4500 MIDTERM -- WEEK 3 QUESTIONS & ANSWERS(GRADED A+)

4500 MIDTERM -- WEEK 3 QUESTIONS
& ANSWERS(GRADED A+)
assessments for high risk pregnancies

fetal movement counting - ANSWERfocus on movements in reclined position

count 6 (should be within 2 hrs)

if less--could be a sign of decreased PLACENTAL FUNCTIONING; further
assessment/eval is required like NST

assessments for high risk pregnancies

electronic fetal monitoring -- NON STRESS TEST (NST)

-procedure
-normal and no risk factors?
-normal and risk factors?
-atypical/abnormal? - ANSWER-empty bladder
-seated or semi-fowlers with slight left tilt
-at least 20 mins

-normal and no risk factors?
--daily fetal movement counting

-normal and risk factors?
--US for either BPP or amniotic fluid vol assessment within 24hrs AND continue daily
fetal movement counts

-atypical/abnormal?
--further testing (such as BPP, amniotic fluid volume, via US)

assessments for high risk pregnancies

Biophysical Profile (BPP)

what does it assess? - ANSWERthe presence of normal BPP indicates that CNS is
functional

fetal breathing movements, fetal movements, fetal tone, amniotic fluid index


**BPP is closest thing we have to doing a physical assessment of the fetus in utero;
done using US...out of 8 if no NST, 10 if there is a NST**

Amniotic Fluid INdex: normal range

,definition of polyhydramnios and oligohydramnios - ANSWERAFI normal = 10-25cm

polyhydramnios = EXCESSIVE AF

olygohydramnios = LESS THAN EXPECTED AF

Polyhydramnios:
-AFI of what?
-US single deepest pocket?
-associated with what? - ANSWERAFI > 25cm
US single depeest pocket >8cm

what about other risk factors? - ANSWERwomen >40 in first pregnancy are at
highest risk of developing a hypertensive disorder in pregnancy

others: women w/ GDM,
first pregnancy,
first pregnancy with new partner,
previous Hx of gestational HTN/pre-eclampsia
Hx of DM, chronic HTN, CKD


associated with NTD, getal GI obstructions, multiple fetuses, linked to DM

*uterus is usually measuring LARGE for dates

maternal complications r/t increased uterine pressure (pressure on lungs, etc.)
*need close fetal/maternal monitoring

Oligohydramnios:
-AFI of what?
-US single deepest pocket?
-causes/associated with what?
-main problem for which fetal organ system?
-uterus r/t dates
-rule out ______ - ANSWERAFI < 5cm
US single deepest pocket < 2cm

causes: uretoplacental insufficiency
--congenital GI anomolies, IUGR, ROM

major problem for FETAL LUNG DEVELOPMENT
also--less of a cushion so cord can get compressed

uterus will measure SMALL for dates

rule out ROM

umbilical artery doppler

, concerns?
can be seen on what?
sometimes what is recommended immediately? - ANSWER*placental insufficiency,
IGUR*

concerns: reduced, absent, or reversed umbilical artery end-diastolic flow

could be seen on BPP

sometimes delivery is recommended immediately...can give steroids to PP to help w/
lung development

complicated pregnancy -- hypertensive disorders of pregnancy

who is at highest risk?
Hypertensive Disorders of Pregnancy
--increasingly common, affecting ____% of pregnancies
--leading cause of what? - ANSWER5-10%

• HTN is the leading cause of maternal and perinatal morbidity and mortality
worldwide.
• Mortality is primarily from hepatic rupture, placental abruption, and eclampsia.

HTN in pregnancy
--parameters
--procedure - ANSWERSystolic BP > (or equal to) 140mmHg and/or diastolic BP >
(or equal to) 90mmHg

at least 2 measurements, sitting position, proper sized cuff, taken at least 15mins
apart

using same arm -- arm w/ higher value should be used

severe HTN definition - ANSWERsystolic BP > (or equal to) 160mmHg
or
diastolic BP > (or equal to) 110mmHg

based on at least 2 measurements, taken at least 15mins apart

pre-existing hypertension:
HTN pre-pregnancy or diagnosis before _____________.

is the pregnancy usually complicated?

increased risk for what? - ANSWERbefore 20 weeks gestation

no, pregnancy is usually uncomplicated

increased risk of poor fetal growth, fetal stillbirth