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

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. WHAT TO PREPARE PRIOR TO TEST WHAT TO DO DURING &AFTER TEST

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

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

ULTRASOUND DX TEST USES HIGH FREQUENCY SOUND WAVES EXCEEDING 20,000 CYCLES PER SECOND TO PRODUCE AN IMAGE.US USES A TRANSDUCER TO TURN SOUND WAVES INTO AN ELECTRONICAL SIGNAL SONOGRAM

Ultrasound

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

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

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

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

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

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

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

NONSTRESS NST DX TEST DONE WITH EXTERNAL ELECTRIC FETAL MONITOR FHR ACCELERATIONS WITH FM REACTIVE STRIP-REASSURING BEAT ACCELERATION IN FHR ABOVE BASELINE WITH VARIBILITY.

Reactive NST

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

Nonreactive NST

CONTRACTION STRESS TEST- CST DONE WITH EXTERNAL FETAL MONITOR & STIMULATION OF UTERUS BY VARIOUS METHODS. POSITIVE TEST- NONREASSURING- 3 UC IN 10 MIN. PERIOD, LATE DECELERATIONS WITH UC, NO ACCELERATIONS OF FHR WITH UC OR FM, ABSENT OR MIN VARIABLITY

Positive CST- Nonreassuring FHR Pattern

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

Negative CST

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

Aminocentesis

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

Chorioic Villus Sampling-CVS vs Aminocentesis

PERCUTANEOUS UMBILICAL BLOOD SAMPLING-PUBS INVASIVE PROCEDURE DONE WITH US TO OBTAIN FETAL BLOOD. USED TO DX VARIOUS CONDITIONS. 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