IMPLICATION:

➢ABNORMAL
➢Mother needs another test, maybe a biophysical
profile.
➢NORMAL
➢High-risk pregnancy outcomes

❖Unsatisfactory recording uninterpretable; repeat

test in 24 hours.
Preparation:
➢Requires external electronic FHT monitoring with ultrasound
transducer and tocodynamometer to detect uterine activity.

INTERPRETATION:
➢NORMAL: NEGATIVE
➢No late decelerations of FHR with each of 3 contractions
during 1 10 minutes interval.
➢ABNORMAL : POSITIVE
➢With late decelerations of FHR with three contractions in 10
minutes.
IMPLICATION OOF RESULTS:
❖NORMAL
❖Pregnancy continues, normal result of OCT may require
weekly test.
❖ABNORMAL
❖May indicate a need to terminate pregnancy

❑Suspicious result: late decelerations occurring in less

than half of uterine contractions. Test should be repeated
in 24 hours.
4. NIPPLE STIMULATION CONTRACTION TEST
➢To determines feto-placental function/ well being
➢Breast are stimulated with rolling of nipples or warm towel
application. Stimulation of the nipple causes stimulus to be
sent to the posterior pituitary gland which in turn secretes
oxytocin.
➢The baseline data are obtained through monitoring as in
OCT procedure
➢Interpretation: same as in OCT; the absence of late
decelerations in 10 minutes is the desired result.
MAJOR RISK:
✓Trauma : fetus, placenta, umbilical cord, and maternal
surface
✓Infection
✓Abortion
✓Preterm labor

Amount of amniotic fluid to be aspirated:

➢Up to 30 ml at 15 to 18 weeks gestation
PREPARATION:
➢Secure an informed consent.
➢Increased oral fluids: take 1 quart water 2 hours before.
➢Prepare needle : g 20-22; 3”-6”
➢Prepare for administration of local anesthesia of the
abdomen
➢Provide psychological support.
➢Prepare for ultrasonography: to locate placenta and to
provide visualization to a blind procedure.
➢Ultrasound in amniocentesis: client needed to void
➢Pelvic ultrasound only: client should not void
Implications of Bloody tap:
➢Decreased L/S ratio
➢Fetal blood – false high levels of alpha-fetoprotein (AFP)

After care:
❖Monitor for 30 to 60 minutes
❖Observe for side effects such as:
❖Vaginal discharge
❖Increased uterine/ fetal activity
❖Fever and chills.
Analysis of Amniotic fluid:
a. Most commonly used today to determine fetal lung maturity.
Foam stability test or shake test
➢Result – L/S ratio of 2:1 means mature lungs.
b. Determination of age of gestation as is:
➢Creatinine levels: 2.0 mg- 36 weeks AOG; more than 2.0
mg – greater than 36 weeks.
➢Nile blue stain (lipid cells0: when 20% of cells are stained
with orange, it means the fetal weight is at least 2,500g.
c. alpha-feto-protein (AFP) levels:
➢Increasing/ high levels is may indicate the presence of a
neural defects such as spina bifida or tracheoesophageal
atresia.
d. Genetic disorders: for chromosomal studies.
e. Rh incompatibility:
➢ increased levels of bilirubin identified in isoimmunization;
evaluated for intrauterine transfusion or delivery.
f. Inborn errors of metabolism:
➢biochemical analysis of fetal cell enzymes.
g. Fetal distress:
➢passage of meconium in cephalic presentation( not
significant in breech presentation.
h. Sex-linked disorder:
➢sex chromosome determination.
7. X-ray: lateral pelvimetry
➢Indications for radiography to determine pelvic size and
shape:
➢Suspected cephalopelvic disproportion
➢History of injury/disease of the pelvis and spine
➢Previous difficult delivery
➢Cases of maternal deformity or limp.
8. Serial estriol determination
➢Measures feto-placental well being
➢Specimens: serum or 24 hour urine (most commonly used.)
Results:
Normal: gradual increase in serial estriol which is 12 to 50
mg/day at term.
Abnormal: sudden drop of less than 50% of the previous level
means fetal distress.
Persistent low levels: means fetal well being is compromised.
9. CHORIONIC VILLI SAMPLING (CVS)
➢Supplies same data as amniocentesis but can be done
earlier and quicker results can be obtain.
➢Earliest test possible on fetal cells
➢Sample obtained by slender catheter passed through
cervix to implantation site.
➢Aspiration of villi done during the 8 to 12 weeks of
pregnancy.
➢Nursing care:
➢Instruct to drink fluid so that bladder is full; after test monitor
for uterine contractions vaginal discharges, and teach to
observe for signs of infection.
The difference of Amniocentesis and chorionic villus sampling
10. PERCUTANEOUS UMBILICAL BLOOD SAMPLING (PUBS)
➢Used in 2nd and 3rd trimester.
➢Uses ultrasound to locate umbilical cord.
➢Cord blood aspirated and tested.