1.

ULTRASONOGRAPHY
A. Definition – It is an imaging technique that uses sound waves to produce images of a
fetus in the uterus.
B. Purposes - It is to check the baby's development and to help pick up any abnormalities.
C. Preparation
 Empty your bladder 90 minutes before exam time.
 Consume one 8-ounce glasses of fluid about an hour before exam time.
 Arrive in your appointment without urinating before the ultrasound, arrive with a
full bladder.
D. Major risks
An ultrasound carries minimal risks. Unlike X-rays or CT scans, ultrasounds use no
radiation. For this reason, they are the preferred method for examining a developing
fetus during pregnancy.

2. NON-STRESS TEST(BST)
A. Definition - A nonstress test is a common prenatal test used to check on a baby's health.
B. Purposes - During a nonstress test, the baby's heart rate is monitored to see how it
responds to the baby's movements.
C. Preparation
 You will have your blood pressure taken before the nonstress test begins.
D. Interpretation
 Reactive
 Nonreactive
E. Implication
 Reactive. Before week 32 of pregnancy, results are considered normal (reactive)
if your baby's heartbeat accelerates to a certain level above the baseline twice or
more for at least 10 seconds each within a 20-minute window. At week 32 of
pregnancy or later, if your baby's heartbeat accelerates to a certain level above
the baseline twice or more for at least 15 seconds each within a 20-minute
window, the results are considered reactive.
 Nonreactive. If your baby's heartbeat does not meet the criteria described above,
the results are considered nonreactive. Nonreactive results might occur because
your baby was inactive or asleep during the test.
F. Major risks
It is a non-invasive test used for the surveillance of high-risk pregnancies when the fetus
is judged clinically to be at risk for hypoxemia or increased risk of death.

3. OXYTOCIN CHALLENGE TEST (OCT) OR CONTRACTION STRESS TEST (CST)

 A. Definition - A contraction stress test (CST) is performed near the end of pregnancy (34
weeks' gestation) to determine how well the fetus will cope with the contractions of
childbirth.
B. Purposes
 The contraction stress test helps predict how your baby will do during labor.
C. Preparation
 You will lie down with two belts around your belly.
 One measures your baby's heartbeat and the other measures contractions.
 To trigger contractions, your doctor may give you a dose of the drug oxytocin
through an IV in your arm. Or your doctor may suggest that you rub your nipples
through your clothing, which can start contractions.
 Then you wait while the monitors record contractions and your baby's heartbeat.

D. Interpretation/Implication
 If the baby's heart rate drops during contractions, it could be a sign of problems.
The doctor may suggest further testing. Sometimes, early delivery is the best
option.
 If the baby's heart rate stays normal during the test, it implies that there are no
problems and during labor the baby will be able handle the delivery.
E. Major Risks
 It may cause labor to start sooner than your expected delivery date.
 It may cause contractions that go on for a long time. This may cause problems
with your baby. The contractions usually stop when the oxytocin is stopped. You
may get a medicine to stop the contractions. In very rare cases, the contractions
don't stop. If that happens, your doctor may suggest delivery.
4.NIPPLE-STIMULATION CONTRACTION TEST
A. Definition - Nipple stimulation is an effective way to induce labor, backed by scientific
research.
B. Purposes - This helps initiate labor and makes contractions longer and stronger.
C. Preparation
 The nurse instructs the patient on the procedure, as follows. One nipple is
massaged gently through clothing until a contraction begins, or for a maximum of
2 minutes.
 If at least 3 contractions in 10 minutes is not achieved, then the patient rests for 5
minutes and the other nipple is stimulated.
D. Interpretation/Implication

Interpretation Implication
Positive Presence of late decelerations with at
least 50% of the contractions
Negative No late or significant variable
decelerations, with at least 3 uterine
contractions (lasting 40 seconds) in 10-
minute period.
Equivocal—Suspicious Presence of late decelerations with fewer
than 50% of contractions or significant
 variable decelerations. Requires repeat
testing on following day.
Equivocal—Tachysystole Presence of contractions that occur more
frequently than every 2 minutes or last
longer than 90 seconds in the presence of
late decelerations. Requires repeat
testing on following day.
Equivocal—Unsatisfactory Fewer than three contractions occur
within 10 minutes, or a tracing quality that
cannot be interpreted. Requires repeat
testing on following day.

E. Major Risks
 The test is riskier for women who have placenta previa, a higher risk of uterine
rupture, or who had a previous C-section.

