All Charts and Diagnostics

7/31/2019 All Charts and Diagnostics

1/16

LABORATORY VALUES FOR PREGNANT AND NONPREGNANT WOMEN

VALUES NONPREGNANT PREGNANT

HEMATOLOGIC

COMPLETE BLOOD COUNT (CBC)

Hemoglobin, g/dl 12-16* >11*

Hematocrit, packed cell volume (PCV), 37-47* >33*

Red blood cell (RBC) volume, per ml 1600 1500-1900

Plasma volume, per ml 2400 3700

RBC count, million per mm3 4.2-5.4 5-6.25

White blood cells, total per mm3 5000-10,000 5000-1 5,000

Neutrophils, % 55-70 60-85

Lymphocytes, % 20-40 15-40

Erythrocyte sedimentation rate, mm/hr 20 Elevated in second and third trimesters

Mean corpuscular hemoglobin concentration

(MCHC), g/dl packed RBCs

32-36 No change in hemoglobin concentration

Mean corpuscular hemoglobin (MCH), pg 27-31 No change per pg (less than I ng)

Mean corpuscular volume (MCV),

cubic micrometer

80-95 No change per cubic micrometer

BLOOD COAGULATION

AND

FIBRINOLYTIC ACTIVITY

Factor VII 65-140 Increase in pregnancy, return to normal in

early puerperium

Factor VIII 55-145 Increases during pregnancy and immediatafter birth

Factor IX 60140 See Factor VII

Factor X 45155 See Factor VII

Factor XI 65-135 Decrease in pregnancy

Factor XII 50150 See Factor VII

Prothrombin time (PT), sec 11-12.5 Slight decrease in pregnancy

Partial Thromboplastin time (PTT), sec 6070 Slight decrease in pregnancy and decrease

during second and third stage of labor

(indicates dotting at placental Site)

Bleeding time, min 1-9 (Ivy test) No appreciable" changeCoagulation time, min 6-1 0

(Lee/white test)

No appreciable change

Platelets, per mm3 150,000-400,000 No Significant change until 3-5 days after

birth and then a rapid increase (may

predispose woman to thrombosis) and

gradual return to normal


2/16

Fibrinolytic activity Normal Decreases in pregnancy and then abruptly

returns to normal (protection against

thromboembolism)

Fibrinogen, mg/dl 200400 Increased levels late in pregnancy

MINERAL AND VITAMIN CONCENTRATIONS

Vitamin B12, folic acid, ascorbic acid Normal Moderate decreaseSERUM PROTEINS

Total, g/dl 6.4-8.3 5.5-7.5

Albumin, g/dl 3.5-5 Slight increase

Globulin, total, g/dl 2.3-3.4 3-4

BLOOD GLUCOSE

Fasting, mg/dl 70105 Decreases

2-hr postprandial, mg/dl


3/16

CARDIOVASCULAR CHANGES IN PREGNANCY

Heart rate Increases 10-15 beats/minBlood pressure Remains at pre pregnancy levels in first trimester (systolic)

Slight decrease in second trimester (systolic and diastolic) Returns to pre pregnancy levels in late third trimester (diastolic)

Blood volume Increases by 1500 ml or 40%-50% above pre pregnancy levelRed blood cell mass Increases 17%Hemoglobin DecreasesHematocrit DecreasesWhite blood cell count Increases in second and third trimestersCardiac output Increases 30%-50%

RESPIRATORY CHANGES IN PREGNANCY

Respiratory rate Unchanged or slightly increased

Tidal volume Increased 30%-40%

Vital capacity Unchanged

Inspiratory capacity Increased

Expiratory volume Decreased

Total lung capacity Unchanged to slightly decreased

Oxygen consumption Increased 15%-20%

FREQUENCY OF DERMATOLOGIC DISORDERS OF PREGNANCY

Cholestasis of pregnancy: Common-I.5%-2%

Pruritic urticarial papules and plaques of pregnancy (PUPPP):Common-O.25% to 1%

Pruritic of pregnancy: Uncommon-O.3%

Herpes gestations: Rare-O.002%

Impetigo herpetiformis: Very rare


4/16

KEY POINTS

The biochemical, physiologic, and anatomic adaptations that occur during pregnancy are profound andrevert to the non-pregnant state after birth and lactation.

Maternal adaptations are attributed to the hormones of pregnancy and to mechanical pressures exerted bthe enlarging uterus and other tissues

ELISA testing, with monoclonal antibody technology, is the most popular method of pregnancy testing andthe basis for most over-the-counter home pregnancy tests.

Presumptive, probable, and positive signs of pregnancy aid in the diagnosis of pregnancy; only positive sig(identification of a fetal heartbeat, verification of fetal movements, and visualization of the fetus) can

establish the diagnosis of pregnancy

Adaptations to pregnancy protect the woman's normal physiologic functioning, meet the metabolicdemands pregnancy imposes, and provide for fetal development and growth needs.

Although the pH of the pregnant woman's vaginal secretions is more acidic, she is more vulnerable to somvaginal infections, especially yeast infections.

Increased vascularity and sensitivity of the vagina and other pelvic viscera may lead to a high degree ofsexual interest and arousal.

Some adaptations to pregnancy result in discomforts such as fatigue, urinary frequency, nausea, and breasensitivity.

