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Antenatal Testing

by Veronica Gillispie, MD, FACOG
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    Now we will discuss antenatal testing. So the purpose of antenatal testing is to ensure fetal well being. And when we say reassure us or ensure fetal well being, we mean that there are no signs of fetal asphyxia. So let's first talk about the non-stress test. So the non-stress test is performed by doing the external fetal monitoring to look at the fetal heart rate. We then determined if the fetal heart rate is reactive which means fetal well being is reassured or is it non-reactive. Meaning there is additional testing needed to be done to assure fetal well being. Reactive and this is very important, means that there is two accelerations of greater than 15 beats per minute lasting at least 15 seconds over a 20 minute time period. So again you are looking at a 20 minute time period on the external fetal monitor and you're looking to find two accelerations of greater than 15 beats per minute each lasting for at least 15 seconds. So the next type of antenatal testing is the biophysical profile. Now with the biophysical profile, you're looking at 5 different categories expecting to see certain things in this category. Patients are given a two if the fetus performs the maneuvers that we're looking for and 0 if they do not perform the maneuvers. Again give 30 minutes to observe it. So we're looking at fetal movement, we're looking at fetal tone, fetal breathing, the amniotic fluid and again the non-stress test. So with the fetal movement we're looking to see three growth movements within that 30 minute time period. Fetal tone is looking for 5 movements, like the hands moving, the fingers, opening and closing the palm. Fetal breathing we're looking for sustained breathing for 30 seconds over that 30 minute...

    About the Lecture

    The lecture Antenatal Testing by Veronica Gillispie, MD, FACOG is from the course Antenatal Care. It contains the following chapters:

    • Antenatal Testing
    • Non-Stress Test
    • Biophysical Profile
    • Contraction Stress Test

    Included Quiz Questions

    1. 2 accelerations of over 15 beats per minute from the baseline fetal heart rate, each lasting over 15 seconds, are seen on a 20 minute strip.
    2. 2 accelerations of 10 beats per minute from the baseline fetal heart rate, each lasting 15 seconds, are seen on a 20 minute strip.
    3. 2 accelerations of 15 beats per minute from the baseline fetal heart rate, each lasting over 15 seconds, are seen on a 30 minute strip.
    4. 1 acceleration of 15 beats per minute from the baseline fetal heart rate lasting 15 seconds is seen on a 10 minute strip.
    5. 1 acceleration of 20 beats per minute from the baseline fetal heart rate, lasting 30 seconds, is seen on a 20 minute strip.
    1. Umbilical artery doppler
    2. Fetal tone
    3. Fetal breathing
    4. Amniotic fluid volume
    5. External fetal heart rate monitoring
    1. 4/8, plan to deliver immediately
    2. 6/8, further testing recommended
    3. 6/10, plan to deliver
    4. 4/10, further testing required
    5. 8/10, fetal reassurance.
    1. If more than 50% of induced contractions are associated with late decelerations in the fetal heart rate over 10 minutes.
    2. If less than 50% of induced contractions of associated with late decelerations in the fetal heart rate over 10 minutes.
    3. If no accelerations are noted over a period of 20 minutes of monitoring.
    4. If greater than 2 accelerations are noted over a period of 20 minutes of monitoring.
    5. If there are no decelerations observed over 20 minutes.
    1. That there are no signs of fetal asphyxia
    2. That there are is normal fetal movement
    3. That there are no signs of fetal growth restriction
    4. That there is enough amniotic fluid
    5. That there is normal umbilical artery flow
    1. Perform an umbilical artery doppler to evaluate for increased resistance in the placenta
    2. Perform a non-stress test
    3. Perform a contraction stress test
    4. Perform a biophysical profile
    5. Advise the patient to quit smoking immediately

    Author of lecture Antenatal Testing

     Veronica Gillispie, MD, FACOG

    Veronica Gillispie, MD, FACOG


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