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What is CVS and what does it do? (4)
Chronic villus sampling
- 1. removal of tissue specimen from fetal portion of placenta
- 2.tissue reflects genetic makeup of fetus
- 3.can do chromosomal testing
- 4. guided by ultrasound
When is the CVS performed?
Between 10-12 weeks, allows enough time for abortion.
What are the complications of CVS? (4)
- 1. vaginal spotting/bleeding immediately afterward
- 2. miscarriage
- 3. rupture of membranes
- 4. chorioamnionitis
- 5. If Rh- should have rhogam
What is PUBS?
percutaneous umbilical blood sampling
it is guided by ultrasound, provides direct access to fetal circulation by withdrawing blood
What is the procedure of PUBS? (4)
1. needle is inserted into fetal umbilical vessel (vein), usually punctured near its insertion into the placenta.
2. a small amount of blood is removed & tested immediately by the APT test to ensure its fetal origin
3. getting chromosomal bilirubin & hematocrit
4. if performed before 10 weeks may have limb defects
What does the follow up include in the PUBS?
continous FHR monitoring for several minutes to 1 hour, a repeated ultrasound exam 1 hour after to ensure that no further bleeding or hematoma has occured.
What is ABO incompatibility?
- Mothers blood is different than the baby, mothers antibodies attack baby RBC and breaks them down causing bilirubin. When the RBC's are destroyed anemia happens.
- Milder effects than RH incompatibility
Explain RH incompatibility.
If the mother is RH- and baby RH+, mother will need to be given rhogam by 72 hours.
Usually given at 28 weeks as preventive.
What happens if Rhogam is not administered?
causes severe anemia & ascites which are fetal hydrops fetalis
What is an indirect coombs test
its a maternal blood test for antibody sensitization.
What is a direct coombs test?
Tests newborn blood for antibodies.
If coombs is +: already has antibodies and can't reverse