As pregnancy progresses, balance and coordination are affected by changes in the woman's joints and hercenter of gravity.


5/16

SIGNS OF PREGNANCY

TIME OF

OCCURRENCE

(GESTATIONAL AGE)

PRESUMPTIVE SIGNS

SIGN OTHER POSSIBLE CAUSE

3-4wk Breast changes Premenstrual changes, oral contraceptiv4wk Amenorrhea Stress, vigorous exercise, early menopau

endocrine problems, malnutrition

4-14 wk Nausea, vomiting Gastrointestinal virus, food poisoning

6-12 wk Urinary frequency Infection, pelvic tumors

12wk Fatigue Stress, illness

16-20 wk Quickening Gas, peristalsis

PROBABLE SIGNS

5wk Goodell sign Pelvic congestion

6-8wk Chadwick sign Pelvic congestion

6-12 wk Hegar sign Pelvic congestion4-12 wk Positive result of pregnancy test (serum) Hydatidiform mole, choriocarcinoma

6-12 wk Positive result of pregnancy test (urine) False-positive results may be caused by

pelvic infection, tumors

16wk Braxton Hicks contractions Myomas, other tumors

16-28 wk Ballottement Tumors, cervical polyps

POSITIVE SIGNS

5-6 wk Visualization of fetus by real-time

ultrasound examination

No other causes

6wk Fetal heart tones detected by ultrasound

examination

No other causes

16wk Visualization of fetus by radiographic

study

No other causes

8-17wk Fetal heart tones detected by Doppler

ultrasound stethoscope

No other causes

17-19 wk Fetal heart tones detected by fetal

stethoscope

No other causes

19-22 wk Fetal movements palpated No other causes

Late pregnancy Fetal movements visible No other causes


6/16

MILESTONES IN HUMAN DEVELOPMENT BEFORE BIRTH SINCE LAST MENSTRUAL PERIOD

4 WEEKS 8 WEEKS 12 WEEKSEXTERNAL APPEARANCE

Body flexed, C-shaped; arm and leg buds

present; head at right angles to body

EXTERNAL APPEARANCE

Body fairly well formed; nose flat, eyes

far apart; digits well formed; head

elevating; tail almost disappeared; eyes,ears, nose, and mouth recognizable

EXTERNAL APPEARANCE

Nails appearing; resembles a human; head

erect but disproportionately large; skin pin

delicate

CROWN-TORUMP MEASUREMENT WEIGHT

0.4-0.5cm;0.4 g

CROWN-TORUMP MEASUREMENT

WEIGHT

2.5-3 cm; 2 g

CROWN-TORUMP MEASUREMENT WEIG

6-9 cm; 19 g

GASTROINTESTINAL SYSTEM

Stomach at midline and fusiform;

conspicuous liver; esophagus short; intestine

a short tube


Intestinal villi developing; small intestines

coil within umbilical cord; palatal folds

present; liver very large


Bile secreted; palatal fusion complete;

intestines have withdrawn from cord and

assume characteristic positions

MUSCULOSKELETAL SYSTEM

All somites present


First indication of ossification--occiput,

mandible, and humerus; fetus capable of

some movement; definitive muscles of

trunk, limbs, and head well represented


Some bones well outlined, ossification

spreading; upper cervical to lower sacral

arches and bodies ossify; smooth muscle

layers indicated in hollow viscera

CIRCULATORY SYSTEM

Heart develops, double chambers visible,

begins to beat; aortic arch and major veins

completed

CIRCULATORY SYSTEM

Main blood vessels assume final plan;

enucleated red cells predominate in

blood

CIRCULATORY SYSTEM

Blood forming in marrow

RESPIRATORY SYSTEM

Primary lung buds appear

RESPIRATORY SYSTEM

Pleural and pericardial cavities forming;

branching bronchioles; nostrils closed by

epithelial plugs

RESPIRATORY SYSTEM

Lungs acquire definite shape; vocal cords

appear

RENAL SYSTEM

Rudimentary ureteral buds appear

RENAL SYSTEM

Earliest secretory tubules differentiating;

bladder-urethra separates from rectum

RENAL SYSTEM

Kidney able to secrete urine; bladder expa

as a sac

NERVOUS SYSTEMWell-marked midbrain flexure; no hindbrain

or cervical flexures; neural groove closed

NERVOUS SYSTEMCerebral cortex begins to acquire typical

cells; differentiation of cerebral cortex,

meninges, ventricular foramina,

cerebrospinal fluid circulation; spinal

cord extends entire length of spine

NERVOUS SYSTEMBrain structural configuration almost

complete; cord shows cervical and lumbar

enlargements; fourth ventricle foramina ar

developed; sucking present

SENSORY ORGANS

Eye and ear appearing as optic vessel and

otocyst

SENSORY ORGANS

Primordial choroid plexuses develop;

large relative to cortex; development

progressing; eyes converging rapidly;

internal ear developing; eyelids fuse

SENSORY ORGANS

Earliest taste buds indicated; characteristic

organization of eye attained

GENITAL SYSTEM

Genital ridge appears (fifth week)

