Screenings for Fetal Problems
1st TRIMESTER (Chorionic villis sampling, US scan)
2nd TRIMESTER (AFP screening or Quad Screening,Amniocentesis)
3rd TRIMESTER (kick counts,Nonstress Test,Biophysical Profile, Percutaneous Umbilical Blood sampling, Contraction Stress Test )
Ultrasound screening -can be vaginal or Abdominal (in latter make Her drink water to fill bladder)
-Confirms viability
-Indicates fetal presentation
-Confirms multiple gestation
-Identifies placental location
-Measurements can be taken to confirm/estimate gestational age
-Identify morphologic anomalies
Chorionic villis sampling
8-12 weeks
for early diagnosis of genetic, metabolic problems
Amniocentesis -13-14 weeks
Is done under US scan to obtain a sample of amniotic fluid for direct analysis of fetal chromosomes, development, viability and lung maturity
AFP
15-18 weeks-Maternal Blood Drawn
AFP also called =Quad marker screening:
-maternal serum alpha fetoprotein (MSAFP),
-human chorionic gonadotropin (HcG),
-unconjugated estriol (UE),
-and inhibin A
low AFP-Down syndrome
high-Spina bifida
it is not an absolute test if it is abnormal -further investigation is recommended
Kick counts (tests Uretro placental capability)
Same time every day mother records how often she feels the fetus move
if mininum 3 movements are not noted within an hour's time, the mother is encouraged to call her physician immediately!
Nonstress Test
checks FHR and mother detects Fetal movements.
Contraction Stress Test -tests perfusion between Placenta and Uterus (basically O2 and CO2 exchange)
-IV accessed and performed in a labor and deliver unit under electronic fetal monitoring
contractions initiated by Pitocin or nipple stimulation
the desired result is a "negative" test which consists of three contractions of moderate intensity in a 10 minute period without evidence of late decelerations
the test is done to detect problems so if it is Positive (persistent late decelerations
) then-CS
how is done:
The electronic fetal monitor is placed on the maternal abdomen for 20-30 minutes
Each time the fetus moves, FHR should accelerate 15 beats/min above the baseline for 15 seconds
A reactive (good) test =>2 accelerations in FHR occur with associated fetal movement
Biophysical Profile (BPP)
identification of a compromised fetus and consists of 5 components:
-fetal breathing movement
-fetal movement of the body or limbs
-fetal tone (extension or flexion of the limbs)
-amniotic fluid volume index (AFI) visualized as of fluid around the fetus
-reactive non-stress test
each component 0-2, 8-10-desirable.
Percutaneous Umbilical Blood sampling -like amniocentesis but cord punctured
-chromosomal anomalies, feta karyotyping, and blood disorders
Evrywhere where woman's abdomen is punctured informed consent is needed, and risks like amnionitis spontaneous abortion, preterm labor/delivery, and premature rupture of membranes must be explained. If she Rh--she may be RHoGAM given.
Everybody have a nice weekend! be more confident and less anxious, and me too) :paw:
