1. Introduction http://www.youtube.com/watch?v=nja- UB7WnHs&feature=related http://www.youtube.com/watch?v=nja- UB7WnHs&feature=related

2. ANTEPARTAL FETAL ASSESSMENT Developed by D. Ann Currie, R.N.,M.S.N. 2012

4. ANTEPARTAL FETAL ASSESSMENT TERMINOLOGY ULTRASOUND LABORATORY TESTS FETAL MOVEMENT COUNT BIOPHYSICAL PROFILE-(BPP) NONSTRESS TEST-(NST) CONTRACTION STRESS TEST-(CST)

5. ANTEPARTAL FETAL ASSESSMENT AMNIOTIC FLUID INDEX-(AFI) DOPPLER FLOW STUDIES PLACENTA LOCATION &GRADING AMNIOCENTESIS CHORIONIC VILLUS SAMPLING-(CVS) PERCUTANEOUS UMBILICAL BLOOD SAMPLING- (PUBS)

6. ANTEPARTAL FETAL ASSESSMENT FETOSCOPY FETAL FIBRONECTIN OTHER

7. 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

8. NURSE’S ROLE RISKS/COMPLICATIONS WHEN TEST WILL BE PREFORMED DURING PREGNANCY CLIENT EDUCATION CLIENT ADVOCATE SUPPORT CLIENT

11. ULTRASOUND WHAT IS AN ULTRASOUND? & HOW DOES IT WORK? TYPES-TRANSVAGINAL & TRANSABDOMINAL USES NURSE’S ROLE WITH ULTRASOUND

12. 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

13. Ultrasound

14. ULTRASOUND-INDICATIONS AND/OR USES POSITIVE DX OF PREGNANCY GESTATIONAL AGE VIABILITY FETAL GROWTH FETAL PRESENTATION MULTIPLE GESTATIONS BPP WITH AMNIOCENTESIS, CVS,or PUBS. AFI PLACENTA GRADING

15. CONT.ULTRASOUND DX OF ETOPIC PREGNANCY, HYDATIDIFORM MOLE,FETAL ANOMALY, UTERINE ANOMALY,CAUSE OF VAGINAL BLEEDING OTHER

16. NURSE’S ROLE WITH ULTRASOUND KNOW THE PROCEDURE AND PURPOSE CLIENT EDUCATION CLIENT ADVOCATE ANSWER QUESTIONS AND CONCERNS ASSESSMENT OF CLIENT PREPARATION OF CLIENT SUPPORT

17. LABORATORY TESTS ALPHA- FETOPROTEIN MATERNAL SERUM ALPHA- FETOPROTEIN- (MSAFP) Quad SCREENING- MSAFP,HCG, diametric inhibin-A, &ESTRIOL FETAL FIBRONECTIN L/S RATIO PHOSPHATIDYL- GLYEROL-(PG) AMNIOCENTSIS SAMPLE STUDIES GENETIC STUDIES

18. 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

19. FETAL MOVEMENT COUNT SEVERAL METHODS- CARDIFF METHOD, DAILY FETAL MOVEMENT RECORD (DFMR),or OTHER. NURSE’S ROLE IN DFMC.

20. BIOPHYSICAL PROFILE (BPP) FETAL HEART RATE FETAL MOVEMENT FETAL BREATHING FETAL TONE AMNIOTIC FLUID INDEX/VOLUME PLACENTA GRADING

22. 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.

23. Reactive NST

24. NST NONREACTIVE STRIP-NONREASSURING-NO ACCELERATIONS WITH FM,ABSENT OR MINIMAL VARIBILITY. CAN BE USED IN PRETERM PREGNANCIES. CAN BE DONE OUTPATIENT OR CLINICS.

25. Nonreactive NST

27. CONTRACTION STRESS TEST- CST DONE WITH EXTERNAL FETAL MONITOR & STIMULATION OF UTERUS BY VARIOUS METHODS. POSITIVE TEST- NONREASSURING- 3 UC IN 10 MIN. PERIOD, LATE DECELERATIONS WITH UC, NO ACCELERATIONS OF FHR WITH UC OR FM, ABSENT OR MIN VARIABLITY

28. Positive CST- Nonreassuring FHR Pattern

29. 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.

30. Negative CST

31. 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.

32. Aminocentesis

34. CHORIONIC VILLUS SAMPLING- CVS INVASIVE PROCEDURE DONE WITH US. USED TO DX GENETIC,METABOLIC,& DNA ABNORMALITIES 1ST TRIMESTER RISKS NURSE’S ROLE

35. Chorioic Villus Sampling-CVS vs Aminocentesis

37. PERCUTANEOUS UMBILICAL BLOOD SAMPLING-PUBS INVASIVE PROCEDURE DONE WITH US TO OBTAIN FETAL BLOOD. USED TO DX VARIOUS CONDITIONS. RISKS NURSE’S ROLE.

38. 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

39. OTHER

40. QUESTIONS

41. THANK YOU http://www.youtube.com/watch?v=UPPbnB5Gs4s&fea ture=related http://www.youtube.com/watch?v=UPPbnB5Gs4s&fea ture=related