NU 122 - Unit Four Exam With
Complete Solution
Which tests can detect chromosomal abnormalities? - ANSWER
Alpha-fetoprotein (AFP) screening, multiple-marker creeping, Chorionic villus
sampling (CVS), and amniocentesis
Purpose of prenatal testing - ANSWER Detect congenital anomalies, to
evaluate the condition of the fetus for high risk pregnancies, and to allow
appropriate intervention and baseline information such as accurate
gestational age.
Maternal medical conditions that indicate need for fetal diagnostic
procedures - ANSWER Preexisting diabetes mellitus or gestational diabetes,
hypertension (chronic or preeclampsia), acute or non acute infections, STDs,
severe anemia, parents carry or express a genetic disorder
Maternal demographic factors that indicate need for fetal diagnostic
procedures - ANSWER Maternal age is less than 16 or greater than 35,
poverty, non-white, inadequate prenatal care
Obstetric factors that indicate need for fetal diagnostic procedures -
ANSWER History of low birth weight, history of preterm labor, multifetal
pregnancy, malpresentation, previous fetal loss, previous birth of infant with
congenital anomaly, previous infant LGA, hydramnios, oligohydramnios,
decrease or absence of fetal movements, uncertainty about gestational age,
suspected intrauterine growth restriction, discordant fetal growth of twins,
postmaturity, preterm labor, grand multiparty
,Concurrent maternal factors indicating need for fetal diagnostic procedures -
ANSWER Prepregnancy BMI less than 18.5 kg, prepregnancy BMI 25kg+,
inadequate weight gain or poor pattern of weight gain, excessive weight
gain, use of drugs, alcohol, or tobacco
How is gestational age measured via ultrasound during the first trimester? -
ANSWER Measuring the crown-rump length of the embryo
How is gestational age measured via ultrasound during the second trimester?
- ANSWER Measuring the biparietal diameter, femur length, and abdominal
circumference
What is the purpose of a transvaginal ultrasound? - ANSWER Determine
multifetal pregnancy, bicornate uterus, presence and location of pregnancy,
and presence of ovarian cysts
AFP assessment is performed on maternal serum or amniotic fluid to identify
- ANSWER Open body wall defects or chromosomal anomalies
What are the three other markers that are often assessed with AFP? -
ANSWER Human chorionic gonadotropin, estriol, inhibin A
If abnormalities are noted through the maternal serum AFP (MSAFP), what
does this mean? - ANSWER Identifies the woman as being a candidate for
further, more invasive testing
What is the purpose of Chorionic Villus Sampling (CVS)? - ANSWER Provides
information about numbers chromosomal defects or metabolic abnormalities
What is the benefit of using Chorionic Villus Sampling (CVS) vs.
Amniocentesis? - ANSWER CVS can be performed at early as 10 weeks of
gestation
, Indications for second trimester amniocentesis - ANSWER Maternal age 35+
years
Chromosomal abnormality in close family member
Sex determination for maternal carrier of X-linked disorder
Birth of previous infant with chromosomal abnormalities, neural tube defect,
or body wall defect
Pregnancy after multiple spontaneous abortions
Elevated levels of maternal serum AFP that remain unexplained
Maternal Rh sensitization
What is the purpose of an amniocentesis performed beyond the second
trimester? - ANSWER Determine fetal lung maturity, so that doctors can
prepare better if the think the mom needs to deliver early
What is the purpose of Percutaneous Umbilical Blood Sampling? - ANSWER
To detect blood disorders, acid-base imbalance, infection, or fetal genetic
disease (Karyotyping)
What does Percutaneous Umbilical Blood Sampling involve? - ANSWER The
aspiration of fetal blood from the umbilical cord near the placenta for
prenatal diagnosis or therapy
What is a reactive NST? - ANSWER 2 FHR accelerations of 15 beats or more
from baseline lasting for at least 15 seconds in a 20 minute time frame (this
is a reassuring sign)
What position should a woman be in for an Antepartum Fetal Surveillance? -
ANSWER A reclined position that she finds comfortable
Complete Solution
Which tests can detect chromosomal abnormalities? - ANSWER
Alpha-fetoprotein (AFP) screening, multiple-marker creeping, Chorionic villus
sampling (CVS), and amniocentesis
Purpose of prenatal testing - ANSWER Detect congenital anomalies, to
evaluate the condition of the fetus for high risk pregnancies, and to allow
appropriate intervention and baseline information such as accurate
gestational age.
