Term
Chorionic Villi Sampling
1. Semester 2. Purpose 3.Procedure 4.Advantages 5.Disadvantages |
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Definition
| 1. 1 2. genetic testing 3. Cervical/abdominal biopsy of chorionic villi 4. early testing 5. Risk of bleeding, loss, limb reduction, infection, RhoGam needed, AFP still needed, not insurance guaranteed |
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Term
Alpha Fetoprotein
1. Semester 2. Purpose 3.Procedure 4.Advantages 5.Disadvantages |
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Definition
| 1. 2 2. low levels Tris 21 High levels NTD, twins, wrong GA; part of triple and quad tests 3. blood sample of MSAFP 16-18wk 4. detection of trisome, NTD 5. screening tool only, false neg possible, age/wt/race/GA calculation |
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Term
Ultrasound 1
1. Semester 2. Purpose 3.Procedure |
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Definition
| 1. 1 2. VIS: CVS; confirm pregnancy, gravidy, GA (head circumference, femur length, head-to-rump length), r/o ectopic (c vag pain, bleed, HcG no uterine growth), find cause of bleed, find neck fold 3. full bladder, transvaginal for fatties |
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Term
Ultrasound 2
1. Semester 2. Purpose |
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Definition
| 1. 2 2. VIS: Amnio; Polyhydramnios (diabetes, twin-twin), oligohydramnios (smoker, multi-para, HTN, HELP)congenital abnormality, IUGR, placenta place, cervical exam in preterm |
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Term
Ultrasound 3
1. Semester 2. Purpose |
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Definition
| 1. 3 2. Macrosomia, fetal position, abruptae or previa, external amnio, BPP, amniotic fluid assess, Doppler flow, placental age, assess need for cerclage |
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Term
Amniocentesis
1. Semester 2. Purpose 3.Procedure 4.Advantages 5.Disadvantages |
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Definition
| 1. 2-3 2. NTD, genetic disorder, Rh incompatibility (fetal edema and anemia,) ; 3rd- lung maturity for diabetic mom 3. needle through abdomen into amniotic sack 4. notice of potential risk 5. Risk of bleed, cord puncture, infection, Preterm labor, PROM; must get consent before procedure, pt must have ride home |
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Term
Fetal Blood Sampling
1. Semester 2. Purpose 3.Procedure 4.Advantages 5.Disadvantages |
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Definition
| 1. 2-3 2. specific to causative factor 3. Amniocentesis with sample of umbilical blood 4. 5. Risk of cord leak or hematoma (Kleihauer Betke tells us maternal-fetal transfusion) |
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Term
Fetal Fibrinectin (Biochemical)
1. Semester 2. Purpose 3.Procedure 4.Advantages |
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Definition
| 1. after 20 weeks 2. discover PROM 3. vaginal swab 4. identifies risk for ptl 4. False + from bleeding, sex or vaginal exam |
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Term
Lecithin/Sphingomyelin ratio
1. Semester 2. Purpose 3.Procedure |
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Definition
| 1. 3 2. fetal lung maturity; 2:1 ratio is reassuring, with PG (phosphatidyl glycerol) and PI (phosphatidylinositol) if diabetic 3. amnio fluid tested |
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Term
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Definition
| 10FM/2Hr is reassuring, best at night or after meals; should see a consistent trend |
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Term
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Definition
| Reassuring/ Reactive: 15 X 15 X 2 / 20 (15bpm above baseline for 15secs twice in 20 minutes) or 10X10X2/20 for 32 weeks or less |
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Term
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Definition
| After Non-Reactive NST: Negative (no late or variable decelerations over 3 contractions in 10 minutes) is reassuring; positive, equivocal-suspicious, equivocal-hyperstimulation, unsatisfactory are indicative of need for c-sec; RISK for PTL |
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Term
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Definition
Biophysical Profile: Done after a non-reactive NST to measure fetal movement, tone, breathing, HR and amniotic fluid volume (AFV)
Parameter: 2 points(WNL);0 points(risk)
NST: 2 accelerations in 20 mins; 0-1 acceleration
Ultrasound / activity: 3 movements in 30 minutes; <3 movements
Ultrasound / breathing: 30 seconds of rhythmic breathing; <30 seconds
Ultrasound / tone: Quick extension and flexion; Poor/slow/absent reflex
Ultrasound / AFV: 2cm+ pocket of fluid; <2cm pocket of fluid
How to read: 8-10 Reassuring 6 Equivical 4 Abnormal |
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Term
| Which of the following women should have AFP? A. has a cardiac anomaly B. has been exposed to AIDS C. is in preterm labor D. has a child with Spina Bifida |
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Definition
| D. This patient is at higher risk for a fetus with anencephaly |
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Term
Which of the following is not a traditional measurement used during ultrasound to determine gestational age beyond the first trimester?
