Mid 104 Activity Learning 1 PDF
Mid 104 Activity Learning 1 PDF
Mid 104 Activity Learning 1 PDF
CITY UNIVERSITY
San Vicente West, Urdaneta City, Pangasinan 2428
urdanetacityuniversity@yahoo.com
(075) 568-7612 / (075) 568-2475 loc. 110
E-mail: ucu.reg@gmail.com
SCHOOL OF MIDWIFERY
Established in 1973
Level II Accreditation Status-ALCU-COA
least 15 seconds on two separate occasions during a 20-minute span, the result is normal, or "reactive." A
normal result means that your baby is probably doing fine for now. NST has no risks to mother and her
baby.
Here are some reasons you might have a non-stress test:
You have diabetes that's treated with medication, high blood pressure, or some other medical condition
that could affect your pregnancy.
You have gestational hypertension.
Your baby appears to be small or not growing properly.
Your baby is less active than normal.
You have too much or too little amniotic fluid.
You've had a procedure such as an external cephalic version (to turn a breech baby) or third trimester
amniocentesis (to determine whether your baby's lungs are mature enough for birth or to rule out a
uterine infection). Afterward, your practitioner will order a non-tress test to make sure that your
baby's doing well.
You're past your due date and your practitioner wants to see how your baby is holding up during his
extended stay in the womb.
You've previously lost a baby in the second half of pregnancy, for an unknown reason or because of a
problem that might happen again in this pregnancy. In this case, non-stress testing may start as
early as 28 weeks.
You have a medical problem that may jeopardize your baby's health.
Your baby has been diagnosed with an abnormality or birth defect and needs to be monitored.
INTERPRETATION OF NON-STRESS TEST (NST)
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Accelerations Accels
*15 x 15 the acme of the acceleration is >15 beats/minute above the baseline, and
the acceleration lasts >15 seconds and <2 minutes from the onset to return to baseline.
*10 x 10 for preterm <32 weeks, having an acme >10 beats/min above the baseline with a duration
of >10 seconds from onset to the return to baseline.
II.
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If current uterine activity consists of three contractions of at least forty seconds duration
occurring within a ten minutes period, the fetal heart rate response to these contractions
will be evaluated. The administration of Oxytocin is not necessary and the test is complete.
If the level of uterine activity does not meet the above criteria Oxytocin will be given to
stimulate or increase uterine contractions.
The Oxytocin is always given as a piggyback infusion. The line with the Oxytocin should
be connected to the mainline at the most proximal port to the IV insertion site. The
Oxytocin infusion will always be regulated by using an infusion pump.
The Oxytocin infusion for the OCT will begin at 0.5 mU/min and the infusion rate may be
doubled every 20 minutes until uterine activity begins.
Once uterine activity is established smaller increments for Oxytocin increases may be used
until adequate uterine activity is achieved. Adequate uterine activity is defined, for the
purpose of this test, as 3 contractions of at least 40 seconds, duration within a 10 minutes
window.
Smaller increases may decrease the risk of uterine hyperstimulation
If the Oxytocin infusion is at a rate of 16 mU/min and uterine activity has not been
established notify the provider.
At a dose of 16mU/min the incremental increasing of Oxytocin will decrease to 0.5-1.0
mU/min every 15 minutes.
III. Contraindications
This "stress test" is usually not performed if there are any signs of premature birth, placenta Previa,
vasa Previa, cervical incompetence, multiple gestation, previous classic caesarian section. Other
contraindications include but are not limited to previous uterine incision with scarring, previous
myomectomy entering the uterine cavity, and PROM. Any contraindication to labor is contraindication to
CST.
IV. Interpretation of Result of NONTRACTION STRESS TEST
Result
Interpretation
Positive (Abnormal)
Negative(Normal)
Equivocal
Suspicious
Equivocal
Tachysystole
Equivocal
Unsatisfactory
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Abnormal (0 points)
Fetal Breathing
movements
Qualitative AFV/AFI
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Normal (2 points)
No movements of movements
slow & incomplete
Each assessment is graded either 0 or 2 points, and then added up to yield a number between 0 and
10. A BPP of 8 or 10 is generally considered reassuring.
The presence of these biophysical variables implies absence of significant central nervous system
hypoxemia/acidemia at the time of testing.