GENITAL SYSTEM

Testes and ovaries distinguishable;external genitalia sexless but begin to

differentiate

GENITAL SYSTEM

Sex recognizable; internal and external sexorgans specific


7/16


8/16

40 cm; 3200+ g


NONE

SIGNIFICANT


NONE

SIGNIFICANT


NONE

SIGNIFICANT

MUSCULO-

SKELETAL SYSTEM

Middle fourth phalanxes ossify; permanent,minimum tone teeth primordia seen; can turn

head to side

MUSCULO-

SKELETAL SYSTEM

NONESIGNIFICANT

MUSCULO-

SKELETAL SYSTEM

36 WeeksDistal femoral ossification centers present;

sustained, definite movements; fair tone; c

turn and elevate head

40 Weeks

Active, sustained movement; good tone; m

lift head

CIRCULATORY SYSTEM

NONE

SIGNIFICANT

CIRCULATORY SYSTEM

NONE

SIGNIFICANT

CIRCULATORY SYSTEM

NONE

SIGNIFICANT

RESPIRATORY SYSTEM

Lecithin forming on alveolar surfaces

RESPIRATORY SYSTEM

LS ratio = 1.2: I

RESPIRATORY SYSTEM

36 Weeks

LS ratio> 2: I40Weeks

Pulmonary branching only two thirds

complete

RENAL SYSTEM

NONE

SIGNIFICANT

RENAL SYSTEM

NONE

SIGNIFICANT

RENAL SYSTEM

36 Weeks

Formation of new nephrons ceases

NERVOUS SYSTEM

Appearance of cerebral fissures, convolutions

rapidly appearing; indefinite sleep-wake

cycle; cryweak or absent; weak suck reflex

NERVOUS SYSTEM

NONE

SIGNIFICANT

NERVOUS SYSTEM

36 Weeks

End of spinal cord at level of third lumbar

vertebra (L3); definite sleep-wake cycle

40 Weeks

Myelination of brain begins; patterned slee

wake cycle with alert periods; cries when

hungry or uncomfortable; strong suck refle

SENSORY ORGANS

Eyelids reopen; retinal layers completed,

light-receptive; pupils capable of reacting to

light

SENSORY ORGANS

Sense of taste present; aware of sounds

outside mother's body

SENSORY ORGANS

NONE

SIGNIFICANT

GENITAL SYSTEM

NONE

SIGNIFICANT

GENITAL SYSTEM

Testes descending to scrotum

GENITAL SYSTEM

40 Weeks

Testes in scrotum; labia majora well

developed


9/16

DAILY FOOD GUIDE FOR PREGNANCYAND LACTATIONFOOD GROUP DAILY AMOUNT OF FOOD

RECOMMENDED FOR WOMEN*

SERVING SIZE

GRAINS 6 ounce-equivalents

At least half of grain servings should be

whole grains. Whole groins are those that

contain the entire grain kernel (bran,germ, endosperm), e.g., whole wheat or

cornmeal, oatmeal, and brown rice.

Refined grains have been milled to remove

the bran and germ, e.g., white flour, white

bread. Degermed cornmeal, white rice,

and corn or flour tortillas.

I ounce-equivalent = I slice bread. I cup read

to-eat cereal, or '12 cup cooked rice or pasta

cooked cereal

VEGETABLES

Vary the vegetables consumed to take advantage of the

different nutrients they offer.

2.5 Cups

Weekly intake should include at least the

following: 3 cups dark green vegetables

(e.g., spinach or greens, broccoli, bok choy,

romaine lettuce); 2 cups orange vegetables

(e.g., carrots; acorn, butternut, or hubbard

squash; sweet potatoes); 3 cups dry beans

or peas (e.g., black, navy, or kidney beans;chickpeas; black-eyed peas; split peas;

lentils; soy beans; tofu); 3 cup starchy

vegetables (corn, green peas, potatoes);

and 6.5 cups of other vegetables (e.g.,

artichokes, asparagus. bean sprouts.

Brussels sprouts green beans, cauliflower,

cucumber, tomatoes, iceberg or head

lettuce, vegetable juice).

I cup = 2 cups raw leafy greens; I cup of othe

vegetables, raw or cooked; or I cup of vegeta

juice

FRUITS 1.5 cups I cup = I cup raw, frozen or canned fruit;

I cup 100% juice; or 'h cup dried fruit

MILK, YOGURT, AND CHEESE (MILK GROUP) 3 cups

For nonpregnant and pregnant; 4 for

lactation

Most milk group choices should be fat-freeor low-fat.

I cup = I cup milk or yogurt; 1.5 ounces natu

cheese; 2 ounces processed cheese (such as

American); 2 cups cottage cheese;

1.5 cups ice cream (choose fat-free or low-famost often)

MEAT, POULTRY, FISH, DRY BEANS, EGGS, AND NUTS

(MEAT AND BEANS GROUPS)

5 ounce-equivalents

Most meat and poultry choices should be

lean or low-fat. Fish, nuts, and seeds

contain healthy oils. so choose these foods

frequently instead of meat or poultry.

