ANTEPARTAL FETAL ASSESSMENT

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

ANTEPARTAL FETAL ASSESSMENTTERMINOLOGYULTRASOUNDLABORATORY TESTSFETAL MOVEMENT COUNTBIOPHYSICAL PROFILE-(BPP)NONSTRESS TEST-(NST)CONTRACTION STRESS TEST-(CST)

ANTEPARTAL FETAL ASSESSMENTAMNIOTIC FLUID INDEX-(AFI)DOPPLER FLOW STUDIESPLACENTA LOCATION &GRADINGAMNIOCENTESISCHORIONIC VILLUS SAMPLING-(CVS)PERCUTANEOUS UMBILICAL BLOOD

SAMPLING-(PUBS)

ANTEPARTAL FETAL ASSESSMENTFETOSCOPYFETAL FIBRONECTINOTHER

NURSE’S ROLE WITH ANTEPARTAL FETAL ASSESSMENT

KNOWLEDGE OF THE TESTS :INDICATIONS/USES OF TESTMEANING OF THE RESULTS OF THE TESTHOW PROCEDURE IS DONE.WHAT TO PREPARE PRIOR TO TESTWHAT TO DO DURING &AFTER TEST

NURSE’S ROLERISKS/COMPLICATIONSWHEN TEST WILL BE PREFORMED

DURING PREGNANCYCLIENT EDUCATIONCLIENT ADVOCATESUPPORT CLIENT

ULTRASOUNDWHAT IS AN ULTRASOUND? & HOW DOES

IT WORK?TYPES-TRANSVAGINAL &

TRANSABDOMINALUSESNURSE’S ROLE WITH ULTRASOUND

ULTRASOUND

DX TESTUSES 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

VIABILITYFETAL GROWTHFETAL

PRESENTATION

MULTIPLE GESTATIONS

BPPWITH

AMNIOCENTESIS, CVS,or PUBS.

AFIPLACENTA

GRADING

CONT.ULTRASOUNDDX OF ETOPIC

PREGNANCY, HYDATIDIFORM MOLE,FETAL ANOMALY, UTERINE ANOMALY,CAUSE OF VAGINAL BLEEDING

OTHER

NURSE’S ROLE WITH ULTRASOUNDKNOW THE

PROCEDURE AND PURPOSE

CLIENT EDUCATION

CLIENT ADVOCATE

ANSWER QUESTIONS AND CONCERNS

ASSESSMENT OF CLIENT

PREPARATION OF CLIENT

SUPPORT

LABORATORY TESTSALPHA-

FETOPROTEINMATERNAL

SERUM ALPHA- FETOPROTEIN-(MSAFP)

TRIPLE SCREENING-MSAFP,HCG , &ESTRIOL

FETAL FIBRONECTIN

L/S RATIOPHOSPHATIDYL-

GLYEROL-(PG)AMNIOCENTSIS

SAMPLE STUDIESGENETIC

STUDIES

FETAL MOVEMENT COUNTNONVASIVECOST-EFFECTIVECAN BE USED IN FETAL SURVEILLANCE IN

LOW RISK & HIGH RISK PREGNANCIES..DONE BY CLIENTDOCUMENT BY USE OF A LOG

FETAL MOVEMENT COUNTSEVERAL METHODS- CARDIFF METHOD ,

DAILY FETAL MOVEMENT RECORD (DFMR),or OTHER.

NURSE’S ROLE IN DFMC.

BIOPHYSICAL PROFILE (BPP)FETAL HEART RATEFETAL MOVEMENTFETAL BREATHINGFETAL TONEAMNIOTIC FLUID INDEX/VOLUMEPLACENTA GRADING

NONSTRESS NSTDX TEST DONE WITH EXTERNAL ELECTRIC

FETAL MONITORFHR ACCELERATIONS WITH FMREACTIVE STRIP-REASSURING-15-20 BEAT

ACCELERATION IN FHR ABOVE BASELINE WITH FM.FHR-110-160@BASELINE,AVE VARIBILITY.

Reactive NST

NSTNONREACTIVE 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-CSTDONE 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

CSTNEGATIVE TEST-REASSURING-NO LATE

DECELERATIONS WITH UC, FHR 110-160, AVE. VARIABILITY,& FHR ACCELERATIONS WITH FM AND UC.

USUALLY DONE IN HOSPITAL.MAY CAUSE LABOR.

Negative CST

AMNIOCENTESISINVASIVE PROCEDURE USED TO DX

GENETIC ,CHROMOSOMAL , OR BIOCHEMICAL PROBLEMS,OR LUNG MATURITY.

DONE WITH US.STERILE TECHNIQUE USED.RISKS/SIDE EFFECYSNURSE’S ROLE.

Aminocentesis

CHORIONIC VILLUS SAMPLING-CVS

INVASIVE PROCEDURE DONE WITH US.USED TO DX GENETIC,METABOLIC,& DNA

ABNORMALITIES1ST TRIMESTERRISKSNURSE’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.RISKSNURSE’S ROLE.

FETOSCOPYINVASIVE PROCEDURE USED TO DIRECTLY

OBSERVE FETUS AND/OR OBTAIN BLOOD OR SKIN SAMPLES. ALSO SOME SURGERIES CAN BE DONE /

RISKSNURSE’S ROLE

OTHER