Chapter 6
Antepartal Tests
Roberta F. Durham, R N, P h D
Cecilia Urbina, S N, R A
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Objectives
The learner will be able to
 Identify the purpose and indication for key antenatal
tests
 Describe the procedure, interpretation, advantages,
and risks of common antenatal tests
 Articulate the nursing responsibilities related to key
antenatal tests
 Identify patient teaching needs related to antenatal
tests
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Assessment for Risk Factors
 Biophysical factors
mom or baby
 Psychosocial factors maternal behaviors or lifestyle: smoking, drugs
 Sociodemographic factors age, parity, income, ethnicity
 Environmental factors environmental exposures
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Nurse’s Role in Antepartal Tests
 Provide information regarding the test
 Provide comfort
 Reassure the woman and her partner
 Provide support to woman and her partner
 Document response and the results of tests
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*Ultrasonography
 *Procedure
Know the types and when most
commonly performed
 *Risks
 *Nursing actions
Know patient education and prep
Based on when performed and type – Transvaginal vs abdominal
For study - Be sure to answer the bullets where there are asterisks!
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Biochemical Assessments
 Chorionic Villus Sampling
 Amniocentesis
 Percutaneous blood sampling
 Maternal Assays
 Know when these are performed, purpose, how,
patient education and prep, risks and benefits
 Review the next few slides
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*Chorionic Villi Sampling (CVS)
 *Procedure
 *Interpretation
 *Advantages
‒ Why this over Amnio?
 *Risks
 *Nursing actions
‒ Include pertinent patient
education post procedure
 For study - Be sure to answer the bullets where there are asterisks!
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*Amniocentesis
 *Procedure
 *Interpretation
 *Advantages
 *Risks
 *Nursing actions
‒ Include pertinent patient
education post procedure
For study - Be sure to answer the bullets where there are asterisks!
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*Percutaneous Umbilical Blood Sampling (PUBS)
 *Procedure
 Interpretation
 *Advantages
 *Risks
 *Nursing actions
 For study - Be sure to answer the bullets where there are asterisks!
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*Alpha-fetoprotein (AFP)/α1-Fetoprotein/Maternal
Serum Alpha-Fetoprotein (MSAFP)
 *Procedure Include timing of procedure
 *Interpretation
 *Advantages
 *Risks
 *Nursing actions
 For study - Be sure to answer the bullets where there are asterisks!
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*Multiple Marker
 Triple marker - AFP, hCG, estriol levels
• Procedure
• Interpretation
• *Advantages
• Risks
• Nursing actions
• Quad Screen – All the above plus inhibin A
• (same as above)
•
Understand what the test is screening for and when this is performed
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*Tests of Fetal Status and Fetal Well Being
 *Daily Fetal Movement Count (aka Kick counts)
 *NonStress Test (NST)
‒ Vibroacoustic Stimulation (VAS)
 Contraction Stress Test (CST)
 *Amniotic Fluid Index (AFI)
 *Biophysical Profile (BPP) – know what is
scored!
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*Daily Fetal Movement Count
 *Procedure
 *Interpretation
 *Advantages
 *Risks
 *Nursing action
 For study - Be sure to answer the bullets where there are asterisks!
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*NonStress Test (NST)
 *Procedure
 *Interpretation
• correct terms for results – be specific
 *Advantages
 *Risks
 *Nursing actions
We will discuss more when we study
Fetal monitoring.
For study - Be sure to answer the bullets where there are asterisks!
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Vibroacoustic Stimulation (VAS)
 *Procedure
 *Interpretation
 *Advantages
 *Risks
 *Nursing actions
This can be done during a Nonstress test.
For study - Be sure to answer the bullets where there are asterisks!
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*Contraction Stress Test (CST)
 *Procedure
 *Interpretation
 *Advantages
 *Risks
 Nursing actions
Not commonly done anymore. Please read over but do not overexert yourself
with this
For study - Be sure to answer the bullets where there are asterisks!
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Amniotic Fluid Index (AFI)
 Procedure
 Interpretation
 Advantages
 Risks
 Nursing actions
 Know why this might be done
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Biophysical Profile (BPP)
 *Procedure
 *Interpretation
 *Advantages
 *Risks
 *Nursing actions
 *Modified BPP
*Be sure to know what is being scored! And what a good score / bad score is
For study - Be sure to answer the bullets where there are asterisks!
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Question
The multiple marker screenings identify:
A. Neural tube defects
B. Cerebral palsy
C. Hemolytic diseases
D. Cleft palate
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Answer
A. Neural tube defects
Multiple marker screenings can identify most
open neural tube defects. They also identify
Down syndrome.
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