Prenatal Tests and Procedures: Pregnancy Care PDF

Importance of each of these laboratory 3. Blood typing (abo and rh typing): Examinations: RH factor and blood grouping: blood typing determines the abo blood group (a, 1. Ur...

Importance of each of these laboratory 3. Blood typing (abo and rh typing): Examinations: RH factor and blood grouping: blood typing determines the abo blood group (a, 1. Urinalysis: b, ab, or o) and the RH factor(positive or detection of protein and glucose: negative). RH incompatibility between the urinalysis helps detect the presence of mother and fetus can lead to abnormal levels of protein or glucose in complications, so it's crucial to identify the urine.elevated levels may indicate and manage rh-negative pregnancies conditions such as preeclampsia or appropriately. gestational diabetes. identification of blood group antibodies: screening for infections: urinalysis can blood typing helps identify antibodies that identify urinary tract infections (utis) that could potentially cause issues during may pose a risk during pregnancy. pregnancy, such as hemolytic disease of Untreated utis can lead to complications, the newborn. including preterm labor. monitoring kidney function: abnormalities in urine components may indicate kidney Importance of these tests in pregnancy: dysfunction, and regular urinalysis helps 1. Early detection of complications: monitor kidney function during pregnancy > these laboratory tests allow for the early detection of conditions such as anemia, 2. Complete blood count (cbc): infections, and preeclampsia, enabling timely intervention and management Hemoglobin and hematocrit levels: cbc assesses the levels of hemoglobin and 2. Risk assessment and management: hematocrit, providing information about > results from these tests contribute to risk the mother's oxygen-carrying capacity. assessment, allowing healthcare providers to Low levels may indicate anemia,a tailor renatal care plans based on individual common condition during pregnancy. needs and potential risks. white blood cell count: cbc helps identify infections or jnflammation. 3. Prevention of complications Elevated white blood cell counts may > monitoring urine and blood parameters helps signal an underlying infection that needs prevent and manage complications that could attention. adversely affect the health of both the mother platelet count: platelets are essential for and the developing fetus blood clotting. Abnormalities may be 4. Optimization of treatment plans: indicative of bleeding disorders. > results guide healthcare providers in optimizing treatment plans, such as adjusting iron supplementation for anemia or providing appropriate interventions for infections 5. Rh sensitization prevention: 5. Dental treatments and safety: > blood typing helps prevent rh sensitization by > dental treatments, including cleanings, fillings, identifying rh-negative pregnancies that require and root canals, are generally safe during rh immunoglobulin (rhig) to prevent the pregnancy. However, it's essential for healthcare development of rh antibodies providers to be aware of the pregnancy status to tailor treatments accordingly and ensure the 6. Overall health monitoring safety of both the mother and the baby. 6. Oral health education: Several reasons highlighting the importance > oral examinations provide an opportunity for of oral examination during pregnancy: healthcare professionals to educate pregnant 1. Hormonal changes and oral health: women about the importance of oral hygiene, proper nutrition, and lifestyle factors that impact > pregnancy is associated with hormonal oral health. changes, including an increase in estrogen and progesterone. These hormonal shifts can affect 7. Identification and management of dental oral tissues, increasing the risk of gum issues: inflammation, gingivitis, and other oral health > oral examinations help identify and address issues. dental issues such as cavities, gum disease, and 2. Prevention and management of gingivitis: oral infections. Prompt intervention can prevent the progression of dental problems and maintain > hormonal changes during pregnancy can lead overall oral health. to an increased susceptibility to gingivitis (inflammation of the gums). Regular oral 8. X-ray safety precautions: examinations and cleanings help prevent and > while routine dental x-rays are generally manage gingivitis, reducing the risk of more avoided during pregnancy, if x-rays are severe gum disease. necessary, appropriate safety precautions, such 3. Gum disease and pregnancy complications: as the use of lead aprons, can be taken to minimize radiation exposure to the developing > severe gum disease (periodontitis) has been fetus. associated with an increased risk of certain pregnancy complications, such as preterm birth 9. Prevention of pregnancy tumors: and low birth weight. Proper oral care helps > some pregnant women may develop pregnancy minimize this risk. tumors (pyogenic granulomas) on the gums due 4. Morning sickness and dental erosion: to hormonal changes. Regular dental check-ups facilitate the identification and management of > some pregnant women experience morning these benign growths. sickness, which can lead to increased acidity in the mouth. Acidic conditions can contribyte to 10. Preparation for delivery: dental erosion. Regular dental check-ups can > addressing oral health issues before delivery address erosion issues and provide preventive helps ensure that the pregnant woman is in good measures. oral health, reducing the risk of complications and providing a positive foundation for The importance of prenatal care in pregnancy postpartum dental care. is multifaceted and encompasses various aspects: early detection and management of risks Referral in pregnancy - is a crucial aspect of promotion of maternal health comprehensive prenatal care, and it involves the timely transfer of a pregnant woman from one fetal monitoring and developmental level of care to another, usually from primary assessment care to specialized or higher-level care. The nutritional guidance importance of referral in pregnancy lies in prevention and treatment of anemia ensuring the well-being of both the expectant screening for infections mother and the developing fetus. immunizations and vaccinations Key reasons highlighting the importance of referral in pregnancy. History of present pregnancy management of high-risk conditions Confirmation of pregnancy expertise in complicated obstetric Expected date of delivery (edd) and age of situations gestation (aog) access to advanced diagnostic services coordination of multidisciplinary care timely intervention and treatment Components of the physical assessment in management of obstetric emergencies pregnancy: ensuring access to neonatal care general appearance addressing social and psychological vital signs factors weight and body mass index(bmi) optimizing resource utilization: fundal height measurement abdominal examination Referral helps optimize the use of healthcare fetal heart rate monitoring resources by directing pregnant women to the pelvic examination appropriate level of care. This ensures that more edema assessment specialized resources are allocated to those who skin changes need them the most, promoting efficient breast examination healthcare delivery. urinalysis orthostatic blood pressure measurement assessment of respiratory system, Prenatal care cardiovascular, musculoskeletal antenatal care refers to the health care given to neurological assessment a woman and her family during pregnancy review of lab results primary goal: to provide maximum health to expectant mothers and their babies Laboratory tests 4. Rubella immunity (german measles): blood tests checks for immunity to rubella to determine if the woman needs a rubella vaccine. Rubella serology infection during pregnancy can cause serious rubella antibody titer birth defects. dm universal screening 5. Varicella (chickenpox) immunity: maternal serum alpha-fetoprotein determines immunity to the varicella-zoster virus. Non-immune women may be advised to urinalysis receive the varicella vaccine before becoming pregnant. Blood tests are an essential part of prenatal 6. Hepatitis b surface antigen (hbsag): care, providing valuable information about the screens for the presence of hepatitis b virus. If health of the pregnant woman and the positive, steps can be taken to prevent the developing fetus. transmission of the virus to the newborn. 7. Syphilis testing: These tests help identify potential risks, monitor screens for syphilis, a sexually transmitted for conditions that may affect the pregnancy, and infection that can have serious consequences if guide healthcare providers in tailoring care plans untreated during pregnancy. 1. Blood type and rh factor: 8. HIV testing: determines the woman's blood type (a, b, ab, o) Checks for the presence of the human and rh factor (positive or negative). Rh factor is immunodeficiency virus (hiv). Early detection important to identify any potential rh and management are crucial to prevent mother- incompatibility between the mother and the to-child transmission. fetus 9. Chlamydia and gonorrhea testing. 