Maternal medical conditions that indicate need for fetal diagnostic
procedures - ANSWER Preexisting diabetes mellitus or gestational diabetes,
hypertension (chronic or preeclampsia), acute or non acute infections, STDs,
severe anemia, parents carry or express a genetic disorder
Maternal demographic factors that indicate need for fetal diagnostic
procedures - ANSWER Maternal age is less than 16 or greater than 35,
poverty, non-white, inadequate prenatal care
Obstetric factors that indicate need for fetal diagnostic procedures -
ANSWER History of low birth weight, history of preterm labor, multifetal
pregnancy, malpresentation, previous fetal loss, previous birth of infant with
congenital anomaly, previous infant LGA, hydramnios, oligohydramnios,
decrease or absence of fetal movements, uncertainty about gestational age,
suspected intrauterine growth restriction, discordant fetal growth of twins,
postmaturity, preterm labor, grand multiparty
,Concurrent maternal factors indicating need for fetal diagnostic procedures -
ANSWER Prepregnancy BMI less than 18.5 kg, prepregnancy BMI 25kg+,
inadequate weight gain or poor pattern of weight gain, excessive weight
gain, use of drugs, alcohol, or tobacco
How is gestational age measured via ultrasound during the first trimester? -
ANSWER Measuring the crown-rump length of the embryo
How is gestational age measured via ultrasound during the second trimester?
- ANSWER Measuring the biparietal diameter, femur length, and abdominal
circumference
What is the purpose of a transvaginal ultrasound? - ANSWER Determine
multifetal pregnancy, bicornate uterus, presence and location of pregnancy,
and presence of ovarian cysts
AFP assessment is performed on maternal serum or amniotic fluid to identify
- ANSWER Open body wall defects or chromosomal anomalies
What are the three other markers that are often assessed with AFP? -
ANSWER Human chorionic gonadotropin, estriol, inhibin A
If abnormalities are noted through the maternal serum AFP (MSAFP), what
does this mean? - ANSWER Identifies the woman as being a candidate for
further, more invasive testing
What is the purpose of Chorionic Villus Sampling (CVS)? - ANSWER Provides
information about numbers chromosomal defects or metabolic abnormalities
What is the benefit of using Chorionic Villus Sampling (CVS) vs.
Amniocentesis? - ANSWER CVS can be performed at early as 10 weeks of
gestation
, Indications for second trimester amniocentesis - ANSWER Maternal age 35+
years
Chromosomal abnormality in close family member
Sex determination for maternal carrier of X-linked disorder
Birth of previous infant with chromosomal abnormalities, neural tube defect,
or body wall defect
Pregnancy after multiple spontaneous abortions
Elevated levels of maternal serum AFP that remain unexplained
Maternal Rh sensitization
What is the purpose of an amniocentesis performed beyond the second
trimester? - ANSWER Determine fetal lung maturity, so that doctors can
prepare better if the think the mom needs to deliver early
What is the purpose of Percutaneous Umbilical Blood Sampling? - ANSWER
To detect blood disorders, acid-base imbalance, infection, or fetal genetic
disease (Karyotyping)
What does Percutaneous Umbilical Blood Sampling involve? - ANSWER The
aspiration of fetal blood from the umbilical cord near the placenta for
prenatal diagnosis or therapy
What is a reactive NST? - ANSWER 2 FHR accelerations of 15 beats or more
from baseline lasting for at least 15 seconds in a 20 minute time frame (this
is a reassuring sign)
What position should a woman be in for an Antepartum Fetal Surveillance? -
ANSWER A reclined position that she finds comfortable