I ounce-equivalent = I ounce (30 g) meat,

poultry, or fish; cup cooked dry beans, I eg

tablespoon (15 ml) peanut butter;

ounce nuts or seeds

OILS 6 teaspoons (30 ml)

Choose oils rather than solid fats. Solid fats

are fats that are solid at room

temperature, such as butter, shortening,

stick margarine, and pork, chicken, or beef

fat: Read the label: choose products with

no trans fats. Limit intake of saturated fats,

and choose oils high in monounsaturatedand polyunsaturated

Fats

I teaspoon = I teaspoon liquid oil (olive, cano

sunflower, safflower. peanut, soybean,

cottonseed, etc.) or soft margarine (tub or

squeeze bottle); I tablespoon mayonnaise or

Italian salad dressing; 3/4 tablespoon Thous

Island salad dressing; 8 large olives; 1/6

medium avocado; 1/3 ounce dry roasted

peanuts, mixed nuts, cashews, sunflower se


10/16

POPULAR FOODS OF VARIOUS CULTURAL AND ETHNIC GROUPS AND THEIR PLACE IN MYPYRAMID

CULTURAL OR ETHNIC GROUP OR EATING PATIERN

FOOD GROUPS

CULTURAL AND

ETHNIC GROUPS

GRAINS VEGETABLE FRUIT MILK MEAT AND BEANS

Mexican Tortilla

Taco shell

Posole (corn soup)

Rice Postres

(pastries]"

Other vegetables:

Chayote (Mexican

squash) Jicama (root

vegetable)

Nopales (cactus

leaves) Tomato

Corn

Avocado

Mango

Papaya

Plantano (cooking

banana)

Zapote (sweet,

yellowish fruit)

Queso Blanco (white

Mexican cheese)

Custard (I cup = I cup

milk serving) Leche

(milk)

Chorizo (sausage)*

Chicken, beef, goat, or

pork Beans. Dry, cooked

African-American

soul food (Southern-

style cooking)

Biscuit Cornbread

Grits, rice, macaroni,

or noodles Hominy

Crackers Hush

puppies

Dark green: Collard,

kale, mustard, or

turnip greens Orange:

Sweet potatoes

Other: Okra Snap,

pole, Lima, and butter

beans Turnips

Summer squash

(yellow or zucchini)

Coleslaw

Blackberries Melons

Muscadines

(grapes)Peaches

Buttermilk Pork (cured ham and

uncured cuts), chicken,

beef, fish Peas or beans

(black-eyed, crowder,

purple-hull, or cream)

Vegetarian Whole-grain bread

Cereal, cooked or

ready to-eat Brown

rice Whole-grain pasta

Bagel

All All Milk and cheese

(Iactovegetarians) Soy

milk, calcium-fortified

Soy cheese

Cooked dry beans or pe

Tofu (soybean curd) or

tempeh (fermented soy

Nuts or seeds Peanut

butter Egg

(ovovegetarians)

Italian Bread sticks, breads

Gnocchi (dumplings)

Polenta (corn meal

mush) Risotto (creamy

rice dish) Pastas

Dark green: Spinach

Other: Artichoke

Eggplant Mushrooms

Marinara sauce

Berries

Figs Pomegranate

Cheeses (mozzarella,

parmesan, Romano,

ricotta, etc.) Gelato

(Italian ice cream)

Veal or beef

Fish

Sausage*

Luncheon meats*

Lentils

SquidAlmonds, pistachios

Chinese Rice or millet Rice

vermicelli (thin rice

pasta) Cellophane

noodles (bean thread)

Steamed rolls Rice

congee (soup) Rice

sticks

Other: Pea pods Yard-

long beans Baby corn

Bamboo shoots Straw

mushrooms Eggplant

Bitter melon

Guava Lychee

Persimmon Pummelo

Kumquat Star fruit

Soy milk Pork, fish, chicken Shrim

crab, lobster Tofu or

tempeh

Indian (south Asia) Breads: roti (chapati),

naan, paratha, batura,

puris, dosa, Idli Rice or

rice pilau Pooha,

upma, sabudana

Dark green:

Saag (mixed greens

and

potatoes)

Spinach

Other:Green peppers

Cabbage

Eggplant

Green beans

Methi (fenugreek

leaves)

Cucumbers

Chutney or vegetable

pickles

Mango

Dates

Raisins

Melons

Figs

Fruit juices andnectars

Yogurt Dal (lentils, mung beans

other dried beans)

Beef, chicken (some are

vegetarian)


11/16

Native American Bread

Fry bread

Wild rice or oats

Popcorn

Tortilla

Mush (cooked cereal)

Orange:

Winter squash (hard

outer

shell)

Starchy:

Potato

Corn

Other:Rhubarb

Berries

Cherries

Plums

Apples

Peaches

Wild game (deer, rabbit

elk,

beaver)

Lamb

Salmon and other fish

Clams, mussels

Crab

Duck or quail

Middle Eastern Rice or bulgur

(cracked

wheat)

Couscous

Bread

Pita

Yellow:

Pumpkin or winter

squash

(Butternut)

Other:

Peppers

Tomatoes

Grape leaves

Cucumbers

Fava beans

Eggplant

Apricots

Grapes

Melons

Dried fruits: dates,

raisins,

apricots

Yogurt Lamb, goat, fish

Almonds

Pistachio nuts

Dried beans and peas,

lentils

Egg


12/16

Calculating the Body Mass Index (BMI) Example: Mrs. White is 54 tall and weighs 130 lbs. Todetermine her BMI:

Convert weight into kilograms. (divide weight inpounds by 2.2)

130 / 2.2 = 59 kg

Convert height into centimeters. (multiply heightin inches by 2.5)

5 x 12 = 60 + 4 = 64 inches (foot to inches)

