Amniocentesis | LAPATHA, SJ
C. Diagnostic Tests
AMNIOCENTESIS
Aspiration of amniotic fluid at 14 – 16
weeks AOG
- 15ml of fluid is withdrawn guided by UTZ
(Ultrasounds)
Review:
- Amniotic Fluids such as Fetal structures,
umbilical cord, amniotic pillar.
- Amniotic Fluid is formed by amniotic villi
that is being ingested by the child then it
comes to produce urine that’s why it’s in
cycle that the child might drink his own
urine.
- Polyhydramnios is when you have too
much amniotic fluid that is more than
2000mL . Amniotic fluid is the fluid that
surrounds your baby while they're in your
body before birth.
- Renal agenesis is the name given to a
condition that is present at birth that is an
absence of one or both kidneys.
- Also, cause by Olygohydramnios is when
you have too little amniotic fluid or less than
300 mL.
-
Complications:
a. Miscarriage – an any form of Abortion or
the mother by herself. Abortion is refers to
the availability of pregnancy before the age
viability, (GTPAL) so less than 26 weeks
you are inevitable abortion
b. Infection – when there is a complication of
amniocentesis because there is an
invasion of the skin activity into the
amniotic sac
c. Preterm Labor - caused by dehydration,
urinary
tract
infection
(UTI),
chorioamnionitis (fetus and amniotic fluid
are infected by bacteria).
REMINDERS:
- Advise woman to avoid DBE (deep
breathing exercise) Because of the
possible accidental puncture into the child
that is too much moving.
- Place woman supine with towel at the
- right buttocks
Review:
Supine hypotensive syndrome – or inferior vena
cava compression syndrome. Caused when the
gravid uterus compresses the IVC in a supine
position, leading to decreased venous return
centrally.
(if OB condition during MCN, always answer left
side lying, except in quarterlocks that is
Trendelenburg position )
FINDINGS:
I.
AFP – Alpha-fetoprotein
- Developing’s fetus’s liver and yolk sac.
- If there are opening of the child’s body, so
the AFP will go out into the amniotic fluid.
Then,if high, possible multiple pregnancy,
Neural tube defects (a condition where the
mother is deficient of folic acid)
or
MULTIFETAL;
if low, DOWN SYNDROME.
- Needed 400 mg of folic acid in pregnancy.
- If less than 400mg FA, Neural Tube
Defects.
Kinds of NTDs:
1. absence of brain or Anencephaly,
2. smaller brain/head or Microcephaly,
3. Spina bifida
4 types: occulta non-fusion of the
spinal vertebra
Meningocele – least severe,
vertebra do not close, opening the
back, that allows the meninges,
CSF to sac out through opening.
Myelomeningocele – severe,
vertebra don’t close completely,
spinal cord is protective by
meninges
4. Encephalocele an opening of the skull, so
the brain will go out into the cranial defects.
II.
Chromosomal Analysis
- Determine any chromosomal abbreviations
- Defects:
- If C7, 65 roses or Cystic Fibrosis
- If C10, Hirschsprung’s Disease
- If C21, Trisomy 21, Down Syndrome
- If C22, Tetralogy of Fallon
III.
COLOR
- Normal water color to slight yellow
- Strong yellow – RH incompatibility (Mother
is (-), fetus(+) – erythroblastosis fetalis)
- Green – meconium staining
- Black meconium – fetus is died
IV.
Lecithin Sphingomyelin Ratio
2:1 (the child is mature lungs),
- if DM or diabetes, ratio is 3:1
V.
Bilirubin Determination
Amniocentesis | LAPATHA, SJ
2. BIOPYSICAL PROFILE
Purpose: Determine is child is survivable while in the womb.
Each component is 2 points , if perfect is 10 points
COMPONENT
DEFINITION
Fetal movements
3 body or limb movements
Fetal tone
One episode of active extension and flexion of the
limbs: opening and closing of hand
Fetal breathing movement
Episode of >= 30 seconds in 30 minutes.
Hiccups are considered breathing anxiety
Amniotic fluid volume
Single 2 cm x 2cm pocket is considered adequate
Non-stress test
2 accelerations > 15 beats per minute of at least 15
seconds duration.
Review:
anthropometric measurement of the baby
Head
Circumference
=
more
than
hydrocephalus, less than is microcephaly.
Anencephaly – No cerebral defects
Neural Tube defects – deficiency of folic acid.
VI.
I.
V.
PROFILE
OF
AN
AVERAGE
NEWBORN
A. Head Circumference = 34 – 35 cm,
Middle of the forehead
B. Chest Circumference = 32 – 33 cm
Nipple line and surrounds it
D .Abdominal Circumference = 30 – 31 cm
Above abdomen
C. Length = 43 – 53 cm
Oxyput to feet
Weight = 2.5 – 3.5 kg
is
VITAL SIGNS
TEMPERATURE
37.2 degrees celcius or 99 degrees
Farenheit
- Through Rectum Temp
NURSE ROLE
- In the first day of life – take temperature q4
hours.
- Thereafter, the temperature is taken OD
(once a day) unless, the temperature is
elevated.
II.
PULSE
- 120 – 140 bpm
- Slightly irregular immature regulatory
system at the medulla oblongata.
III.
RESPIRATION
- 30 – 60 CPM (Cycle per minute)
- PERIODIC RESPIRATIONS are normal
(periods of apnea for less than 15 seconds
– with NO CYANOSIS)
- >15s id Pathologic apnea, <15 is
Physiologic apnea.
Amniocentesis | LAPATHA, SJ
IV.
BLOOD PRESSURE
- Somewhat inaccurate – not routinely
assessed
Important!
A depressed respiratory effort might be
anticipated in a new born whose mother
received large amounts of analgesia or a
general anesthetic during labor or birth.
VII.
MATERNAL – INFANT BONDING
1. Uninterrupted Skin to Skin Contact for 90
minutes
2. Breastfeeding
Checklist
Anatomy Male – Female
Mens 1
Mens 2
Growing Fetus 1
2
3
Appearance of Newborn 1
2
Immediate Newborn Care 1
Immediate Newborn Care 2
Done: Profile of a Newborn
Extrauterine Tansition
Growth and Development
Hypertonc &Hypotonic
Intrapartum Complication
HMOLE
Preterm Labor & Incompetent Cervix
Danger signs of labor
Stages of Labor
!V. GTPAL
V.
Diagnosis of Pregnancy
Fetal Circu & Milestone
Fetal Movement & FHT
PIH
RH INCOM
EDC & AOG
Leopolds
Hydrocephalus
Cardiac 1
2
2
Gastro 1
2
Postpartum Bladder
Postpartum Breast
Postpartum Homan
Muscolo
Sickle Anemia
Tetralogy of Fallot