c
c

 ˜Y Performed for the purpose to detect genetic




c


 abnormalities
 
*



 ˜Y From the Greek term O

for O & 
 for
˜Y Begins at 18-20 weeks; peaks at 29-38 weeks



˜Y „

uask mother to lie in left ˜Y ›spiration of amniotic fluid from the pregnant
recumbent position after a meal & record number of uterus for examination
fetal movements in an hour) ˜Y an be done as early as 12th ʹ 13th week of
˜Y è

 u ount-to-Ten; records the interval it pregnancy
takes for her to feel 10 fetal movements) ˜Y equires only 1ml of fluid for analysis
   ˜Y Performed to determine genetic disorders, the sex of
˜Y 120 ʹ 160 beats per minute the fetus, & fetal lung maturity
˜Y ÿeard & counted as early as 8 ʹ 12 weeks by ˜Y -%
 !

! "#
1.Y Oaternal ÿemorrhage
˜Y ‘ „


 uassessment of the Fÿ in 2.Y nfection
terms of baseline & long & short-term variability) 3.Y h isoimmunization
˜Y |




umeasures the response of Fÿ to 4.Y ›bruptio placentae
fetal movement) 5.Y ›mniotic fluid emboli
˜Y è


„


 ufetal heart rate is analyzed 6.Y rritation of the fetus ї premature labor
in conjunction with contractions) ˜Y # &
 '  
%
 

 1.Y btain informed consent
 
$%
1.Y iiagnose pregnancy as early as 6 weeks gestation
2.Y onfirm the presence, size, & location of the
placenta & amniotic fluid
3.Y Establish that fetus is ј in size & has no gross
defects
4.Y Establish the presentation & position of the fetus
usex can be diagnosed if a penis is revealed)
5.Y Predict maturity by measurement of the biparietal
diameter
6.Y Used to discover complications of pregnancy
2.Y nstruct the client to empty the bladder before the
procedure
3.Y Place the client in supine position, draping
appropriately
4.Y Prepare the client for ultrasound, which is
performed to locate the placenta
5.Y btain baseline V/S & Fÿ , & monitor every 15
minutes
6.Y ›bdomen will be washed with antiseptic solution &
local anesthetic will be applied
7.Y Warn the client that she may feel a sensation of
˜Y ntermittent sound waves of high frequency are pressure as the needle used for aspiration, a 3- or 4-
projected toward the uterus by a transducer placed inch, 20- to 22 gauge spinal needle, is introduced
on the abdomen 8.Y io not suggest she take a deep breath & hold it as a
˜Y # &
 '  
% distraction against discomfort
1.Y The woman usually needs to have a full bladder to 9.Y 30 minutes after the procedure, assess Fÿ &
obtain a better image of the fetus uterine contractions
2.Y nstruct to drink a full glass of water before the 10.Y h-negative women may be given hoG›O for risks
procedure; instruct not to void before the procedure related to the procedure
3.Y nform the client that the test presents no known 11.Y nstruct the client that if chills, fever, leakage of fluid
risks to the client or fetus at the needle insertion site, A fetal movement, or
 
 ()
(
 uterine contractions occur, she is to notify the
˜Y ›lpha-fetoprotein is produced by the fetal liver; physician or health care provider
present in amniotic fluid and maternal serum *.
(c
/ 

˜Y ј in maternal serum ʹ open spinal or abdominal ˜Y Protein components of the lung enzyme surfactant
nd th
defect that the alveoli begin to form about the 22 ʹ 24
˜Y A - chromosomal defect weeks of pregnancy
˜Y Begins to rise at 11 weeks͛ gestation then steadily ј ˜Y ietermined quickly by shake test or sent for
until term laboratory analysis
th
˜Y Traditionally assessed at the 15 week of pregnancy ˜Y |ormal: 2:1
˜Y # &
 '  
% 
(/
*(

1.Y Explain that the level is determined by a single ˜Y ombines 4 ʹ 6 parameters: fetal breathing
maternal blood sample drawn at 15 ʹ 18 weeks͛ movements, fetal movement, fetal tone, amniotic
gestation fluid volume, fetal heart reactivity, & placental grade
2.Y f the level is elevated & the gestation is less than 18 ˜Y Each item has a potential scoring of 2, highest is a 12
nd
weeks͛ gestation, a 2 sample is drawn ˜Y Oore accurate in predicting fetal well-being than any
3.Y ›n ultrasound is performed for elevated levels to single assessment
rule out fetal abnormalities or multiple gestation ˜Y Similar to ›


at birth ї 
 ›

 (
* c ˜Y Oay be done as often as daily during high-risk
˜Y ›nalysis of 3 indicators: maternal serum for alpha- pregnancy
fetoprotein, unconjugated estriol, human chorionic ˜Y Score is 8 ʹ 12 ї fetus is doing well
gonadotropin ˜Y Score of 4 ʹ 6 ї fetus is in jeopardy
˜Y oield more reliable results ˜Y O
 

ї 2 assessments:
˜Y equires only a single venipuncture amniotic fluid index & nonstress test
*

*

(c+*
,
˜Y Biopsy & analysis of chorionic villi for chromosome
analysis
˜Y ione at 10 ʹ 12 weeks of pregnancy
˜Y è



 is the alternative