 2 hrs after taking a walk, drinking something sweet and make sure to be in a quiet environment

21
Q

When during the pregnancy are non-stress tests (NST) begun?

A

26-28 wks, only useful during the 3 trimester

22
Q

What is a normal (“Reactive”) NST?

A

≥ 2 heart rate accelerations periods of ≥ 15 BPM for ≥ 15 secs within a 20 min period

23
Q

What to do if specified HR criteria are not met within for NST?

A

wait another 20 mins (making 40 mins total), to account for fetal sleep time

24
Q

How long does the typical fetal sleep period last?

A

about 40 mins

25
Q

Why should a prego woman not smoke prior to having a non-stress test?

A

it could cause a false positive

26
Q

Contra-indications for Contractions Stess Test?

A

hx of preterm labor, previous classical/vertical incision c-section, placenta previa (placenta lies low, near cervix)

27
Q

Drug of choice for contraction stress test?

A

Pitocin

28
Q

Number of contractions and length wanted during a contraction stress test?

A

3 contractions, lasting ≥ 40 secs in 10 mins

29
Q

What is a (1) positive and (2) negative contraction stress test interpretation?

A

1) repetitive late decelerations or drop in HR

2) no decelerations or drop in HR

30
Q

Fluid amount for the below:

1) oligohydramnios
2) normal AFI
3) polyhydramnios

A

1) ≤ 4 cm
2) 5-19 cm
3) ≥ 20 cm

31
Q

What test(s) are an alternative to a complete Biophysical Profile?

A

NST with AFI

32
Q

Interpret the results and determine whether a complete BPPis needed:

1) Reactive NST and AFI of 3
2) Reactive NST and AFI 23
3) Reactive NST and AFI 16

A
  • 1 & 2: perform full BPP

- 3: normal results, no BPP needed

33
Q

Interpret the NST results (normal or not normal):

1) 3 periods of acceleration (20, 15, 20 BPM), (20, 25, 15 secs), within 12 minutes
2) 4 periods of acceleration (20, 15, 20 BPM), (20, 25, 15 secs), within 25 minutes
3) 2 periods of acceleration (24, 12, 22 BPM), (20, 25, 15 secs), within 10 minutes

A

1) normal
2) non-normal (timeframe is longer than 20 mins)
3) non-normal (12 BPM is < 15)

34
Q

BPP Scoring and interpretation:

1) 8-10/10
2) 6/10
3) 4/10
4) 2/10
5) 0/10
6) <6/10

A

1) low risk for perinatal asphyxia
2) Probable perinatal asphyxia
3) high risk for perinatal asphyxia
4) perinatal asphyxia almost certain
5) perinatal asphyxia certain
6) plan will be to deliver if the fetus is mature

35
Q

Components of the BPP include?

A

1) Nonstress test: reactive = 2 points, non=0
2) Fetal breathing:
- 2points: ≥20 secs of rythmic breathing ≤ 30 mins
- 0 points: other
3) Fetal Activity
- 2 points: ≥ 2 torso/limb movements
- 0 points: < 2 movements
4) Muscle tone
- 2 points: ≥ flexion and extension of limb or trunk
- 0 points: poor/none
5) Qualitative Amniotic Fluid volume
- 2 points: ≥ 1 vertical pockets with ≥ 2 cm of AF
- 0 points: < 2 cm of AF

36
Q

Infections associated with Congenital Disorders in the Fetus/Neonate?

A

TORCH:

  • Toxoplasmosis
  • Other (chlamydia, syphilis, varicella)
  • Rubella
  • Cytomegalovirus
  • Herpes Simplex
37
Q

Adolescent Pregnancies (phase of adolescence)

1) early
2) mid
3) late

A

1) 10-13
2) 14-16
3) 17-20