2. Complete blood count (cbc): screens for these sexually transmitted measures various components of the blood, infections, which can lead to complications if including red blood cells, white blood cells, and untreated during pregnancy platelets. This test assesses for conditions such as anemia and helps monitor overall blood 10. Thyroid function tests: health. Measures thyroid hormone levels to assess 3.blood glucose testing: thyroid function. Thyroid disordersncan impact pregnancy and fetal development. screens for gestational diabetes, a form of diabetes that can develop during pregnancy. This 11. Serum alpha-fetoprotein (afp) test: typically involves a glucose challenge test part of the multiple-marker screening for neural followed by a glucose tolerance test if the initial tube defects and chromosomal abnormalities. results are elevated. Abnormal afp levels may prompt further testing 12. Pap smear (cervical screening): 4.syphilis serology: screens for cervical abnormalities or infections. purpose: screens for syphilis infection It may be performed during routine prenatal rationale: early detection and treatment of care. syphilis during pregnancy are crucial to prevent congenital syphilis, which can lead to severe complications for the baby. Serology in pregnancy - refers to the examination of blood serum to detect the 5. HIV serology: presence of specified antibodies or infectious purpose: screens for the presence of the human agents that may impact the health of the immunodeficiency virus (hiv) pregnant woman and the developing fetus. rationale: identifies hiv-positive individuals, allowing for appropriate medical care and Several serological tests are routinely performed interventions to prevent mother-to-child during pregnancy to assess immunity, screen for transmission infectious diseases, and identify potential risks. 6. Chlamydia and gonorrhea testing: 1. Rubella serology: purpose: screens for these sexually transmitted purpose: determines immunity to rubella infections (german measles) rationale: early detection and treatment are rationale: rubella infection during pregnancy can essential to prevent complications for both the lead to congenital rubella syndrome, causing pregnant woman and the newborn serious birth defects. Immunity is assessed 7. group b streptococcus (gbs) screening. through the presence of rubella antibodies purpose: identifies the presence of group b 2. Varicella (chickenpox) serology: streptococcus bacteria purpose: determines immunity to the varicella- rationale: presence of gbs may necessitate zoster virus antibiotic prophylaxis during labor to prevent rationale: non-immune pregnant women may be neonatal infection advised to get vaccinated after childbirth to 8. Toxoplasmosis serology: prevent complications if exposed to the virus purpose: screens for antibodies to the 3. Hepatitis b surface antigen (hbsag) toxoplasma gondii parasite purpose: screens for the presence of hepatitis b rationale: toxoplasmosis can have serious virus consequences for the fetus identifying immunity rationale: identifies carriers of hepatitis b to or active infection guides management implement preventive measures and reduce the risk of mother-to-child transmission 9. Cytomegalovirus (cmv) serology: are two types of antibodies associated with rubella purpose: detects antibodies to cmv 1. IGG (immunoglobulin g): rationale: cmv infection during pregnancy can have implications for the fetus. Serology helps - IGG antibodies indicate immunity to rubella. assess past exposure or active infection - a positive igg result suggests that the person 10. Herpes simplex virus (hsv) serology: has either been vaccinated against rubella or has had past infection and developed immunity. purpose: screens for antibodies to hsv. - immunity to rubella is important, especially for rationale: identifies past exposure or active women of childbearing age, as contracting infection, as herpes can pose risks during rubella during pregnancy can lead to serious pregnancy and childbirth birth defects in the developing fetus. 11. parvovirus b19 serology: 2. IGM (immunoglobulin m) purpose: screens for antibodies to parvovirus - IGM antibodies are produced in response to a b19 recent rubella infection rationale: parvovirus b19 infection during - detecting IGM antibodies may indicate a recent pregnancy can lead to fetal complications or current rubella infection serology helps assess immunity. - In the context of pregnancy, a positive igm 12. Cystic fibrosis carrier screening: result could raise concerns about the potential purpose: identifies carriers of the cystic fibrosis risk to the developing fetus. gene rationale: if both partners are carriers, there is a Interpretation of rubella antibody titer results: risk of having a child with cystic fibrosis. Screening helps inform reproductive decisions 1. Immune (positive igg, negative igm): - indicates immunity to rubella, either through vaccination or past infection Rubella antibody titer - is a blood test that measures the level of antibodies specific to the - no current or recent rubella infection is present rubella virus in an individual's blood 2. Non-immune (negative igg, negative or Rubella, also known as german measles, is a positive igm). viral infection that can cause mild symptoms in - Suggests a lack of immunity to rubella children and adults but can have severe consequences if contracted during - If igm is positive, it may indicate a recent pregnancy,leading to congenital rubella rubella infection syndrome - Non-immune status is a concern for pregnant The rubella antibody titer test is important in women, and vaccination may be assessing a person's immunity to rubella. There - Recommended after childbirth to prevent future rubella infections 3. Indeterminate or equivocal results: Alpha-fetoprotein (afp) is a protein produced by the fetal liver, and small amounts of it cross the - Some tests may yield results that are placenta and enter the maternal bloodstream. indeterminate or equivocal Msafp levels can be measured through a blood - In such cases, healthcare providers may test to assess the risk of specific conditions in recommend further testing or retesting to clarify the developing fetus the immune status. Maternal serum alpha-fetoprotein screening Dm universal screening - typically refers to 1. Purpose diabetes mellitus universal screening, a process aimed at identifying individuals who may have The primary purpose of msafp screening is to diabetes or are at risk of developing diabetes assess the risk of certain fetal abnormalities common tests for diabetes screening include particularly neural tube defects (ntds) and chromosomal abnormalities 1. Fasting blood glucose test (fbg) 2. Timing This test measures blood glucose levels after an overnight fast. Elevated fasting blood glucose Msafp testing is typically performed between the levels may indicate diabetes or prediabetes 15th and 20th weeks of gestation. This timing is important for accurate assessment, as afp levels 2. Oral glucose tolerance test (ogtt) vary throughout pregnancy The ogtt involves fasting overnight and then 3. Conditions screened: drinking a glucose solution. Blood glucose levels are measured at intervals after consuming the Neural tube defects (ntds): an elevated msafp solution, this test is often used to diagnose level may indicate the presence of a neural tube gestational diabetes during pregnancy but may defect, such as spina bifida or anencephaly. also be used for non-pregnant individuals. - Down syndrome (trisomy 21): low 3. Hemoglobin a1c (hba1c) test: levels of msafp, in combination with other markers, may be The hba1c test provides an average of blood associated with an increased risk glucose levels over the past two to three months. of down syndrome It is a long-term indicator of blood sugar control 4. Interpretation of results: 4. random blood glucose test: Elevated msafp: this may indicate an This test measures blood glucose levels at any increased risk of a neural tube defect or time, regardless of when the individual last ate. It other conditions. Further diagnostic tests, is often used in emergency situations such as ultrasound or amniocentesis, may be recommended to confirm or rule out abnormalities Maternal serum alpha-fetoprotein (MSAFP) - is a blood test performed during pregnancy to Low msafp: low levels may be associated screen for certain fetal abnormalities with an increased risk of chromosomal abnormalities particularly down  syndrome. However, this marker is often medical conditions (e.g., red or brown used in combination with other markers urine may suggest blood) for a more accurate assessment. Clarity: clear urine is generally normal. Follow-up testing: If MSAFP levels are Cloudy urine may indicate the presence outside the normal range, additional of cells, proteins, or other substances testing is usually recommended to 2. Chemical examination: provide a more definitive diagnosis. This may include ultrasound examinations, Ph level: measures the acidity or alkalinity amniocentesis, or other genetic testing of urine. Normal urine ph ranges from methods. acidic to slightly alkaline. False positives and false negatives: Msafp Protein: normally, urine contains a screening may yield false positives or minimal amount of protein. Elevated false negatives. Other factors, such as protein levels may indicate kidney maternal weight gestational age, and damage or other conditions multiple pregnancies, can influence Glucose: presence of glucose in urine msafp levels. may suggest diabetes or other metabolic disorders 7. Integrated or sequential screening Ketones: ketones in urine may be a sign of In some cases, msafp testing may be part of certain metabolic conditioms, such as integrated or sequential screening, which diabetic ketoacidosis or fasting combines results from multiple tests to provide a 3. Microscopic examination: more comprehensive assessment of the risk of fetal abnormalities Red blood cells (rbcs): microscopic examination can quantify the number of red blood cells in the urine, providing Urinalysis is a diagnostic test that involves the additional information about the source examination of urine to assess various aspects of bleeding of kidney function, overall health, and the White blood cells (wbcs): elevated levels presence of certain medical conditions may indicate inflammation or infection in It is a routine and non-invasive test often the urinary tract. performed as part of general health check-ups, epithelial cells: presence of certain types prenatal care, and the evaluation of specific of cells may indicate kidney or bladder symptoms issues Casts: these are structures formed in the kidney tubules and can indicate kidney Urinalysis and the information it provides disease. 