The OB provider is concerned about placental perfusion and intrauterine growth restriction (IUGR) after noting minimal fetal growth over the past month.

What non-invasive antenatal test would the nurse anticipate the provider will order?

Choice A rationale
Variable decelerations are not related to the use of narcotic analgesics. Narcotic analgesics can cause other fetal heart rate changes, such as decreased variability, but they do not cause variable decelerations.
Choice B rationale
Variable decelerations are due to umbilical cord compression. This is the correct interpretation. Umbilical cord compression can lead to transient decreases in fetal blood flow and oxygenation, resulting in variable decelerations on the fetal monitor tracing.
Choice C rationale
Variable decelerations are not caused by maternal hypotension. Maternal hypotension can lead to late decelerations due to uteroplacental insufficiency, but it does not cause variable decelerations.
Choice D rationale
Variable decelerations are not indicative of fetal hypoxia. While severe and persistent variable decelerations can lead to fetal hypoxia, the primary cause of variable decelerations is umbilical cord compression.

Choice A rationale
Amniocentesis is a diagnostic test that involves extracting a small amount of amniotic fluid from the uterus to test for chromosomal abnormalities and genetic disorders. It is typically performed between 15 and 20 weeks of pregnancy. The fluid contains fetal cells and various chemicals produced by the baby, which can be analyzed to detect conditions such as Down syndrome, trisomy 18, and neural tube defects. This test is highly accurate and is often recommended when screening tests like the MSAFP indicate a potential issue.
Choice B rationale
A Nonstress Test (NST) is a non-invasive test that measures the fetal heart rate in response to its movements. It is used to assess fetal well-being, particularly in the third trimester, but it does not provide information about chromosomal abnormalities. The NST is typically used to monitor high-risk pregnancies and to ensure that the fetus is receiving enough oxygen.
Choice C rationale
A Biophysical Profile (BPP) combines an ultrasound with a Nonstress Test to evaluate the fetus’s health. It assesses fetal breathing movements, body movements, muscle tone, amniotic fluid volume, and heart rate reactivity. While it provides a comprehensive assessment of fetal well-being, it does not specifically diagnose chromosomal abnormalities. The BPP is often used in the third trimester to monitor high-risk pregnancies.
Choice D rationale
Chorionic Villus Sampling (CVS) is another diagnostic test that can detect chromosomal abnormalities and genetic disorders. It involves taking a small sample of placental tissue (chorionic villi) for analysis. CVS is typically performed between 10 and 13 weeks of pregnancy, earlier than amniocentesis. While it provides similar diagnostic information, it is not the test of choice following an abnormal MSAFP result, which is usually conducted later in pregnancy.