Risk Factors in Pregnancy
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What is Polyhydramnios?
Too much amniotic fluid.
What causes Polyhydramnios?
- 1. Diabetes mellitus
- 2. Fetal congenital anomalies
What is IUGR?
Intrauterine Growth Restriction
What will keep a baby from growing? (IUGR) maternal causes:
- HTN disorders
- chronic renal disease
- poor weight gain
- smoking, ETOH, illicit drug use
- cyanotic heart disease
- multiple gestation
What will keep a baby from growing?
- chromosomal abnormalities
- congenital malformations
- intrauterine infection
- genetic syndromes (trisomy 13 & 18)
- abnormal placental development
What is Oligohydramnios?
Too little amniotic fluid
What causes Oligohydramnios?
- renal agenesis (Potter syndrome)
- premature rupure of membranes
- prolonged prgnancy
- uteroplacental insufficiency
- maternal HTN disorders
What risk factors are associated with chromosomal abnormality?
Maternal age of >35
What is DFMC? What is it used for?
- Daily Fetal Movement Count
- used to monitor fetus in pregnancies complicated by conditions tha mya affect oxygenation.
- Also called kick counts. Fewer than 3 kick in 1 hour warrants further evaluation.
Why do we do ultrasounds?
- fetal heart activity
- gestational age
- fetal growth (measure head, abdomen)
- fetal anatomy
- fetal genetic disorders & physical anomalies
- placental position and function
- adjunct to other invasive tests
What is a Doppler blood flow analysis?
Ultra sound looking at blood flow flow through umbilical cord to make sure getting O2's needed.
What is a Biophysical profile (BPP)?
Looks at amniotic fluid volume and making sure baby is getting enough O2's
What does the score on a Biophysical profile (BPP) mean?
If score is >6 then baby is OK, if <6 then worrisome that baby is not getting enough O2's. If <20 weeks gestation, there is nothing that can really be done.
What is PUBS used for?
Percutaneous umbilical blood sampling
To see if hemolytic anemia and check the Rh factor. (baby's cell's attacking mom's)
What is PUBS?
- Percutaneous Umbilical Blood Sampling
- 1. Direct access to fetal circulation during 2nd & 3rd trimesters.
- 2.Used for fetal blood sampling and transfusion
- 3.Insertion of needle directly into fetal umbilical vessel under US guidance
What are the risks of PUBS?
(Percutaneous umbilical blood sampling)
- ruptured membranes
1. What is CVS?
2. Why do it?
- 1. Chorionic villus sampling
- 2. Instead of an amniocentesis,
- technique for genetic studies
1.What are risks for CVS (Chorionic villus sampling)?
2. How is it done?
- 1. Miscarriage is the risk
- 2. transvaginally with small catheter to placenta, removal of small tissue specimen from fetal portion of placenta. Performed 10 & 12 weeks of gestation.
1.What is MSAFP?
2.When is it done?
- Maternal Serum Alpha-Fetoprotein
- 1. Used as screening tool for neural tube defects (NTDs) in pregnancy (spinal bifida)
- 2. Recommended for all pregnant women
What does Coomb's test determine?
- Test for Rh incompatibility.
- Detects other antibodies that may place fetus at risk for incompatibility with maternal antigens.
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