1. Physical examination: 4. Specific gravity: Color: normal urine is typically pale to Measures the concentration of urine. Low dark yellow. Unusual colors may indicate specific gravity may indicate dilute urine, the presence of certain substances or while high specific gravity may suggest concentrated urine  5. Bilirubin and urobilinogen: There are different methods and technologies used to assess fetal heart rate at different stages The presence of bilirubin may indicate of pregnancy. liver or gallbladder issues. Urobilinogen levels can provide information about liver 1. Doppler ultrasound: function and red blood cell breakdown Doppler ultrasound is a common and non- 6. Nitrites and leukocyte esterase: Presence invasive method for monitoring fetal heart rate a of nitrites and leukocyte esterase may doppler device uses sound waves to detect and suggest a urinary tract infection (uti) amplify the fetal heart sounds. The doppler is typically applied to the mother's abdomen, and 7. Ketones: the amplified sound of the fetal heartbeat is Detection of ketones may occur in conditions heard such as uncontrolled diabetes, fasting, or 2. Electronic fetal monitoring (EFM): certain metabolic disorders. Electronic fetal monitoring involves the use of 8. microorganisms: specialized equipment to continuously Identification of bacteria or other Monitor the fetal heart rate and uterine microorganisms in the urine may indicate an contractions during labor. There are two types of infection. EFM: 9. crystals: - External monitoring: involves placing sensors Presence of crystals in urine may be on the mother's abdomen to monitor both the associated with conditions such as kidney fetal heart rate and uterine contractions stones. - Internal monitoring: in certain situations, 10. pregnancy testing: - in some cases, especially during labor, internal monitoring may urinalysis may include testing for human be used. This involves attaching a small electrode to the baby's scalp to directly measure Chorionic gonadotropin (hcg),a hormone the fetal heart rate. produced during pregnancy. 1. Fetoscope: Fetal assessment - A fetoscope is a type of stethoscope designed fetal heart rate for listening to the fetal heart sounds. It is used fetal heart monitoring during routine prenatal check-ups and is a less technologically advanced but effective method for assessing fetal heart rate. Fetal heart rate assessment - is a crucial component of prenatal care, providing valuable 2. cardiotocography (ctg): information about the well-being of the - CTG is a method that combines electronic fetal developing fetus. Monitoring the fetal heart rate monitoring with a recording of uterine helps healthcare providers assess the baby's contractions. It provides a continuous tracing of cardiac health and response to various stimuli the fetal heart rate and uterine activity during 3. estriol: labor. a form of estrogen produced by both the fetus 3. Kick counting: and the placenta. Estriol levels in the mother's blood can provide information about fetal well- - In addition to formal assessments, pregnant being women are often encouraged to monitor fetal movements or kicks as an indirect indicator of fetal wellbeing. Changes in fetal movement patterns can sometimes be associated with changes in fetal health. NORMAL FETAL HEART RATE:120-160BPM Fetal heart monitoring is a critical aspect of prenatal care and is often performed during labor to assess the well-being of the fetus. The components and the significance of the l/s ratio The triple serum test - also known as the triple 1. Lecithin: screen or triple marker test, is a maternal blood screening test performed during pregnancy to Lecithin is a phospholipid that plays a crucial assess the risk of certain chromosomal role in the formation of pulmonary surfactant. abnormalities and neural tube defects in the Surfactant is a substance produced by the lungs developing fetus. It measures the levels of three that helps maintain the elasticity of the alveoli substances in the mother's blood. (air sacs) and prevents their collapse. Adequate surfactant is essential for normal lung function, 1. alpha-fetoprotein (afp): especially for the transition to breathing air after produced by the fetal liver, afp is a protein that birth crosses the placenta and enters the mother's 2. Sphingomyelin: bloodstream. Elevated or decreased levels of afp can be associated with certain conditions. sphingomyelin is another type of phospholipid found in amniotic fluid 2. human chorionic gonadotropin (hcg): Interpretation: a hormone produced by the placenta, hcg levels are measured in the mother's blood. Abnormal A ratio of 2:1 or higher is generally considered levels of hcg may be associated with indicative of fetal lung maturity chromosomal abnormalities. A lower ratio, especially below 1.5:1, may suggest a higher risk