WGU D447
Women's & Children's Health
EXAM STUDY GUIDE
Take and pass the OA :)
, ANTEPARTUM FOCUS TOPICS
- Alpha-fetoprotein testing - Hypertensive Disorders
o Chronic hypertension
- Maternal Blood Type (need for RhoGAM?) o Gestational hypertension
o Preeclampsia
- HIV (if positive ‒ what treatment would be used in o Eclampsia
pregnancy, labor, postpartum? Vaginal delivery or o Medications (ex. labetalol, magnesium sulfate)
cesarean section and why? Care for baby after
delivery (bath, meds?) - Spontaneous Abortions
- Diet/Nutrition in Pregnancy - Fetal Well-Being Testing
- Chorionic villus sampling
- Amniocentesis
- Calculating GPTAL
- Nonstress testing
- Biophysical testing
- Gestational Diabetes (labs, diagnosis, meds)
- Kick Counts
- Contraction stress test
, OB: Antepartum
Alpha-fetoprotein (AFP) Testing
o Maternal blood test that evaluates AFP levels and are used as a Risks w/ AFP testing:
screening tool (NOT diagnostic tool) to detect neural tube
§ High false-positive results can occur with:
defects (NTDs) in pregnancy
§ Oligohydramnios
o Recommended for all pregnant women, regardless of age or other
§ Multifetal gestation
risk factors
§ Decreased maternal weight
o AFP is produced in the fetal GI tract and liver
§ Underestimated fetal gestational age
o Detectable as soon as 7 weeks of gestation ; Screening done § False low levels can occur as a result of:
between 15 - 20 weeks
§ Fetal death
o If levels are elevated after 15 weeks ‒ indicates open neural tube
§ Increased maternal weight
defect (spina bifida, anencephaly, or an abdominal wall defect
§ Overestimated fetal gestational age
such as omphalocele) or other genetic defects relating to the CNS
o Elevated results are from increased leakage of CSF or abdominal • Spina bifida is a CNS defect that results from
failure of the neural tube to close
fluid into the amniotic fluid thru the closure defect Risk for infection before the closure of the sac,
Spina bifida •
which is done soon after birth.
o Low levels are associated with Down syndrome (trisomy 21) means • A sterile normal saline dressing is placed over
the sac to maintain moisture of the sac and its
“split spine” contents.
o Abnormal findings require further testing for diagnosis • This prevents tearing or breakdown of
the skin integrity at the site.
o (i.e. amniocentesis, CVS, or ultrasonography)
, OB: Antepartum
Maternal vs. Fetal Blood Type
The most common blood group
o ABO typing is performed to determined the womenʼs blood type incompatibility in baby is
between a mom with O blood
o Rh positive ( + ) à presence of antigen and baby with A or B blood
o Rh negative ( - ) à absence of antigen NEGATIVE? NEED RHOGAM TO PREVENT RH ISOIMMUNIZATION
o RhoGAM prevents the mothers immune system from creating antibodies against babyʼs Rh + blood
o Given intramuscular (IM) route at 28 weeks gestation and then within 72 hours after delivery if baby is Rh +
o NOT effective if mom is already sensitized à important to give with each pregnancy to prevent this
o ↑Increased risk for fetal blood being transferred to the maternal circulation during placental separation
o Baby usually not affected in first pregnancy ~ antibodies form completely after baby is born
o For a subsequent pregnancy (2nd baby), mom is now sensitized and previously formed antibodies will attack fetal
erythrocytes (if baby is Rh POSITIVE again) thru passive immunity, causing hemolysis in baby à Fetal risk: anemia,
hepatosplenomegaly, heart failure, jaundice
o A maternal antibody titer (indirect Coombs test) should be drawn at the 1st prenatal visit
o A positive indirect Coombs test indicates antibodies against Rh+ RBCs are present in the maternal blood
Women's & Children's Health
EXAM STUDY GUIDE
Take and pass the OA :)
, ANTEPARTUM FOCUS TOPICS
- Alpha-fetoprotein testing - Hypertensive Disorders
o Chronic hypertension
- Maternal Blood Type (need for RhoGAM?) o Gestational hypertension
o Preeclampsia
- HIV (if positive ‒ what treatment would be used in o Eclampsia
pregnancy, labor, postpartum? Vaginal delivery or o Medications (ex. labetalol, magnesium sulfate)
cesarean section and why? Care for baby after
delivery (bath, meds?) - Spontaneous Abortions
- Diet/Nutrition in Pregnancy - Fetal Well-Being Testing
- Chorionic villus sampling
- Amniocentesis
- Calculating GPTAL
- Nonstress testing
- Biophysical testing
- Gestational Diabetes (labs, diagnosis, meds)
- Kick Counts
- Contraction stress test
, OB: Antepartum
Alpha-fetoprotein (AFP) Testing
o Maternal blood test that evaluates AFP levels and are used as a Risks w/ AFP testing:
screening tool (NOT diagnostic tool) to detect neural tube
§ High false-positive results can occur with:
defects (NTDs) in pregnancy
§ Oligohydramnios
o Recommended for all pregnant women, regardless of age or other
§ Multifetal gestation
risk factors
§ Decreased maternal weight
o AFP is produced in the fetal GI tract and liver
§ Underestimated fetal gestational age
o Detectable as soon as 7 weeks of gestation ; Screening done § False low levels can occur as a result of:
between 15 - 20 weeks
§ Fetal death
o If levels are elevated after 15 weeks ‒ indicates open neural tube
§ Increased maternal weight
defect (spina bifida, anencephaly, or an abdominal wall defect
§ Overestimated fetal gestational age
such as omphalocele) or other genetic defects relating to the CNS
o Elevated results are from increased leakage of CSF or abdominal • Spina bifida is a CNS defect that results from
failure of the neural tube to close
fluid into the amniotic fluid thru the closure defect Risk for infection before the closure of the sac,
Spina bifida •
which is done soon after birth.
o Low levels are associated with Down syndrome (trisomy 21) means • A sterile normal saline dressing is placed over
the sac to maintain moisture of the sac and its
“split spine” contents.
o Abnormal findings require further testing for diagnosis • This prevents tearing or breakdown of
the skin integrity at the site.
o (i.e. amniocentesis, CVS, or ultrasonography)
, OB: Antepartum
Maternal vs. Fetal Blood Type
The most common blood group
o ABO typing is performed to determined the womenʼs blood type incompatibility in baby is
between a mom with O blood
o Rh positive ( + ) à presence of antigen and baby with A or B blood
o Rh negative ( - ) à absence of antigen NEGATIVE? NEED RHOGAM TO PREVENT RH ISOIMMUNIZATION
o RhoGAM prevents the mothers immune system from creating antibodies against babyʼs Rh + blood
o Given intramuscular (IM) route at 28 weeks gestation and then within 72 hours after delivery if baby is Rh +
o NOT effective if mom is already sensitized à important to give with each pregnancy to prevent this
o ↑Increased risk for fetal blood being transferred to the maternal circulation during placental separation
o Baby usually not affected in first pregnancy ~ antibodies form completely after baby is born
o For a subsequent pregnancy (2nd baby), mom is now sensitized and previously formed antibodies will attack fetal
erythrocytes (if baby is Rh POSITIVE again) thru passive immunity, causing hemolysis in baby à Fetal risk: anemia,
hepatosplenomegaly, heart failure, jaundice
o A maternal antibody titer (indirect Coombs test) should be drawn at the 1st prenatal visit
o A positive indirect Coombs test indicates antibodies against Rh+ RBCs are present in the maternal blood
