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High Risk Pregnancy Factors -ANSWERS-- + family hx of congenital abnormalities
- Genetic disorders
- Chromosomal abnormalities
- Age
- DM
- Pre-e
Amniocentesis risks before 14 wks -ANSWERS-Club foot
Amniocentesis risks 15-16 wks -ANSWERS-Respiratory distress
Nursing Care for Amniocentesis -ANSWERS-- Empty bladder
- Baseline monitoring VS
- EFM post procedure
- Give rhogam if Rh-
- Obs for bleeding, leaking, bruising
- D/C teaching (no heavy lifting)
Normal AFI -ANSWERS-5-25 cm
What is total AFI volume at 36 wks -ANSWERS-800-1000 and will slowly start to
decrease as pregnancy decreases
,AFI -ANSWERS-Measure of pockets of fluid in all 4 uterine quadrants
Amniotic fluid = -ANSWERS-Fetal pee
What creates ferning? -ANSWERS-Sodium in amniotic fluid
L/S ration -ANSWERS-- Types of surfactant
- Lecithin/Sphingomyelin
- S remains the same throughout pregnancy
- L rises with lung maturity
<1:5 L/S Ration -ANSWERS-Fetal lungs are immature
>2:1 L/S Ration -ANSWERS-Fetal lungs are mature
What L/S ratio is needed for lung maturity in moms with DM? -ANSWERS-3:1
What is present if lungs are mature? -ANSWERS-Phosphatidyglycerol (PG)
Kick Count -ANSWERS-Same time daily, lie on a side, parameter is 10 movement
within 2 hrs (can stop at 45 mins if 10 movements). If <10 movement, need further
testing.
Most common C/O adverse neonatal outcomes -ANSWERS-DFM
Determines GA within 1 wk in 1st trimester -ANSWERS-Crown rump
What is looked at in 2nd trimester US? -ANSWERS-Biparietal diameter
, What causes lagging abd circumfrence? -ANSWERS-Shunting of blood away from abd
and is the first growth rate decline of the fetus
Amniocentesis -ANSWERS-Analysis of amniotic fluid for cultures, genetic studies, CNS
anomalies, ventral wall defects, lung maturity
When is an amniocentesis normally performed? -ANSWERS-14-20 wks
How much fluid can be removed on amniocentesis before 14 wks? -ANSWERS-1 mL
per gestational wk
What is L/S ratio used for? -ANSWERS-Determines fetal lung maturity in 3rd trimester
Risks of Amniocentesis -ANSWERS-- Fetal death
- Club foot
- Infection
- ROM
- Bleeding
- PTD
Reasons for False + L/S Ratio -ANSWERS-- DM
- Meconium
- Erythroblastosis fetalis
- Placental/fetal disorders
- RBCs in fluid
Chorionic Villus Sampling (CVS) -ANSWERS-Placental villi obtained 10-13 wks via
catheter into uterus for DNA and chromosome analysis
What can CVS not diagnose? -ANSWERS-NTD/Spina bifida