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Chapter 9: Assessment for Risk Factors

Chapter 9: Assessment for Risk Factors. Study Guide. Assessment of Fetal Well-Being. Maternal health problems Fetal and neonatal health problems Biophysical risks Psychosocial risks Sociodemographic risks Environmental risks. Assessment of Fetal Well-Being.

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Chapter 9: Assessment for Risk Factors

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  1. Chapter 9: Assessment for Risk Factors Study Guide

  2. Assessment of Fetal Well-Being • Maternal health problems • Fetal and neonatal health problems • Biophysical risks • Psychosocial risks • Sociodemographic risks • Environmental risks

  3. Assessment of Fetal Well-Being • Maternal assessment of fetal activity • Fetus spends about 10% making body movements • Sleep-wake cycle • Typical activity • 9:00pm- 1:00am • After 38 weeks: 75% sleep phase

  4. Ultrasound • Intermittent ultrasonic waves transmitted by an alternating current to a transducer • Ultrasonic waves deflect off tissues within the woman’s abdomen, showing stuctures of varying densities

  5. US: Two Most Common • Transabdominal • Transvaginal

  6. Clinical Applications • First trimester • Second trimester & third trimester

  7. Clinical Applications (con’t) • Fetal heart activity • Gestational age • Fetal growth • Fetal anatomy • Fetal disorders and anomalies • Placental position and function • Adjunct to antepartum testing

  8. Fetal well-being • Amniotic fluid volume • Doppler Flow Studies • Biophysical profile

  9. Amniocentesis • After 14th week of pregnancy • Indications • Complications • Maternal • Fetal

  10. Percutaneous Umbilical Blood Sampling (PUBS) • Percutaneous Umbilical Blood Sampling • Indications • Complications • Fetal risks • Follow-up

  11. Chorionic Villus Sampling (CVS) • CVS- small sample of chorionic villi from developing placenta • Advantages • Disadvantages

  12. Maternal Assays • Alpha-fetoprotein • Coombs test

  13. Non-stress Test • Based on the knowledge that when the fetus has adequate oxygentation and an intact CNS there are accels of the FHR with FM

  14. NST • Procedure for NST • EFM • FM is documented • Interpretation • Reactive • Non-reactive • Unsatisfactory test

  15. Vibroacoustic Stimulation Test • Handheld battery operated device applied to the woman’s abdomen over fetal head • Advantages

  16. Contraction Stress Test (CST) • Evaluates O2 and CO2 exchange via the placenta • ID’s the fetus at risk for intrauterine asphyxia by observing response of the FHR to the stress of uc’s

  17. Contraction Stress Test (CST) • Procedure

  18. Contraction Stress Test (CST) Results • Negative • Positive • Equivocal or suspicious

  19. Amniotic Fluid Analysis • Amniocentesis • Diagnostic use: • Genetic disorders • Fetal health • Fetal lung maturity • Neural tube defects • Triple screen/quadruple screen • Nursing Management

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