64 inches x 2.5 = 160 cm (inches to cm)

Convert centimeters into meters. (divide result by100)

160 / 100 = 1.6 meters

Square height in meters. 1.6 x 1.6 = 2.56 Divide weight in kilograms by height in meters

squared.59 / 2.56 = 23 BMI

nterpretation of Result:

23 BMI = Normal Weight, thus, Mrs. White enters pregnancy at normal weight.


13/16

LABORATORY TESTS IN PRENATAL PERIOD

LABORATORY TEST PURPOSE

Hemoglobin, hematocrit, WBC, differential Detects anemia; detects infection

Hemoglobin electrophoresis Identifies women with hemoglobinopathies (e.g., sic

cell anemia, thalassemia)

Blood type, Rh, and irregular antibody Identifies those fetuses at risk for developingerythroblastosis

fetalis or hyperbilirubinemia in neonatal period

Rubella titer Determines immunity to rubella

Tuberculin skin testing; chest film after 20 weeks of gestation in

women with reactive tuberculin tests

Screens for exposure to tuberculosis

Urinalysis, including microscopic examination of urinary

sediment; pH, specific gravity, color, glucose, albumin, protein,

RBCs, WBCs, casts, acetone; hCG

Identifies women with unsuspected diabetes mellitu

renal

disease, hypertensive disease of pregnancy; infectio

occult

hematuria

Urine culture Identifies women with Asymptomatic bacteriuria

Renal function tests: BUN, creatinine, electrolytes, creatinine

clearance, total protein excretion

Evaluates level of possible renal compromise in wom

with a

history of diabetes, hypertension, or renal disease

Pap test Screens for cervical intraepithelial neoplasia. herpes

simplex type 2,and HPV

Vaginal or rectal smear for Neisseria gonorrhea, Chlamydia, HPV,

GBS

Screens high risk population for asymptomatic

infection; GBS

done at 35-37 weeks

RPR,VDRL, or FTA-ABS Identifies women with untreated syphilis

HIV* antibody, hepatitis B surface antigen, toxoplasmosis Screens for specific infections

l-hr glucose tolerance Screens for gestational diabetes; done at initial visit

women

with risk factors; done at 24-28 weeks for all pregna

women

3-hr glucose tolerance Screens for diabetes In women with elevated glucos

level after 1-hr test; must have two elevated reading

for diagnosis

Cardiac evaluation: ECG, chest x-ray film, and echocardiogram Evaluates cardiac function in women with a history o

hypertension or cardiac disease


14/16

Nageles

Rule

Nageles rule is used to determine the EDD on the basis of the first day of the last menstrual period or LMP

calculate the date of birth in this rule, subtract 3 months from the first day of LMP then add 7 days and

change the year. For example the last menstrual period (LMP) began July 30, 2010. To determine the EDD

follow the following steps:

Subtract 3 months (June 30, May 30, April 30) = April 30, 2010 Add 7 days then change the year = April 30 + 7 (April has 30 days only, thus, adding 7 days would make

the EDD May 7) = May 7 (change the year) = May 7, 2011

Modified

McDonalds

Rule

Measuring the fundic height in McDonalds rule

McDonalds Rule or method is used to determine the age of gestation by measuring from the fundus

(obtaining the fundal height) to the symphysis pubis. The distance in centimeters will determine the age of

gestation from 16-38 weeks. (From Benson and Pernolls handbook ofobstetrics and gynecology)

Johnsons

Rule

Johnsons rule is used to estimate the weight of the fetus in grams. To determine this, a standard formula is

used.

Formula: fundic height in cmn x k

k is constant, it is always 155

n is 12 if the fetus is engaged. It is 11 if the fetus is not yet engaged.

Example:

A fundic height of 28 cm, and the fetus is not engaged.

28 cm11 x 155 = 17 x 155 = 2635 grams

Bartholome

ws Rule of

fourths

This method estimates the age of gestation relative to the height of the fundus of the uterus above the

symphysis pubis.

By 3rd

lunar month (12 weeks), the fundus is slightly palpated above the above the symphysis pubis.

By the 5th lunar month (20 weeks), the fundus is palpable at the level of the umbilicus.

On the 9th

lunar month, the fundus is at the level of the xiphoid process.

image from womenshealthapta.org

Haase rule The length of the fetus in centimeters, divided by 5, is the duration ofpregnancy in months, the age of thefetus
http://nursingcrib.com/nursing-notes-reviewer/maternal-child-health/estimates-in-pregnancy/http://nursingcrib.com/nursing-notes-reviewer/maternal-child-health/estimates-in-pregnancy/http://www.medilexicon.com/medicaldictionary.php?t=79171http://www.medilexicon.com/medicaldictionary.php?t=79171http://nursingcrib.com/nursing-notes-reviewer/maternal-child-health/estimates-in-pregnancy/


15/16

INVASIVENESS TEST COMMENTS TIME

NON-INVASIVE

Fetal Cells in

Maternal Blood

(FCMB)

Based on enrichment of fetal cells which circulate in maternal blood.

Since fetal cells hold all the genetic information of the developing

fetus they can be used to perform prenatal diagnosis.