5. BIOPHYSICAL PROFILE (BPP)

A. Definition - A biophysical profile (BPP) test measures the health of your baby (fetus)
during pregnancy.
B. Purposes - The BPP measures your baby's heart rate, muscle tone, movement,
breathing, and the amount of amniotic fluid around your baby.
C. Preparation
 You may be asked to drink water or other liquids just before testing. You will be
able to empty your bladder after the test.
 Non-stress test
 Fetal ultrasound

D. Interpretation/Implication
BPP measures five areas of your baby's health (heart rate, breathing, movement,
muscle tone, and amniotic fluid) on a numeric scale of zero to two. When the scores are
combined, results indicate the following:
 A total of eight to 10 indicates that your baby is healthy.
 A point-total of six to eight will require you to have the test repeated in 12 to 24
hours.
 If the score is four or less, this indicates the baby is having problems, and further
testing will be necessary to identify the challenges the baby may be facing.
E. Major Risks
There is very little chance of either the mother or the baby having a problem from a
biophysical profile (BPP). But you may feel anxious if the ultrasound reveals a problem
with your pregnancy or baby. A nonstress test may falsely show distress in a baby that is
actually healthy.

6. AMNIOCENTESIS
 A. Definition - Amniocentesis is a procedure in which amniotic fluid is removed from the
uterus for testing or treatment.
B. Purposes – For prenatal diagnosis of chromosomal abnormalities and fetal infections as
well as for sex determination.
C. Preparation
 If you're having amniocentesis done before week 20 of pregnancy, it might be
helpful to have your bladder full during the procedure to support the uterus. Drink
plenty of fluids before your appointment. After 20 weeks of pregnancy, your
bladder should be empty during amniocentesis to minimize the chance of
puncture.
D. Interpretation/Implication
 Normal result- This means that none of the conditions that were tested for were
found in the baby.
 Positive result – The baby has 1 or more of the conditions they were tested for.
E. Major Risks
Amniocentesis carries various risks, including: Leaking amniotic fluid, Miscarriage,
Needle injury, Rh sensitization, Infection, and Infection transmission.

7. X RAY LATERAL PELVIMETRY

A. Definition - X-ray pelvimetry is a radiological investigation that involves the measurement
of different anthropometric dimensions of the pelvis.
B. Purposes – To identify babies whose heads are too big for their mother's pelvis that may
interfere in normal labor.
C. Preparation
 X-rays are usually avoided during pregnancy because there's a small chance the
radiation may harm the developing baby.
 Double precaution because the patient is pregnant.
 Empty bladder
 The patient will be asked to remove some clothing, jewelry, or any metal objects
that might interfere with the image.

D. Interpretation/Implication
 Appropriate size of the pelvis and head of the baby – Normal delivery is
suggested.
 Small Pelvis and big size of the head of the baby – Caesarean section is
recommended.
E. Major Risks
There is a big chance the radiation may harm the developing baby.

8. SERIAL ESTRIOL DETERMINATION

A. Definition – It is an integral part of the evaluation and monitoring of high-risk obstetric
patients for fetal well-being.
B. Purposes - To evaluate serial measurements of estriol (E3) to detect increased risk of
chromosomal or congenital anomalies.
 C. Preparation
 24 hour Urine sample is needed.
 Blood sample
D. Interpretation/Implication
 If levels of unconjugated estriol are in normal result the baby is in a normal
without any chromosomal or congenital anomalies.
 If levels of unconjugated estriol (uE3 or free estriol) are abnormally low in a
pregnant woman, this may indicate chromosomal or congenital anomalies like
Down syndrome or Edward's syndrome.

9. CHORIONIC VILLI SAMPLING

A. Definition - Chorionic villus sampling (CVS) is a prenatal test in which a sample of
chorionic villi is removed from the placenta for testing.
B. Purposes - Chorionic villus sampling can reveal whether a baby has a chromosomal
condition, such as Down syndrome, as well as other genetic conditions, such as cystic
fibrosis.
C. Preparation
 Genetic counseling
 Detailed discussion regarding the risks and benefits of the procedure
 Ultrasound exam will be performed to confirm gestational age (the development
stage of the embryo) and the location of the placenta.

D. Interpretation/Implication
 Normal result - The baby will not have any of the disorders that were tested for.
 Positive result - The baby has the disorder that was being tested for.
E. Major risks
CVS may carry a slightly higher risk of miscarriage than amniocentesis, because the
procedure is done in early pregnancy. Infection may also occur.
10. PERCUTANEOUS UMBILICAL BLOOD SAMPLING (PUBS)
A. Definition – It is test used to exam fetal blood directly from the umbilical cord.
B. Purposes - It is used to detect disorders in the fetus.
C. Preparation
 If the patient is 23 or more weeks pregnant, the patient will be asked to avoid
eating or drinking after midnight the night before cordocentesis. This is because
certain complications caused by the procedure might require an emergency
cesarean section.
D. Interpretation/Implication
Positive results:
 Infection – need immediate treatments.
 Severe Anemia – The fetus might need a blood transfusion through the umbilical
cord.
E. Major risks
 The miscarriage rate after PUBS is about 2%.
  As with amniocentesis, there is a risk of infection, cramping, and bleeding.

REFERENCES:

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%20nonstress%20test
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Pattinson, R., Cuthbert, A., & Vannevel, V. (2017). Pelvimetry for fetal cephalic presentations at
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Prenatal Test: Percutaneous Umbilical Blood Sampling (PUBS) (for Parents) - Nemours
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