Introduction
 http://www.youtube.com/watch?v=nja-
UB7WnHs&feature=related
ANTEPARTAL FETAL
ASSESSMENT
 Developed by
 D. Ann Currie, R.N.,M.S.N.
 2012
ANTEPARTAL FETAL ASSESSMENT
 TERMINOLOGY
 ULTRASOUND
 LABORATORY TESTS
 FETAL MOVEMENT COUNT
 BIOPHYSICAL PROFILE-(BPP)
 NONSTRESS TEST-(NST)
 CONTRACTION STRESS TEST-(CST)
ANTEPARTAL FETAL ASSESSMENT
 AMNIOTIC FLUID INDEX-(AFI)
 DOPPLER FLOW STUDIES
 PLACENTA LOCATION &GRADING
 AMNIOCENTESIS
 CHORIONIC VILLUS SAMPLING-(CVS)
 PERCUTANEOUS UMBILICAL BLOOD SAMPLING-
(PUBS)
ANTEPARTAL FETAL ASSESSMENT
 FETOSCOPY
 FETAL FIBRONECTIN
 OTHER
NURSE’S ROLE WITH ANTEPARTAL
FETAL ASSESSMENT
 KNOWLEDGE OF THE TESTS :
 INDICATIONS/USES OF TEST
 MEANING OF THE RESULTS OF THE TEST
 HOW PROCEDURE IS DONE.
 WHAT TO PREPARE PRIOR TO TEST
 WHAT TO DO DURING &AFTER TEST
NURSE’S ROLE
 RISKS/COMPLICATIONS
 WHEN TEST WILL BE PREFORMED DURING
PREGNANCY
 CLIENT EDUCATION
 CLIENT ADVOCATE
 SUPPORT CLIENT
ULTRASOUND
 WHAT IS AN ULTRASOUND? & HOW DOES IT
WORK?
 TYPES-TRANSVAGINAL & TRANSABDOMINAL
 USES
 NURSE’S ROLE WITH ULTRASOUND
ULTRASOUND
 DX TEST
 USES HIGH FREQUENCY SOUND WAVES
EXCEEDING 20,000 CYCLES PER SECOND TO
PRODUCE AN IMAGE.US USES A TRANSDUCER TO
TURN SOUND WAVES INTO AN ELECTRONICAL
SIGNAL
 SONOGRAM
Ultrasound
ULTRASOUND-INDICATIONS
AND/OR USES
 POSITIVE DX OF
 MULTIPLE
PREGNANCY
 GESTATIONAL AGE
 VIABILITY
 FETAL GROWTH
 FETAL
PRESENTATION
GESTATIONS
 BPP
 WITH
AMNIOCENTESIS,
CVS,or PUBS.
 AFI
 PLACENTA GRADING
CONT.ULTRASOUND
 DX OF ETOPIC
PREGNANCY,
HYDATIDIFORM
MOLE,FETAL
ANOMALY, UTERINE
ANOMALY,CAUSE OF
VAGINAL BLEEDING
 OTHER
NURSE’S ROLE WITH ULTRASOUND
 KNOW THE
 ASSESSMENT OF
PROCEDURE AND
PURPOSE
 CLIENT EDUCATION
 CLIENT ADVOCATE
 ANSWER
QUESTIONS AND
CONCERNS
CLIENT
 PREPARATION OF
CLIENT
 SUPPORT
LABORATORY TESTS
 ALPHA-
 FETAL FIBRONECTIN
FETOPROTEIN
 MATERNAL SERUM
ALPHAFETOPROTEIN(MSAFP)
 Quad SCREENINGMSAFP,HCG ,
diametric inhibin-A,
&ESTRIOL
 L/S RATIO
 PHOSPHATIDYL-
GLYEROL-(PG)
 AMNIOCENTSIS
SAMPLE STUDIES
 GENETIC STUDIES
FETAL MOVEMENT COUNT
 NONVASIVE
 COST-EFFECTIVE
 CAN BE USED IN FETAL SURVEILLANCE IN LOW
RISK & HIGH RISK PREGNANCIES..
 DONE BY CLIENT
 DOCUMENT BY USE OF A LOG
FETAL MOVEMENT COUNT
 SEVERAL METHODS- CARDIFF METHOD , DAILY
FETAL MOVEMENT RECORD (DFMR),or OTHER.
 NURSE’S ROLE IN DFMC.
BIOPHYSICAL PROFILE
 FETAL HEART RATE
 FETAL MOVEMENT
 FETAL BREATHING
 FETAL TONE
 AMNIOTIC FLUID INDEX/VOLUME
 PLACENTA GRADING
(BPP)
NONSTRESS
NST
 DX TEST DONE WITH EXTERNAL ELECTRIC FETAL
MONITOR
 FHR ACCELERATIONS WITH FM
 REACTIVE STRIP-REASSURING-15-20 BEAT
ACCELERATION IN FHR ABOVE BASELINE WITH
FM.FHR-110-160@BASELINE,AVE VARIBILITY.
Reactive NST
NST
 NONREACTIVE STRIP-NONREASSURING-NO
ACCELERATIONS WITH FM,ABSENT OR MINIMAL
VARIBILITY.
 CAN BE USED IN PRETERM PREGNANCIES.
 CAN BE DONE OUTPATIENT OR CLINICS.
Nonreactive NST
CONTRACTION STRESS TESTCST
 DONE WITH EXTERNAL FETAL MONITOR &
STIMULATION OF UTERUS BY VARIOUS
METHODS.
 POSITIVE TEST- NONREASSURING3 UC IN 10
MIN. PERIOD, LATE DECELERATIONS WITH UC,
NO ACCELERATIONS OF FHR WITH UC OR FM,
ABSENT OR MIN VARIABLITY
Positive CST- Nonreassuring
FHR Pattern
CST
 NEGATIVE TEST-REASSURING-NO LATE
DECELERATIONS WITH UC, FHR 110-160, AVE.
VARIABILITY,& FHR ACCELERATIONS WITH FM
AND UC.
 USUALLY DONE IN HOSPITAL.
 MAY CAUSE LABOR.
Negative CST
AMNIOCENTESIS
 INVASIVE PROCEDURE USED TO DX GENETIC
,CHROMOSOMAL , OR BIOCHEMICAL
PROBLEMS,OR LUNG MATURITY.
 DONE WITH US.
 STERILE TECHNIQUE USED.
 RISKS/SIDE EFFECYS
 NURSE’S ROLE.
Aminocentesis
CHORIONIC VILLUS SAMPLINGCVS
 INVASIVE PROCEDURE DONE WITH US.
 USED TO DX GENETIC,METABOLIC,& DNA
ABNORMALITIES
 1ST TRIMESTER
 RISKS
 NURSE’S ROLE
Chorioic Villus Sampling-CVS vs
Aminocentesis
PERCUTANEOUS UMBILICAL
BLOOD SAMPLING-PUBS
 INVASIVE PROCEDURE DONE WITH US TO
OBTAIN FETAL BLOOD.
 USED TO DX VARIOUS CONDITIONS.
 RISKS
 NURSE’S ROLE.
FETOSCOPY
 INVASIVE PROCEDURE USED TO DIRECTLY
OBSERVE FETUS AND/OR OBTAIN BLOOD OR
SKIN SAMPLES. ALSO SOME SURGERIES CAN BE
DONE /
 RISKS
 NURSE’S ROLE
OTHER
QUESTIONS
THANK YOU
 http://www.youtube.com/watch?v=UPPbnB5Gs4s&fea
ture=related