First

Trimest

NON-INVASIVECell-free Fetal DNA

in Maternal Blood

Based on DNA of fetal origin circulating in the maternal blood. Testingcan potentially identify

fetalaneuploidy(available in the United States, beginning 2011) and

genderof a fetus as early as six weeks into a pregnancy. Fetal DNA

ranges from about 2-10% of the total DNA in maternal blood.

First

Trimest

NON-INVASIVE

Preimplantation

Genetic

Diagnosis(PGD)

Duringin vitro fertilization(IVF) procedures, it is possible to sample

cells fromhuman embryosprior the implantation.[6]PGD is in itself

non-invasive, but IVF usually involves invasive procedures such

astransvaginal oocyte retrieval

Prior T

Implant

on

NON-INVASIVEExternal

ExaminationExamination of the woman'suterusfrom outside the body.

First O

Secon

Trimest

NON-INVASIVEUltrasound

Detection

Commonly dating scans (sometimes known as booking scans) from 7

weeks to confirm pregnancy dates and look fortwins. The

specializednuchal scanat 1113 weeks may be used to identify

higher risks of Downs syndrome. Latermorphology scans from 18

weeks may check for any abnormal development.

First O

Secon

Trimest

NON-INVASIVE Fetal Heartbeat Listening to the fetal heartbeat (seestethoscope)

First O

Secon

Trimest

NON-INVASIVE Non-Stress TestUse ofcardiotocographyduring the third trimester to monitor fetal

wellbeing

Third

Trimest

LESS INVASIVE

Transcervical

Retrieval Of

Trophoblast Cells

Cervical mucus aspiration,cervical swabbing,andcervicalorintrauterine lavagecan be used to retrieve trophoblast

cells for diagnostic purposes, includingprenatal genetic analysis.

Success rates for retrieving fetal trophoblast cells vary from 40% to

90%.[7]

It can be used forfetal sex determinationand

identifyaneuploidies.Antibody markershave proven useful to select

trophoblast cells for genetic analysis and to demonstrate that the

abundance of recoverable trophoblast cells diminishes in abnormal

gestations, such as inectopic pregnancyoran embryonic gestation.

First

Trimest

LESS INVASIVEMaternal Serum

Screening

Including -hCG,PAPP-A,alpha fetoprotein, intact or beta hCG,

inhibin-A.

See separate sectionbelow

First O

Secon

Trimest

MORE INVASIVEChorionic Villus

Sampling

Involves getting a sample of thechorionic villusand testing it. This

can be done earlier than amniocentesis, but may have a higher risk of

miscarriage, estimated at 1%.

