Positive findings strong predictor of preterm labor or rupture of the membranes

Positive findings strong predictor of preterm labor

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Positive findings = strong predictor of preterm labor or rupture of the membranes w/in 2 weeks of positive test o fFN levels are measured with an enzyme immunoassay o fFN is present the first half of pregnancy o Is NOT present after 20 weeks o Is found in amniotic fluid (possible ROM) o Is present again near term o Found in cervical area (swab) as well as amniotic fluid (AF) o Because sexual intercourse within the previous 24 hrs, vaginal creams, and recent vaginal exams can cause false findings, they should be avoided prior to a fetal fibronectin (fFN) test. Percutaneous Umbilical Blood Sampling (PUBS) or Cordocentesis—obtain blood from umbilical cord o helps Dx blood disorders (hemophilias, hemoglobinopathies) and incompatibilities, fetal infections, chromosomes abnormalities, non-immune hydrops, and isoimmune hemolytic disorders. o Risks: bleeding from sampling site, premature ROM, chorioamnionitis, and fetal bradycardia Chapter 22 Critical Factors in Labor=4 TQ Birth Passageway (R/T type of pelvis) o Gynecoid (50%) : “female pelvis” and Anthropoid—favorable to vaginal birth o Android (20%) “male pelvis” and platypelloid pelvises—not favorable to vaginal birth; difficult labor
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Birth passenger (Fetus) o Fetal attitude—refers to the relation of the fetal body parts to one another; posture the fetus assumes as it conforms to the shape of the uterine cavity (usually a flexed position) o Fetal lie—the relationship of the long, or cephalocaudal axis (spinal column) of the fetus to the long, or cephalocaudal axis of the mother Longitudinal=vertical lie cephalocaudal axis of mother and baby are parallel; transverse=horizontal lie; axis are perpendicular o Fetal presentation—determine by fetal lie and refers to the body part of the fetus that enter the maternal pelvis first and leads through the birth canal during labor Presenting part=portion of the fetus that is felt through the cervix on vaginal exam Cephalic: head first; four types/presenting part: vertex=occiput; sinciput=occipitofrontal diameter; brow=occipitomental diameter; face: submentobregmatic diameter Breech: lower extremities or buttocks Breech=complete=baby sitting Indian style; footling breech position=one foot is trying to come down; frank breech=legs are up and butt is down; Can be delivered vaginally, but more dangerous Shoulder Relationship of Maternal Pelvis and Presenting Part o Engagement—occurs when the largest diameter of presenting part reaches or passes through the pelvic inlet; ex. In cephalic presentation, the biparietal diameter is the largest dimension to pass through the pelvic inlet; ; at zero station the baby is engaged o Station—refers to the relationship of the presenting part of an imaginary line drawn between the ischial spines of the maternal pelvis; ; in a normal pelvis the ischial spines mark the narrowest diameter through which the fetus must pass Negative number=presenting part is above the ischial spines
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