Chapter 6
Know what the tests are for, when they are performed, what information they provide,
advantage/risks,and what nursing actions are required.
Diagnostic vs. Screening Tests
oScreening: identify those who are NOT affected by a disease or abnormality.
Assess risk but cant tell if the baby has it.
Include:
Amniotic fluid index (AFI)
Biophysical profile(BPP)
Contraction stress test(CST)
Daily fetal movement count
Multiple marker screening: alpha-fetoprotein screening, triple
marker, and quad marker
Nonstress test (NST)
Ultrasonography
Nuchal translucency
Umbilical artery Doppler flow
Vibroacoustic stimulation
oDiagnostic: YES or NO answers to whether a fetus is normal or abnormal,
indicated by family history. High risk pregnancies ?
Include:
Amniocentesis
Chorionic villi sampling
Magnetic resonance imaging (MRI)
Percutaneous umbilical blood sampling
Ultrasonography
Genetic Tests
Ultrasound : technique of choice by Pt. only performed for valid reason. Abdominally(full
bladder)/Transvaginal(1st trimester). Accurate for gestational age, fetal growth, fetal &
placenta abnormalities.
oFirst trimester:
Confirm pregnancy/heartbeat
Detect the number of fetuses
Assess for amnionicity and chorionicity of multiples
Estimate gestational age
Evaluate uterine structures
Detect missed abortion, tubal, ectopic, or molar pregnancy
Evaluate vaginal bleeding
Nuchal translucency screening
Visualization during CVS
oSecond Trimester:
Confirm GA and due date
Confirm fetal cardiac activity
Confirm fetal number, position, size, amnionicity, and chorionicity
, Confirm placental location
Estimate fetal weight and GA
Detect fetal anomalies
Evaluate uterine and cervical structures
Evaluate vaginal bleeding
Visualize for diagnostic tests and cephalic version
oThird Trimester:
Confirm GA
Confirm viability
Detect fetal number, position, congenital anomalies, fetal growth, and
IUGR
Detect placental position, abruption, previa, or maturity
Evaluate fetal condition, assess BPP and AFI, perform doppler flow studies
Assess fetal growth
Evaluate uterine and cervical structures
Evaluate vaginal bleeding
Visualize diagnostic tests and cephalic version
oOther:
Standard:
“fetal presentation and number, amniotic fluid volume, cardiac
activity, placental position, fetal biometry (gestational age
measurements), and fetal anatomic survey.
Limited :
Performed any trimester indicated when question requires
investigation.
Specialized:
AKA detailed or targeted
Indicated when there is an increased of anomaly based on history,
laboratory abnormalities.
MRI : Radio evaluation of tissue & organs. Common for complex fetal abnormalities.
Brain abnormalities. No dye. No risks. Radiologist interprets. Involved in pre&post
procedure.
Doppler Flow Studies: to assess placenta perfusion 40% ventricular output.
oInterpretation:
Abnormal if systolic to diastolic ration is >95% or if there is no end
diastolic flow or reversed diastolic flow
Conducted during fetal apnea
Other:
Degree of fetal anemia; measure systolic velocity of middle
cerebral artery aka MCA
Chorionic Villus Sampling aka Biochemical assessment. Aspiration of placental tissue for
chromosomal, metabolic or DNA testing.
Know what the tests are for, when they are performed, what information they provide,
advantage/risks,and what nursing actions are required.
Diagnostic vs. Screening Tests
oScreening: identify those who are NOT affected by a disease or abnormality.
Assess risk but cant tell if the baby has it.
Include:
Amniotic fluid index (AFI)
Biophysical profile(BPP)
Contraction stress test(CST)
Daily fetal movement count
Multiple marker screening: alpha-fetoprotein screening, triple
marker, and quad marker
Nonstress test (NST)
Ultrasonography
Nuchal translucency
Umbilical artery Doppler flow
Vibroacoustic stimulation
oDiagnostic: YES or NO answers to whether a fetus is normal or abnormal,
indicated by family history. High risk pregnancies ?
Include:
Amniocentesis
Chorionic villi sampling
Magnetic resonance imaging (MRI)
Percutaneous umbilical blood sampling
Ultrasonography
Genetic Tests
Ultrasound : technique of choice by Pt. only performed for valid reason. Abdominally(full
bladder)/Transvaginal(1st trimester). Accurate for gestational age, fetal growth, fetal &
placenta abnormalities.
oFirst trimester:
Confirm pregnancy/heartbeat
Detect the number of fetuses
Assess for amnionicity and chorionicity of multiples
Estimate gestational age
Evaluate uterine structures
Detect missed abortion, tubal, ectopic, or molar pregnancy
Evaluate vaginal bleeding
Nuchal translucency screening
Visualization during CVS
oSecond Trimester:
Confirm GA and due date
Confirm fetal cardiac activity
Confirm fetal number, position, size, amnionicity, and chorionicity
, Confirm placental location
Estimate fetal weight and GA
Detect fetal anomalies
Evaluate uterine and cervical structures
Evaluate vaginal bleeding
Visualize for diagnostic tests and cephalic version
oThird Trimester:
Confirm GA
Confirm viability
Detect fetal number, position, congenital anomalies, fetal growth, and
IUGR
Detect placental position, abruption, previa, or maturity
Evaluate fetal condition, assess BPP and AFI, perform doppler flow studies
Assess fetal growth
Evaluate uterine and cervical structures
Evaluate vaginal bleeding
Visualize diagnostic tests and cephalic version
oOther:
Standard:
“fetal presentation and number, amniotic fluid volume, cardiac
activity, placental position, fetal biometry (gestational age
measurements), and fetal anatomic survey.
Limited :
Performed any trimester indicated when question requires
investigation.
Specialized:
AKA detailed or targeted
Indicated when there is an increased of anomaly based on history,
laboratory abnormalities.
MRI : Radio evaluation of tissue & organs. Common for complex fetal abnormalities.
Brain abnormalities. No dye. No risks. Radiologist interprets. Involved in pre&post
procedure.
Doppler Flow Studies: to assess placenta perfusion 40% ventricular output.
oInterpretation:
Abnormal if systolic to diastolic ration is >95% or if there is no end
diastolic flow or reversed diastolic flow
Conducted during fetal apnea
Other:
Degree of fetal anemia; measure systolic velocity of middle
cerebral artery aka MCA
Chorionic Villus Sampling aka Biochemical assessment. Aspiration of placental tissue for
chromosomal, metabolic or DNA testing.
