Obstetrics Book

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Fetal Testing Indications

Aka: Fetal Testing Indications
  1. See Also
    1. Fetal Assessment
    2. Fetal Testing Indications
    3. Fetal Heart Tracing
  2. Background: Abbreviations
    1. NST: Nonstress Test
    2. AFI: Amniotic fluid index
  3. Protocol: Gestational Diabetes
    1. Class A1 (diet controlled, no complications)
      1. NST/AFI: bi-weekly starting at 40 weeks
    2. Class A2 and B (Insulin controlled, no complications)
      1. NST/AFI: Weekly starting at 32 weeks
      2. Ultrasound: Monthly starting at 36 weeks for EFW
    3. Class A or B with poor control, or Classes B-D
      1. NST/AFI: bi-weekly starting at 32 weeks
      2. Obstetric Ultrasound: Monthly starting at 32 weeks
    4. Classes F, H, R, T
      1. NST/AFI: bi-weekly starting at 28 weeks
      2. Obstetric Ultrasound: Monthly starting at 28 weeks
  4. Background: Hypertension
    1. Chronic Hypertension Low Risk
      1. NST/AFI: Weekly starting at 34 weeks
      2. Obstetric Ultrasound: Monthly starting at 32 weeks
    2. Chronic Hypertension High Risk
      1. NST/AFI: Bi-weekly starting at 32 weeks
      2. Obstetric Ultrasound: Monthly starting at 28 weeks
    3. Pregnancy Induced Hypertension (PIH)
      1. NST/AFI: Bi-weekly starting at time of diagnosis
  5. Background: Assorted Maternal Conditions
    1. Maternal Anemia, Sickle Cell Disease (Hematocrit < 28%)
      1. NST/AFI: Weekly starting at 34 weeks
    2. Seizure Disorder
      1. NST/AFI: Weekly starting at 34 weeks
    3. Hyperthyroidism
      1. NST/AFI: Weekly starting at 34 weeks
    4. Maternal Heart Disease
      1. NST/AFI: Weekly starting at 34 weeks
      2. Obstetric Ultrasound: Monthly starting at 28 weeks
    5. Maternal Renal or Collagen Vascular disease
      1. NST/AFI: Weekly starting at 28-30 weeks
      2. Obstetric Ultrasound: Monthly starting at 28 weeks
    6. Advanced Maternal Age (>34 yo)
      1. NST/AFI: Weekly starting at 36 weeks
    7. Asthma (Symptomatic)
      1. NST/AFI: Weekly starting at 34 weeks
    8. Third Trimester abdominal surgery (e.g. Appendectomy)
      1. NST/AFI: Weekly starting at date of surgery
    9. Post-term (>41 weeks)
      1. NST/AFI: Bi-weekly starting at 41 weeks
    10. Previous fetal demise or Stillbirth
      1. NST/AFI: Weekly starting at time of IUFD or 32 weeks
  6. Background: Placenta Conditions
    1. Placenta Previa
      1. NST/AFI: Weekly starting at 34 weeks
    2. Chronic Abruption
      1. NST/AFI: Weekly starting at diagnosis
      2. Obstetric Ultrasound: Monthly starting at diagnosis
  7. Background: Fetal Conditions
    1. Intrauterine Growth Retardation (IUGR)
      1. NST/AFI: Bi-weekly from time of diagnosis (>28 weeks)
      2. Ultrasound: Bi-Monthly from time of diagnosis
    2. Multiple Gestation
      1. NST/AFI: Weekly starting at 28-32 weeks
      2. Ultrasound: Monthly starting at 28 weeks
    3. Rh Isoimmunization
      1. NST/AFI: Weekly starting at 28 weeks
      2. Ultrasound: Monthly starting at 28 weeks
    4. Polyhydramnios (Amniotic fluid index >20)
      1. NST/AFI: Weekly starting at 32 weeks
    5. Oligohydramnios (Amniotic fluid index <5)
      1. NST/AFI: bi-weekly starting at 28 weeks

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