By comparison, a compromised fetus typically exhibits loss of accelerations of the fetal heart rate
(FHR), decreased body movement and breathing, hypotonia, and, less acutely, decreased amniotic
fluid volume.
Recommended Management
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Labor Induction
Midwife Responsibilities
Educate and explain to patient about the procedure, inform that ultrasound might need to be done
with a full bladder and she will likely have blood pressure taken before the test and at regular
intervals during the test.
When an abnormal biophysical profile is obtained, the responsibility of midwife should be
informed immediately the doctor and refer the patient if needed. Further management will be
determined by the overall clinical situation.
Document and explain the result of BPP, Advice pt. of health education of causes and extra
precautions of BPP
4. DOPPLER VELOCIMETRY - is a way to make sure that your baby is getting a healthy supply of
blood. It is to monitor the heartbeat and used to hear an unborn child's heartbeat. You may also need the
test if you have preeclampsia, have a low level of amniotic fluid or IUGR ( intrauterine growth retardation)
due to smoking, alcohol and drugs.
Doppler velocimetry uses ultrasound to check blood flow in the umbilical cord or between the uterus, aorta,
heart and placenta. If the blood supply is restricted, your baby can't get enough nutrients and oxygen.
Doppler velocimetry is painless and safe non-invasive procedure and assessment of circulation in many
clinical conditions. It's similar to a standard ultrasound. A technician will gently press an ultrasound probe
against the outside of your belly.
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3. Discuss the biophysical profile which is a combination of five biophysical variables. Enumerate
and explain the Midwifery responsibilities for each.
ANSWER: A fetal biophysical profile is a prenatal test used to check on a baby's well-being. The test
combines fetal heart rate monitoring (non-stress test) and fetal ultrasound. During a biophysical profile, a
baby's heart rate, breathing, movements, muscle tone and amniotic fluid level are evaluated and given a
score.
Typically, a biophysical profile is recommended for women at risk of pregnancy loss. The test is
usually done after week 32 of pregnancy, but can be done when your pregnancy is far enough along for
delivery to be considered
BPP is done to Check on your baby's health if you have Hyperthyroidism, Bleeding problems,
Lupus, Type 1 diabetes or gestational diabetes, High blood pressure (hypertension), Preeclampsia, A small
amount of amniotic fluid (oligohydramnios) or too much amniotic fluid (polyhydramnios), A multiple
pregnancy (such as twins or triplets), A pregnancy that has gone past your due date, between 40 and 42
weeks.
The BPP has 5 components: 4 ultrasound assessments and an NST. The NST evaluates fetal heart
rate and response to fetal movement.
The 5 discrete Biophysical variables:
Component
Criteria
Fetal
Movement
Amniotic Fluid Volume At least one cord and limb-free fluid pocket which is 2 cm by 2 cm in two
(AFV)
measurements at right angles.
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c. Fetal breathing- Fetal breathing. If your baby displays at least one episode of rhythmic breathing
for 30 seconds or more within 30 minutes, 2 points will be given. If your baby's breathing doesn't
meet the criteria, 0 points will be given
d. Amniotic fluid volume- Amniotic fluid level. The ultrasound technician will look for the largest
visible pocket of amniotic fluid. To obtain a score of 2 points, the pocket must be a certain size. If
your amniotic fluid level doesn't meet the criteria, 0 points will be given.
Midwife Responsibilities:
Explain the procedure that pregnant may need a full bladder for the test. If so, pregnant will be
asked to drink water or other liquids just before the test and to avoid urinating before or during the
test. Usually women in the third trimester do not need to have a full bladder.
Inform pregnant if she smoke, she will be asked to stop smoking for 2 hours before the external
monitoring test because smoking decreases your baby's activity.
Midwife should inform about any concerns that have regarding the need for the test, its risks, how
it will be done, or what the results may mean. To help her understand the importance of this test,
fill out the medical test information form.
Give Health teaching in healthy lifestyle like proper diet, exercise.
Prepared by:
DR. AMELIA C. FERNANDO
University Physician
Noted by:
DR. CHRISTOPHER R. BAEZ
Dean
Submitted by:
FRIDALYN MOJICA
3rd Year BSM
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