of respiratory distress syndrome (rds) in the newborn due to insufficient surfactant production Timing of the test: anemia, blood type compatibility, and other hematological disorders The l/s ratio is often assessed in the third trimester of pregnancy, typically around 32 Indications for cordocentesis: weeks. Genetic testing: cordocentesis is If there is a concern about preterm birth, the test often used to obtain a sample of may be performed earlier to assess the fetal blood for chromosomal likelihood of the baby's lung maturity. analysis, especially when there are concerns about genetic conditions or abnormalities detected through PRENATAL DIAGNOSIS OF CONGENITAL other screening methods. DISORDERS Blood-related disorders: it can be used to assess the fetal blood for 1. Procedure overview: conditions such as anemia, blood Location: cordocentesis is type compatibility, and other performed under ultrasound hematological disorders. guidance Infections: in some cases, Insertion: a thin needle is inserted cordocentesis may be performed through the mother's abdomen to check for fetal infections. and into the umbilical cord which connects the fetus to the placenta Blood sampling: a small amount of 4. Risks and considerations: fetal blood is withdrawn from the - Cordocentesis is an invasive procedure and umbilical vein for analysis. carries a small risk of complications, including Ultrasound guidance: real-time bleeding, infection, and potential harm to the ultrasound imaging is used to fetus. guide the needle safely into the umbilical cord, avoiding the fetus - The decision to undergo cordocentesis is and other structures typically made based on specific indications and the potential benefits of obtaining detailed 2. Timing of cordocentesis diagnostic information. - Cordocentesis is usually performed later in 5. Alternative procedures: pregnancy, typically after 18 weeks of gestation - Cordocentesis is one of several invasive 3. Indications for cordocentesis: prenatal diagnostic procedures. Depending on - Genetic testing: cordocentesis is often used to the clinical situation and the specific information obtain a sample of fetal blood for chromosomal needed, alternatives such as chorionic villus analysis, especially when there are concerns sampling (cvs) or amniocentesis may be about genetic conditions or abnormalities considered. detected through other screening methods - Blood-related disorders: it can be used to assess the fetal blood for conditions such as  A NON-STRESS TEST (NST) is a prenatal test - POSITIVE CST: There is persistent that assesses the well-being of the fetus by late deceleration or late monitoring its heart rate in response to its own decelerations with more than half movements. The test is called" non-stress" the contractions. because it is performed without any external Action: A positive CST means that stress or stimulation applied to the fetus. The the fetus is no longer receiving goal of the non-stress test is to evaluate the fetal adequate oxygen and needs to be heart rate and its variability, which can provide delivered. valuable information about the oxygenation and - NEGATIVE CST: There is no neurological status of the fetus. deceleration. Action: A negative CST means that - REACTIVE NON-STRESS TEST: Two it is safe for the fetus to remain in or more FHR accelerations above utero for the next 7 days. baseline of at least 15 bpm lasting at least 15 seconds in a 20-minute period. It suggests that the fetus The COOMBS TEST is a blood test used during will be born in good condition if pregnancy to detect antibodies that may cause labor occurs within the next week hemolytic disease of the fetus and newborn or seven days however the test (HDFN). It helps determine rh incompatibility may need to be repeated twice a and other blood-related immune reactions week in high-risk patients. between the mother and baby. - NON-REACTIVE NON-STRESS TEST: Absence of accelerations of FHR during the testing period. It INDIRECT COOMBS TEST (ICT) should be followed asap by a contraction stress test. purpose: detects antibodies in the mother's - INCONCLUSIVE TEST: Less than blood that can attack the baby's red blood cells. one acceleration above the When performed: during prenatal screening baseline in a 20-minute period or (usually in the first trimester and again at 28 one that is less than 15 bpm and weeks). last less than 15 seconds. significance: if negative → no harmful The CONTRACTION STRESS TEST (CST), also antibodies detected, no risk of hemolysis. known as the oxytocin challenge test (oct), is a If positive → indicates maternal antibodies that prenatal diagnostic test used to assess the well- may cause fetal hemolysis, requiring further being of the fetus during pregnancy. The test monitoring or treatment (e.g., rh immunoglobulin involves monitoring the fetal heart rate in injection). response to induced uterine contractions. The primary goal of the contraction stress test is to evaluate