ANTEPARTAL FETAL ASSESSMENT - PowerPoint PPT Presentation

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ANTEPARTAL FETAL ASSESSMENT
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ANTEPARTAL FETAL ASSESSMENT

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  1. ANTEPARTAL FETAL ASSESSMENT Developed by D. Ann Currie, R.N.,M.S.N.

  2. ANTEPARTAL FETAL ASSESSMENT • TERMINOLOGY • ULTRASOUND • LABORATORY TESTS • FETAL MOVEMENT COUNT • BIOPHYSICAL PROFILE-(BPP) • NONSTRESS TEST-(NST) • CONTRACTION STRESS TEST-(CST)

  3. ANTEPARTAL FETAL ASSESSMENT • AMNIOTIC FLUID INDEX-(AFI) • DOPPLER FLOW STUDIES • PLACENTA LOCATION &GRADING • AMNIOCENTESIS • CHORIONIC VILLUS SAMPLING-(CVS) • PERCUTANEOUS UMBILICAL BLOOD SAMPLING-(PUBS)

  4. ANTEPARTAL FETAL ASSESSMENT • FETOSCOPY • FETAL FIBRONECTIN • OTHER

  5. 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

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

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

  8. 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

  9. Ultrasound

  10. 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

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

  12. 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

  13. 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

  14. 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

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

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

  17. NONSTRESS NST • DX TEST DONE WITH EXTERNAL ELECTRIC FETAL MONITOR • FHR ACCELERATIONS WITH FM • REACTIVE STRIP-REASSURING-15-20 BEAT ACCELERATION IN FHR ABOVE BASELINE WITH FM.FHR-110-160@BASELINE,AVE VARIBILITY.

  18. Reactive NST

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

  20. Nonreactive NST

  21. 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

  22. Positive CST- Nonreassuring FHR Pattern

  23. CST • NEGATIVE 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.

  24. Negative CST

  25. 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.

  26. Aminocentesis

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

  28. Chorioic Villus Sampling-CVS vs Aminocentesis

  29. PERCUTANEOUS UMBILICAL BLOOD SAMPLING-PUBS • INVASIVE PROCEDURE DONE WITH US TO OBTAIN FETAL BLOOD. • USED TO DX VARIOUS CONDITIONS. • RISKS • NURSE’S ROLE.

  30. 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

  31. OTHER