ANTEPARTAL FETAL ASSESSMENT

 Developed by
 D. Ann Currie, R.N.,M.S.N.

ANTEPARTAL FETAL ASSESSMENT
 TERMINOLOGY
 ULTRASOUND  LABORATORY TESTS  FETAL MOVEMENT COUNT  BIOPHYSICAL PROFILE-(BPP)  NONSTRESS TEST-(NST)  CONTRACTION STRESS TEST-(CST)

ANTEPARTAL FETAL ASSESSMENT  AMNIOTIC FLUID INDEX-(AFI)  DOPPLER FLOW STUDIES  PLACENTA LOCATION &GRADING  AMNIOCENTESIS  CHORIONIC VILLUS SAMPLING-(CVS)  PERCUTANEOUS UMBILICAL BLOOD SAMPLING- (PUBS) .

ANTEPARTAL FETAL ASSESSMENT  FETOSCOPY  FETAL FIBRONECTIN  OTHER .

 WHAT TO PREPARE PRIOR TO TEST  WHAT TO DO DURING &AFTER TEST .NURSE’S ROLE WITH ANTEPARTAL FETAL ASSESSMENT  KNOWLEDGE OF THE TESTS :  INDICATIONS/USES OF TEST  MEANING OF THE RESULTS OF THE TEST  HOW PROCEDURE IS DONE.

NURSE’S ROLE  RISKS/COMPLICATIONS  WHEN TEST WILL BE PREFORMED DURING PREGNANCY  CLIENT EDUCATION  CLIENT ADVOCATE  SUPPORT CLIENT .

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ULTRASOUND  WHAT IS AN ULTRASOUND? & HOW DOES IT WORK?  TYPES-TRANSVAGINAL & TRANSABDOMINAL  USES  NURSE’S ROLE WITH ULTRASOUND .

US USES A TRANSDUCER TO TURN SOUND WAVES INTO AN ELECTRONICAL SIGNAL  SONOGRAM .ULTRASOUND  DX TEST  USES HIGH FREQUENCY SOUND WAVES EXCEEDING 20.000 CYCLES PER SECOND TO PRODUCE AN IMAGE.

Ultrasound .

ULTRASOUND-INDICATIONS AND/OR USES  POSITIVE DX OF  MULTIPLE PREGNANCY  GESTATIONAL AGE  VIABILITY  FETAL GROWTH  FETAL PRESENTATION GESTATIONS  BPP  WITH AMNIOCENTESIS. CVS.  AFI  PLACENTA GRADING .or PUBS.

CAUSE OF VAGINAL BLEEDING . HYDATIDIFORM MOLE.CONT.FETAL ANOMALY. UTERINE ANOMALY.ULTRASOUND  DX OF ETOPIC  OTHER PREGNANCY.

NURSE’S ROLE WITH ULTRASOUND  KNOW THE  ASSESSMENT OF PROCEDURE AND PURPOSE  CLIENT EDUCATION  CLIENT ADVOCATE  ANSWER QUESTIONS AND CONCERNS CLIENT  PREPARATION OF CLIENT  SUPPORT .

LABORATORY TESTS  ALPHA FETAL FIBRONECTIN  L/S RATIO  PHOSPHATIDYL- FETOPROTEIN  MATERNAL SERUM ALPHAFETOPROTEIN(MSAFP)  TRIPLE SCREENINGMSAFP. &ESTRIOL GLYEROL-(PG)  AMNIOCENTSIS SAMPLE STUDIES  GENETIC STUDIES .HCG .

.FETAL MOVEMENT COUNT  NONVASIVE  COST-EFFECTIVE  CAN BE USED IN FETAL SURVEILLANCE IN LOW RISK & HIGH RISK PREGNANCIES.  DONE BY CLIENT  DOCUMENT BY USE OF A LOG .

or OTHER.CARDIFF METHOD .  NURSE’S ROLE IN DFMC.FETAL MOVEMENT COUNT  SEVERAL METHODS. . DAILY FETAL MOVEMENT RECORD (DFMR).

BIOPHYSICAL PROFILE  FETAL HEART RATE  FETAL MOVEMENT  FETAL BREATHING  FETAL TONE  AMNIOTIC FLUID INDEX/VOLUME  PLACENTA GRADING (BPP) .

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NONSTRESS NST  DX TEST DONE WITH EXTERNAL ELECTRIC FETAL MONITOR  FHR ACCELERATIONS WITH FM  REACTIVE STRIP-REASSURING-15-20 BEAT ACCELERATION IN FHR ABOVE BASELINE WITH FM. .FHR-110-160@BASELINE.AVE VARIBILITY.

Reactive NST .

ABSENT OR MINIMAL VARIBILITY. .NST  NONREACTIVE STRIP-NONREASSURING-NO ACCELERATIONS WITH FM.  CAN BE USED IN PRETERM PREGNANCIES.  CAN BE DONE OUTPATIENT OR CLINICS.

Nonreactive NST .

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NONREASSURING3 UC IN 10 MIN.CONTRACTION STRESS TESTCST  DONE WITH EXTERNAL FETAL MONITOR & STIMULATION OF UTERUS BY VARIOUS METHODS. ABSENT OR MIN VARIABLITY . NO ACCELERATIONS OF FHR WITH UC OR FM. PERIOD.  POSITIVE TEST. LATE DECELERATIONS WITH UC.

Positive CST.Nonreassuring FHR Pattern .

VARIABILITY.& FHR ACCELERATIONS WITH FM AND UC. .CST  NEGATIVE TEST-REASSURING-NO LATE DECELERATIONS WITH UC. FHR 110-160.  USUALLY DONE IN HOSPITAL.  MAY CAUSE LABOR. AVE.

Negative CST .

OR LUNG MATURITY. OR BIOCHEMICAL PROBLEMS.  STERILE TECHNIQUE USED.  RISKS/SIDE EFFECYS  NURSE’S ROLE. .AMNIOCENTESIS  INVASIVE PROCEDURE USED TO DX GENETIC .  DONE WITH US.CHROMOSOMAL .

Aminocentesis .

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METABOLIC.& DNA ABNORMALITIES  1ST TRIMESTER  RISKS  NURSE’S ROLE .  USED TO DX GENETIC.CHORIONIC VILLUS SAMPLINGCVS  INVASIVE PROCEDURE DONE WITH US.

Chorioic Villus Sampling-CVS vs Aminocentesis .

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 USED TO DX VARIOUS CONDITIONS.PERCUTANEOUS UMBILICAL BLOOD SAMPLING-PUBS  INVASIVE PROCEDURE DONE WITH US TO OBTAIN FETAL BLOOD.  RISKS  NURSE’S ROLE. .

FETOSCOPY  INVASIVE PROCEDURE USED TO DIRECTLY OBSERVE FETUS AND/OR OBTAIN BLOOD OR SKIN SAMPLES. ALSO SOME SURGERIES CAN BE DONE /  RISKS  NURSE’S ROLE .

OTHER .

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