Nursing 209

N209: Reproductive Health Study Guide

Third Trimester Testing • Group B streptococcus o Vaginal and rectal swab taken between 35-37 weeks gestation o Can cause potentially life-threatening illness in newborn if untreated o Administration of IV antibiotics to mother during labor is the only proven protection for early onset disease • STD testing o Along with HIV testing, may be repeated in high risk population at 35 weeks • Electronic fetal monitoring o Assesses fetal heart rate (FHR) and uterine activity (UA) after 20 th week of pregnancy o Non-stress test  Initiated after 28 th week of gestation  Performed in high risk pregnancies to assess fetal well-being and placental function (diabetes, post dates, and prior pregnancy complications)  Reactive: 15 second acceleration of FHR with 15 beat amplitude twice in a 20 minute period after 32 weeks gestation (less than 32 weeks: 10 second acceleration with 10 second beat amplitude) • Contraction stress test o NST with induced contractions (with nipple stimulation or oxytocin) o Assesses placental function and fetal tolerance to labor o Require three contractions in a 10-minute period o Risk for hyperstimulation with nipple stimulation o Contraindicated in previous c/s, PROM, bleeding, and hypersensitivity to oxytocin o Positive CST may indicate placental insufficiency • Biophysical profile o Assessment of fetal well-being; usually initiated after nonreactive NST result o Ultrasound is used to assess parameters, with a total of 10 points (result is all or nothing for each parameter, either 0 or 2) within 30 minutes o Parameters include breathing, gross body movement, flexion/extension, AFI, and NST o 8-10: Wnl; 6: Equivocal; 4 or less: Abnormal 3.9 Fetal Growth Conception and Fertilization • Occurs during ovulation when sperm joins with the egg; once membrane surrounding the egg has been penetrated by the sperm, it becomes impermeable to other sperm and forms a zygote • If more than one egg is released, there is potential for multiple zygotes

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