Ultrasound and Fetal Monitoring Techniques

Ultrasound in Obstetrics

• Ultrasound was introduced in the 1950s to visualize and assess fetal well-being.
• Ultrasound can assess fetal cardiac activity, anatomical development, and confirmation of chromosomal abnormalities.
• Calculation of gestational age is not typically assessed via ultrasound.

Non-Stress Test

• A non-stress test is a non-invasive method for monitoring fetal well-being using external monitors.
• A non-stress test is used for various conditions including maternal diabetes, preterm labor, and post-date pregnancies.
• A non-stress test would not typically be used for intrauterine growth restriction (IUGR).

Biophysical Profile (BPP)

• This fetal well-being assessment uses ultrasound to evaluate five components: fetal breathing, movement, tone, amniotic fluid volume, and non-stress test results.

Nuchal Translucency

• Nuchal translucency is an early screening tool for chromosomal abnormalities like Trisomy 21, 18, and 13.
• The test is typically performed between 11 and 14 weeks of pregnancy.

Doppler Flow Studies

• Doppler flow studies measure blood flow velocity via ultrasound.
• This assessment is used in high-risk pregnancies with potential complications from hypertension or restrictions in fetal growth.

Chorionic Villus Sampling

• Chorionic villus sampling is used to confirm abnormal chromosomal conditions.
• A sample from the placenta is collected via trans-abdominal or trans-vaginal methods.

Marker Screening Tests

• Marker screening tests are performed to screen for chromosomal disorders and spina bifida.
• These tests often involve analyzing maternal serum.

Dystocia

• Dystocia is when labor deviates from expected progression.
• Contributing factors to dystocia include the passenger, the passageway, and the psyche.
• Pain itself is not a contributing factor to dystocia.

Uterine Rupture

• Uterine rupture involves the muscle fibers splitting open and amniotic fluid and blood enter the abdominal cavity.
• This emergency often leads to a fetal response characterized by bradycardia.

Amniotic Fluid Embolism

• Amniotic fluid embolism is an obstetrical emergency with poor maternal outcomes.
• Several pre-disposing risk factors can contribute to this condition, including uterine overdistension and uterine trauma.
• In cases of amniotic fluid embolism, an intact amniotic membrane is not typically a pre-disposing factor.

Cord Prolapse

• Cord prolapse is an obstetric emergency requiring immediate intervention.
• Elevation of the presenting fetal part (e.g., suprapubic pressure) is usually necessary.
• Single gestation is not considered a risk factor for cord prolapse.

Shoulder Dystocia

• Shoulder dystocia is an emergency that often requires nursing management using the McRoberts maneuver.
• It usually happens after the fetal head has been delivered.
• Assessment of vaginal bleeding and vaginal lacerations is critical in assessing a woman post-shoulder dystocia.

HIV Transmission

• Antiviral therapy administered after delivery is effective in reducing the risk of fetal HIV transmission.
• In HIV positive mothers, performing a vaginal delivery is not the recommended practice to reduce fetal transmission (unless breastfeeding is a risk)

Priority Assessments

• A priority nursing assessment for a mother who has just experienced shoulder dystocia during vaginal delivery is vaginal bleeding.
• Assessing the uterine status (e.g., uterine rupture) is similarly crucial.

Explore the essential techniques in obstetrical ultrasound and fetal monitoring. This quiz covers ultrasound, non-stress tests, biophysical profiles, and nuchal translucency assessments. Test your knowledge on their purposes and applications in ensuring fetal well-being.