After

10 Wee

MORE INVASIVE Amniocentesis

This can be done once enoughamniotic fluidhas developed to

sample. Cells from the fetus will be floating in this fluid, and can be

separated and tested. Miscarriage risk of amniocentesis is commonly

quoted as 0.06% (1:1600). Byamniocentesisis also possible tocry

After

15 Wee
http://en.wikipedia.org/wiki/Aneuploidyhttp://en.wikipedia.org/wiki/Aneuploidyhttp://en.wikipedia.org/wiki/Aneuploidyhttp://en.wikipedia.org/wiki/Baby_Gender_Mentorhttp://en.wikipedia.org/wiki/Baby_Gender_Mentorhttp://en.wikipedia.org/wiki/Preimplantation_genetic_diagnosishttp://en.wikipedia.org/wiki/Preimplantation_genetic_diagnosishttp://en.wikipedia.org/wiki/Preimplantation_genetic_diagnosishttp://en.wikipedia.org/wiki/Preimplantation_genetic_diagnosishttp://en.wikipedia.org/wiki/In_vitro_fertilizationhttp://en.wikipedia.org/wiki/In_vitro_fertilizationhttp://en.wikipedia.org/wiki/In_vitro_fertilizationhttp://en.wikipedia.org/wiki/Human_embryohttp://en.wikipedia.org/wiki/Human_embryohttp://en.wikipedia.org/wiki/Human_embryohttp://en.wikipedia.org/wiki/Prenatal_diagnosis#cite_note-5http://en.wikipedia.org/wiki/Prenatal_diagnosis#cite_note-5http://en.wikipedia.org/wiki/Prenatal_diagnosis#cite_note-5http://en.wikipedia.org/wiki/Transvaginal_oocyte_retrievalhttp://en.wikipedia.org/wiki/Transvaginal_oocyte_retrievalhttp://en.wikipedia.org/wiki/Transvaginal_oocyte_retrievalhttp://en.wikipedia.org/wiki/Uterushttp://en.wikipedia.org/wiki/Uterushttp://en.wikipedia.org/wiki/Uterushttp://en.wikipedia.org/wiki/Obstetric_ultrasonographyhttp://en.wikipedia.org/wiki/Obstetric_ultrasonographyhttp://en.wikipedia.org/wiki/Obstetric_ultrasonographyhttp://en.wikipedia.org/wiki/Twinhttp://en.wikipedia.org/wiki/Twinhttp://en.wikipedia.org/wiki/Twinhttp://en.wikipedia.org/wiki/Nuchal_scanhttp://en.wikipedia.org/wiki/Nuchal_scanhttp://en.wikipedia.org/wiki/Nuchal_scanhttp://en.wikipedia.org/wiki/Stethoscopehttp://en.wikipedia.org/wiki/Stethoscopehttp://en.wikipedia.org/wiki/Stethoscopehttp://en.wikipedia.org/wiki/Non-stress_testhttp://en.wikipedia.org/wiki/Non-stress_testhttp://en.wikipedia.org/wiki/Cardiotocographyhttp://en.wikipedia.org/wiki/Cardiotocographyhttp://en.wikipedia.org/wiki/Cardiotocographyhttp://en.wikipedia.org/wiki/Transcervicalhttp://en.wikipedia.org/wiki/Transcervicalhttp://en.wikipedia.org/wiki/Trophoblast_cellhttp://en.wikipedia.org/wiki/Trophoblast_cellhttp://en.wikipedia.org/w/index.php?title=Cervical_mucus_aspiration&action=edit&redlink=1http://en.wikipedia.org/w/index.php?title=Cervical_mucus_aspiration&action=edit&redlink=1http://en.wikipedia.org/w/index.php?title=Cervical_swabbing&action=edit&redlink=1http://en.wikipedia.org/w/index.php?title=Cervical_swabbing&action=edit&redlink=1http://en.wikipedia.org/w/index.php?title=Cervical_swabbing&action=edit&redlink=1http://en.wikipedia.org/w/index.php?title=Cervical_lavage&action=edit&redlink=1http://en.wikipedia.org/w/index.php?title=Cervical_lavage&action=edit&redlink=1http://en.wikipedia.org/w/index.php?title=Cervical_lavage&action=edit&redlink=1http://en.wikipedia.org/w/index.php?title=Intrauterine_lavage&action=edit&redlink=1http://en.wikipedia.org/w/index.php?title=Intrauterine_lavage&action=edit&redlink=1http://en.wikipedia.org/w/index.php?title=Intrauterine_lavage&action=edit&redlink=1http://en.wikipedia.org/w/index.php?title=Prenatal_genetic_analysis&action=edit&redlink=1http://en.wikipedia.org/w/index.php?title=Prenatal_genetic_analysis&action=edit&redlink=1http://en.wikipedia.org/w/index.php?title=Prenatal_genetic_analysis&action=edit&redlink=1http://en.wikipedia.org/wiki/Prenatal_diagnosis#cite_note-imudia-6http://en.wikipedia.org/wiki/Prenatal_diagnosis#cite_note-imudia-6http://en.wikipedia.org/wiki/Prenatal_diagnosis#cite_note-imudia-6http://en.wikipedia.org/wiki/Fetal_sex_determinationhttp://en.wikipedia.org/wiki/Fetal_sex_determinationhttp://en.wikipedia.org/wiki/Fetal_sex_determinationhttp://en.wikipedia.org/wiki/Aneuploidieshttp://en.wikipedia.org/wiki/Aneuploidieshttp://en.wikipedia.org/wiki/Aneuploidieshttp://en.wikipedia.org/w/index.php?title=Antibody_marker&action=edit&redlink=1http://en.wikipedia.org/w/index.php?title=Antibody_marker&action=edit&redlink=1http://en.wikipedia.org/w/index.php?title=Antibody_marker&action=edit&redlink=1http://en.wikipedia.org/wiki/Ectopic_pregnancyhttp://en.wikipedia.org/wiki/Ectopic_pregnancyhttp://en.wikipedia.org/wiki/Ectopic_pregnancyhttp://en.wikipedia.org/wiki/Anembryonic_gestationhttp://en.wikipedia.org/wiki/Anembryonic_gestationhttp://en.wikipedia.org/wiki/Anembryonic_gestationhttp://en.wikipedia.org/wiki/Human_chorionic_gonadotropinhttp://en.wikipedia.org/wiki/Human_chorionic_gonadotropinhttp://en.wikipedia.org/wiki/Human_chorionic_gonadotropinhttp://en.wikipedia.org/wiki/Pregnancy-associated_plasma_protein_Ahttp://en.wikipedia.org/wiki/Pregnancy-associated_plasma_protein_Ahttp://en.wikipedia.org/wiki/Pregnancy-associated_plasma_protein_Ahttp://en.wikipedia.org/wiki/Alpha_fetoproteinhttp://en.wikipedia.org/wiki/Alpha_fetoproteinhttp://en.wikipedia.org/wiki/Alpha_fetoproteinhttp://en.wikipedia.org/wiki/Prenatal_diagnosis#Maternal_serum_screeninghttp://en.wikipedia.org/wiki/Prenatal_diagnosis#Maternal_serum_screeninghttp://en.wikipedia.org/wiki/Prenatal_diagnosis#Maternal_serum_screeninghttp://en.wikipedia.org/wiki/Chorionic_villus_samplinghttp://en.wikipedia.org/wiki/Chorionic_villus_samplinghttp://en.wikipedia.org/wiki/Chorionic_villus_samplinghttp://en.wikipedia.org/wiki/Chorionic_villushttp://en.wikipedia.org/wiki/Chorionic_villushttp://en.wikipedia.org/wiki/Chorionic_villushttp://en.wikipedia.org/wiki/Amniocentesishttp://en.wikipedia.org/wiki/Amniocentesishttp://en.wikipedia.org/wiki/Amniotic_fluidhttp://en.wikipedia.org/wiki/Amniotic_fluidhttp://en.wikipedia.org/wiki/Amniotic_fluidhttp://en.wikipedia.org/wiki/Amniocentesishttp://en.wikipedia.org/wiki/Amniocentesishttp://en.wikipedia.org/wiki/Amniocentesishttp://en.wikipedia.org/wiki/Cryopreservehttp://en.wikipedia.org/wiki/Cryopreservehttp://en.wikipedia.org/wiki/Cryopreservehttp://en.wikipedia.org/wiki/Amniocentesishttp://en.wikipedia.org/wiki/Amniotic_fluidhttp://en.wikipedia.org/wiki/Amniocentesishttp://en.wikipedia.org/wiki/Chorionic_villushttp://en.wikipedia.org/wiki/Chorionic_villus_samplinghttp://en.wikipedia.org/wiki/Chorionic_villus_samplinghttp://en.wikipedia.org/wiki/Prenatal_diagnosis#Maternal_serum_screeninghttp://en.wikipedia.org/wiki/Alpha_fetoproteinhttp://en.wikipedia.org/wiki/Pregnancy-associated_plasma_protein_Ahttp://en.wikipedia.org/wiki/Human_chorionic_gonadotropinhttp://en.wikipedia.org/wiki/Anembryonic_gestationhttp://en.wikipedia.org/wiki/Ectopic_pregnancyhttp://en.wikipedia.org/w/index.php?title=Antibody_marker&action=edit&redlink=1http://en.wikipedia.org/wiki/Aneuploidieshttp://en.wikipedia.org/wiki/Fetal_sex_determinationhttp://en.wikipedia.org/wiki/Prenatal_diagnosis#cite_note-imudia-6http://en.wikipedia.org/w/index.php?title=Prenatal_genetic_analysis&action=edit&redlink=1http://en.wikipedia.org/w/index.php?title=Intrauterine_lavage&action=edit&redlink=1http://en.wikipedia.org/w/index.php?title=Cervical_lavage&action=edit&redlink=1http://en.wikipedia.org/w/index.php?title=Cervical_swabbing&action=edit&redlink=1http://en.wikipedia.org/w/index.php?title=Cervical_mucus_aspiration&action=edit&redlink=1http://en.wikipedia.org/wiki/Trophoblast_cellhttp://en.wikipedia.org/wiki/Transcervicalhttp://en.wikipedia.org/wiki/Cardiotocographyhttp://en.wikipedia.org/wiki/Non-stress_testhttp://en.wikipedia.org/wiki/Stethoscopehttp://en.wikipedia.org/wiki/Nuchal_scanhttp://en.wikipedia.org/wiki/Twinhttp://en.wikipedia.org/wiki/Obstetric_ultrasonographyhttp://en.wikipedia.org/wiki/Obstetric_ultrasonographyhttp://en.wikipedia.org/wiki/Uterushttp://en.wikipedia.org/wiki/Transvaginal_oocyte_retrievalhttp://en.wikipedia.org/wiki/Prenatal_diagnosis#cite_note-5http://en.wikipedia.org/wiki/Human_embryohttp://en.wikipedia.org/wiki/In_vitro_fertilizationhttp://en.wikipedia.org/wiki/Preimplantation_genetic_diagnosishttp://en.wikipedia.org/wiki/Preimplantation_genetic_diagnosishttp://en.wikipedia.org/wiki/Preimplantation_genetic_diagnosishttp://en.wikipedia.org/wiki/Baby_Gender_Mentorhttp://en.wikipedia.org/wiki/Aneuploidy


