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Screening test for neural tube defects
aFP at 16-18 weeks
What is AFP?
a glycoprotein synthesized early in gestation by the fetal yolk sac and later by fetal GI tract and liver, it is also the major serum protein in the embryo-fetus
When do fetal serum and amniotic AFP levels max out?
when do maternal AFP levels peak?
What is the Sn of the AFP screening test?
90% for aencephaly, 80% for spina bifida
What are the two signs of neural tube defect on ultrasound?
lemon sign, banana sign
What are the components of the quad screen?
dimeric inhibin alpha
what do you do after an abnl quad screen?
cnofirm gestational age by sonography
offer amniocentesis or fetal blood sampling for fetal karyotyping
What is 1T screening?
HCG and PAPP-A with sonographic nuchal translucency
What is the proper dx test fora fetus whose parents are both CF carriers?
if both parents are carriers, the fetus can be tested using chorionic villus sampling or amniocentesis to determine whether it inherited either or both parental mutations
When is amniocentesis generally performed?
What procedure is most commonly used to dx fetal aneuploidy and other genetic disorders?
When is a bx of the chorionic villi generally performed?
What are relative CI to CVS?
vaginal bleeding or spotting
active genital tract infection
exterme uterine ante- or retroflexion
body habitus precluding easy uterine access or clear sonographic visualization of its contents
When can a mother start feeling baby movements?
16-80 weeks multigravida
When do HCG levels nadir?
When can a sonogram detect a gestational sac?
4-5 weeks menstrual age
When can heart motion be seen?
When should a CBC be done?
When should blood type and Rh factor be performed?
When should an Ab screen be performed?
28 weeks if inidicated
When should a GTT be performed?
When is 1T aneuploidy screening offered?
between 11-14 weeks
When should neural-tube defect screening occur?
When should CF screening be offered?
Initial, or 15-20
When should a UA and culture be done?
When do you do GBS creening?
between 35 and 37 weeks
What is the interval schedule for visits?
q4 weeks until 28 weeks
q2 weeks until 36 weeks