Risk Factors in Pregnancy

Too much amniotic fluid.

• 1. Diabetes mellitus
• 2. Fetal congenital anomalies

Intrauterine Growth Restriction

• HTN disorders
• Diabetes
• thrombophilia
• chronic renal disease
• poor weight gain
• smoking, ETOH, illicit drug use
• cyanotic heart disease
• multiple gestation

• chromosomal abnormalities
• congenital malformations
• intrauterine infection
• genetic syndromes (trisomy 13 & 18)
• abnormal placental development

Too little amniotic fluid

• renal agenesis (Potter syndrome)
• premature rupure of membranes
• prolonged prgnancy
• uteroplacental insufficiency
• maternal HTN disorders

Maternal age of >35

• Daily Fetal Movement Count
• used to monitor fetus in pregnancies complicated by conditions tha mya affect oxygenation.
• Also called kick counts. Fewer than 3 kick in 1 hour warrants further evaluation.

• fetal heart activity
• gestational age
• fetal growth (measure head, abdomen)
• fetal anatomy
• fetal genetic disorders & physical anomalies
• placental position and function
• adjunct to other invasive tests

Ultra sound looking at blood flow flow through umbilical cord to make sure getting O2's needed.

Looks at amniotic fluid volume and making sure baby is getting enough O2's

If score is >6 then baby is OK, if <6 then worrisome that baby is not getting enough O2's. If <20 weeks gestation, there is nothing that can really be done.

To see if hemolytic anemia and check the Rh factor. (baby's cell's attacking mom's)

• Percutaneous Umbilical Blood Sampling
• 1. Direct access to fetal circulation during 2nd & 3rd trimesters.
• 2.Used for fetal blood sampling and transfusion
• 3.Insertion of needle directly into fetal umbilical vessel under US guidance

• Miscarriage
• infection
• ruptured membranes

• 1. Chorionic villus sampling
• 2. Instead of an amniocentesis,
• technique for genetic studies

• 1. Miscarriage is the risk
• 2. transvaginally with small catheter to placenta, removal of small tissue specimen from fetal portion of placenta. Performed 10 & 12 weeks of gestation.

• Maternal Serum Alpha-Fetoprotein
• 1. Used as screening tool for neural tube defects (NTDs) in pregnancy (spinal bifida)
• 2. Recommended for all pregnant women

• Test for Rh incompatibility.
• Detects other antibodies that may place fetus at risk for incompatibility with maternal antigens.