A. femur length B. abdominal circumference C. biparietal diameter D. placental size |
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Definition
| C. Biparietal diameter is only accurate for GA in the first trimester |
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Term
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Definition
AFP HCG ESTRIOL
Low Low High trisome 21(Down's)
Low Low Low trisome 18(Edward's)
High WNL WNL Spina Bifida, NTD, GA is wrong |
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Term
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Definition
Same as Triple except:
Inhibin A High: trisome 21 (Down's)
Inhibin A Low: trisome 18 (Edward's) |
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Term
Amnio result: xx/xy
Meconium |
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Definition
female / male
possible hypoxemia |
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Term
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Definition
| Fluid mixed with equal parts saline and alcohol, shaken, and left alone for 15 minutes. If still bubbly, lungs are mature. |
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Term
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Definition
| At 2mg/100 ml (and 37 weeks) the fetal kidneys are functioning |
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Term
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Definition
| The order in which drugs are administered during PPH. Pitocin, Methergine, Hemabate, Cytotec |
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Term
| 5 Factors in determining Maternal Risk for Dystocia |
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Definition
History: VS, labs, prenatal care
GA: Preterm/Term
Multi: Single/twin/multi
ROM: Time, color
Fetus: FHR strip
Contractions: pattern |
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Term
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Definition
| Difficult or prolonged labor due to dysfunction, contraction strength, positioning, pelvic structure, fetal position, size or quantity, culture, SO support |
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Term
| Dystocia: Prolonged Latent Phase |
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Definition
| 17 hr(primipara,)12 hr(multipara; caused by unfavorable cervix, false labor, abnormal uterine activity, medication or dehydration |
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Term
| Dystocia: Slow Slope Active Phase |
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Definition
| <1cm/hr, caused by cephalopelvic disproportion with possible secondary medication or dehydration, abnormal uterine activity |
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Term
| Dystocia: Active Phase Arrest |
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Definition
| Adequate uterine activity but no dilation for 2 hours; caused by cephalopelvic disproportion with possible secondary medication or dehydration, abnormal uterine activity |
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Term
| Dystocia: Prolonged Second Stage |
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Definition
| primi-more than 2 hours or multi-more than 1 hour (add an hour for epidural); may require vacuum |
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Term
| What is the #1 risk of Amniotomy? |
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Definition
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Term
What Bishop's score indicates that labor will begin?
-That it will not? |
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Definition
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Term
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Definition
Uterine Activity (every 10 minutes)
Discomfort (Low abdominal cramp, backache, urinary freq., pelvic pressure)
Discharge (ROM/change or increase of fluid) |
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Term
| Home and Hospital treatment of preterm labor |
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Definition
Home: bedrest and water, treat infection, monitor uterine activity
Hospital: Tocolytics (magnesium sulfate or Terbutaline for emergency) then Antenatal Corticosteroids (Betamethasone), possible cerclage |
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Term
| 5 steps during Maternal/Fetal Distress |
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Definition
1. Increase uterine blood flow
2. Increase fetal O2
3. Sterile Vag exam
4. Notify MD for stat orders
5. Prepare for c/s |
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Term
| Signs of Maternal Distress |
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Definition
1. Placental Bleeding (Previa, Abruptio)
2. Uterine Rupture (bleeding, fetal distress, fetus in abdomen)
3. Pulmonary Edema (fluid sounds in lungs, SOB, Tachycardia)
4. Amniotic Fluid Embolism (SOB, PE, DIC, nausea, tachycardia, fetal distress) |
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Term
| TJC Sentinal Event Alert 44 Preventable Errors (4) |
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Definition
1. Failure to control BP in HTN pt
2. Failure to dx and treat Pulm. Emb. in pt with pre-eclampsia
3. Failure to monitor VS after c/sec
4. Hemorrhage following c/sec |
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Term
| TJC Sentinal Event Alert 44 Recommendations (3) |
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Definition
1. Educate MDs and others about risks involved for women with pre-existing conditions.
2. Identify system problems r/t critical changes in maternal VS; establish protocols and sims to train staff
3. Educate ER staff to identify women who are pregnant/within 42 days postpartum for best treatment. |
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