how well the fetus can tolerate the DIRECT COOMBS TEST (DCT) stress of contractions, providing information about the oxygenation and overall health of the Purpose: detects antibodies already attached to fetus. the baby's red blood cells after birth. When performed: after delivery if newborn - RDS is a condition in which the shows signs of jaundice, anemia, or hemolysis. newborn's lungs are not fully developed, leading to difficulty in Significance: breathing. Administering If positive → suggests hemolytic disease of the betamethasone can enhance the newborn (HDFN), requiring treatment such as production of surfactant in the phototherapy or exchange transfusion. fetal lungs, improving their maturity and function. ADMINISTRATION: WHY IS THE COOMBS TEST IMPORTANT IN PREGNANCY? - The typical regimen involves giving two injections of betamethasone, helps prevent complications from rh 24 hours apart. This course is incompatibility. administered to pregnant women guides rh immunoglobulin (rhogam) between 24 and 34 weeks of administration to rh-negative mothers. Identifies gestation who are at risk of risk for newborn jaundice, anemia, or severe preterm delivery. The injections are hemolysis. usually given intramuscularly. RISKS AND BENEFITS: - The decision to use betamethasone during pregnancy PHARMACOLOGY is based on an assessment of the Betamethasone is a corticosteroid risks and benefits for both the medication that is sometimes used mother and the baby. The potential during pregnancy for specific medical benefits of promoting fetal lung reasons. One of the common uses of maturation are weighed against betamethasone during pregnancy is for any potential risks associated with antenatal (before birth) fetal lung corticosteroid use maturation. Here are some key points regarding the use of betamethasone in Magnesium Sulfate is a drug used to pregnancy: treat convulsions during pregnancy, ANTENATAL FETAL LUNG MATURATION nephritis in children, magnesium deficiency, and tetany. - Betamethasone is often MONITORING AFTER ADMINISTERING administered to pregnant women MAGNESIUM SULFATE IN PREGNANT who are at risk of preterm delivery WOMEN: the goal is to accelerate the - Vital signs monitoring blood development of the fetal lungs and pressure (bp): Monitor every 15-30 reduce the risk of respiratory minutes to assess for hypotension, distress syndrome (RDS) in respiratory rate (rr): should be >12 preterm infants. breaths per minute; respiratory  depression is a sign of for healthcare providers to be aware of any toxicity.heart rate (hr) pre-existing conditions or medications that - Reflex and neurological may interact with methergine assessment deep tendon reflexes PURPOSE (dtrs): - Methergine is primarily used to normal: 2+reflexesdiminished or help control and prevent absent reflexes (o or 1+): postpartum hemorrhage, which is sign of magnesium toxicity → stop a potentially serious complication infusion & give calcium gluconate, of childbirth. level of consciousness (loc). Assess for confusion, drowsiness, or lethargy, which may indicate YUTOPAR is a brand name for RITODRINE, a toxicity. medication that was historically used as a - Monitor hourly urine output: tocolytic agent to delay premature labor or to should be >30 ml/hr. arrest preterm contractions.however, it's Why? Magnesium is excreted by important to note that ritodrine is not the kidneys; low urine output commonly used for this purpose in many increases the risk of toxicity. countries, and its use has decreased over - NURSING ACTIONS: Assess DTRS, time due to safety concerns and the respiration, bp, and urine output availability of alternative tocolytic every 15-30 minutes. Monitor fetal medications. Ritodrine is a beta-2 adrenergic heart rate (fhr) for distress. Keep receptor agonist. It works by relaxing the calcium gluconate (antidote) smooth muscles of the uterus, which can readily available. Stop infusion help to delay premature labor immediately if toxicity signs 1. In the past, ritodrine was used to manage appear and notify the physician. preterm labor by inhibiting uterine METHERGINE, also known as contractions and giving the fetus more METHYLERGONOVINE, is a medication time to develop before delivery commonly used in obstetrics, specifically in 2. Ritodrine may cause side effects such as the postpartum period (after childbirth). It increased heart rate, palpitations, belongs to a class of drugs known as ergot tremors and nervousness. It can also alkaloids and is used to prevent or treat affect blood pressure excessive bleeding (postpartum hemorrhage) that can occur after delivery. Methergine is typically administered orally or through an intramuscular injection. It is often given shortly after the delivery of the baby or after the delivery of the placenta to help prevent excessive bleeding during the postpartum period. Common side effects of methergine may include nausea, vomiting, headache, and increased blood pressure. It’s important