MATERNAL & CHILD NURSING NOTES REVIEWER
By: AGON, ARC
TABLE OF CONTENTS o post-term pregnancy
• REPRODUCTIVE & SEXUAL HEALTH o pregnancy induced hypertension
1. Assessment of Fetal Well-Being o gestational diabetes
o intrauterine growth retardation
• SOURCE: Pilliteri 6th Edition – Maternal and o maternal complaints of decreased fetal
Child Nursing movement
- PROCEDURE:
LESSON XII: ASSESSMENT OF FETAL WELL- o The mother is instructed to push a
BEING marker button when she feels the
- Indications for assessing fetal maturity fetus move.
o The marker button indicates
includes:
movement as it occurred in
o determining the appropriate time for
relationship to the fetal heart rate.
inducing labor
▪ With sufficient placental
o avoiding prematurity guarding the
functioning, the fetus should
high-risk mother.
demonstrate an acceleration in
- Evaluation of fetal maturity and well-being is
heart rate with movement, in
essential in the management of the high-risk
the same way that the adult
pregnancy.
experiences increased heart
rate with exercises.
A. AMNIOCENTESIS
▪ A lack of fetal heart rate
- is withdrawal of amniotic fluid by insertion of
acceleration indicates the need
a needle through the abdominal and uterine
for further testing.
walls.
▪ Patients identified as NST
- procedure is possible after the 14th week of
candidates will generally be
pregnancy when the uterus becomes an
required to: complete an NST
abdominal organ and when there is sufficient
on a regular basis (that is,
fluid for the procedure.
weekly, bi-weekly).
- Information obtained by amniocentesis:
o Color of fluid. METHODS OF CONTRACT PRODUCTION
o Detects fetal chromosomal anomalies A. OXYTOCIN CHALLENGE TEST
such as Down's Syndrome. - A dilute of I.V. solution of oxytocin
o Helps to evaluate the probability of administered to the mother until a contraction
sex-linked genetic disorders. pattern is developed.
o Indicates fetal maturity, in-born - When sufficient information is obtained to
errors, or metabolism, (indicates evaluate the test, the medication is turned off.
disorders like Phenylketonuria - The Oxytocin challenge test evaluates the
(PKU). ability of the placenta to:
- Risks of the procedure (complications are o supply fetal needs in a stressed
less than 1percent): environment.
o the mother o Contractions, such as those of labor,
o Hemorrhage are a stress on the pregnancy.
o Infection - The OCT involves application of the fetal
o Labor monitor to record fetal heart rate and
o Inadvertent damage to the intestines contraction activity.
or bladder - Acceptable results include:
B. NON-STRESS TEST o acceleration of fetal heart rate or no
- evaluates the ability of the placenta to supply change in fetal heart rate baseline
fetal needs in a normal (or unstressed) daily during a contraction.
uterine environment. - Unacceptable results:
- The non-stress test (NST) involves application ▪ deceleration of fetal heart rate
of the fetal monitor to record the fetal heart during a contraction.