16/16

preserveamniotic stem cells.

MORE INVASIVE

Embryoscopy

and

Fetoscopy

Though rarely done, these involve putting a probe into a women's

uterus to observe (with a video camera), or to sample blood or tissue

from the embryo or fetus.

MORE INVASIVE

Percutaneous

Umbilical CordBlood Sampling
http://en.wikipedia.org/wiki/Cryopreservehttp://en.wikipedia.org/wiki/Amniotic_stem_cellshttp://en.wikipedia.org/wiki/Amniotic_stem_cellshttp://en.wikipedia.org/wiki/Amniotic_stem_cellshttp://en.wikipedia.org/w/index.php?title=Embryoscopy&action=edit&redlink=1http://en.wikipedia.org/w/index.php?title=Embryoscopy&action=edit&redlink=1http://en.wikipedia.org/wiki/Fetoscopyhttp://en.wikipedia.org/wiki/Fetoscopyhttp://en.wikipedia.org/wiki/Percutaneous_umbilical_cord_blood_samplinghttp://en.wikipedia.org/wiki/Percutaneous_umbilical_cord_blood_samplinghttp://en.wikipedia.org/wiki/Percutaneous_umbilical_cord_blood_samplinghttp://en.wikipedia.org/wiki/Percutaneous_umbilical_cord_blood_samplinghttp://en.wikipedia.org/wiki/Percutaneous_umbilical_cord_blood_samplinghttp://en.wikipedia.org/wiki/Percutaneous_umbilical_cord_blood_samplinghttp://en.wikipedia.org/wiki/Percutaneous_umbilical_cord_blood_samplinghttp://en.wikipedia.org/wiki/Fetoscopyhttp://en.wikipedia.org/w/index.php?title=Embryoscopy&action=edit&redlink=1http://en.wikipedia.org/wiki/Amniotic_stem_cellshttp://en.wikipedia.org/wiki/Cryopreserve

All Charts and Diagnostics

Documents

Transcript of All Charts and Diagnostics