Medical Terminology: Maternity Tests

1. What are Maternity Tests?
There are several tests that are performed during pregnancy and shortly after childbirth to assess the health of the fetus and newborn. In a high-risk pregnancy, the health care provider might perform a chorionic villus sampling or amniocentesis early on in the pregnancy to determine if the fetus has a genetic disorder or other health issues.
Amniocentesis, for example, may be suggested in high-risk pregnancies that have a high risk of birth defects. This condition is confirmed by performing a cordocentesis, in which a sample of blood is taken from the umbilical cord while in the womb.
Later in the pregnancy, the health care provider performs a biophysical profile of the fetus to determine the overall health of the fetus. This is where an assessment is made of the fetal heart rate, breathing and body movements, muscle tone, and the volume of amniotic fluid.
It is also around this same period when the mother may undergo a contraction stress test. The contraction stress test determines if the fetus is healthy enough to survive the reduced oxygen levels that are common with natural childbirth.
In some pregnancies, the woman might experience an incompetent cervix that could result in the cervix opening prior to the thirty-seventh week of gestation, causing a premature birth. In this situation, the health care provider is likely to perform a cervical cerclage, which temporarily closes the cervix until the mother enters labor.
If the birth is premature, the health care provider may perform a cranial ultrasound to determine if there were complications caused by the premature birth. The newborn is typically administered the sweat test that helps determine if the newborn has a high level of chloride in his or her sweat, which may be an indication of cystic fibrosis.

2. Biophysical Profile (BPP) Test
This test is performed to assess:
- Fetal movement
- Fetal heart rate
- Volume of amniotic fluid
- Muscle tone
- Fetal breathing rate

Understanding the Biophysical Profile Test
The biophysical profile (BPP) BPP assesses the health of the fetus and is commonly performed in the last trimester of the pregnancy, although the health care provider may perform this test earlier and more frequently in high-risk pregnancies. The biophysical profile test consists of a nonstress test and a fetal ultrasound. 

3. Contraction Stress Test
The contraction stress test assesses the health of the placenta and the ability of the fetus to remain healthy during natural childbirth.

Understanding the Contraction Stress Test
The health care provider usually performs a biophysical profile of the fetus to assess breathing, movement, muscle tone, and the volume of amniotic fluid. If the biophysical profile indicates suspicious results, then the health care provider might perform a contraction stress test.
The contraction stress test determines if the fetus will remain healthy during natural childbirth. Uterine contractions reduce oxygen to the fetus, which normally does not harm the fetus. However, some fetuses can become negatively affected by the lower oxygen level so the health care provider might decide on a cesarean birth.
During the contraction stress test a fetal heart monitor is attached to the mother while the mother is administered oxytocin. Oxytocin is a hormone that induces uterine contractions. The fetal heart rate is expected to decelerate during a contraction and accelerate following the contraction. If the heart rate does not accelerate, then the fetus may not remain healthy during natural childbirth.
This test is not usually performed if the mother had a cesarean section in the past, placenta previa, placenta abruptio, incompetent cervix, premature rupture of the amniotic membrane, administered magnesium sulfate, or is pregnant with multiple fetuses.

4. Cranial Ultrasound Test
The cranial ultrasound test assesses the underlying cause of an enlarged head and assesses for:
- Hydrocephalus
- Risk of developing cerebral palsy
- Intraventricular hemorrhage
- Periventricular leukomalacia

Understanding the Cranial Ultrasound Test
A cranial ultrasound is performed on premature newborns to assess complications that might have arisen during the premature birth. During a cranial ultrasound, images of the newborn’s brain are captured, displayed on a computer screen, and stored in a computer. The health care provider might order several cranial ultrasounds weeks apart. Some complications such as intraventricular hemorrhage (IVH) can be detected during the first week of birth, while other complications such as periventricular leukomalacia (PVL) might occur 8. weeks after birth. Periventricular leukomalacia is damaged tissue around the ventricles.
A cranial ultrasound is not performed after the child is 18. months of age because the cranium is fully formed and the fontanelle is closed.

5. Amniocentesis
Amniocentesis is ordered to assess fetal lung development and assess:
- Birth defects
- Chorioamnionitis
- Rh antibodies

Understanding the Amniocentesis Test
Amniotic fluid contains cells shed by the fetus. At about the sixteenth week of gestation, the health care provider may perform amniocentesis, which is the removal of some amniotic fluid. Fetal cells contain amniotic fluid and are analyzed to determine if the fetus has a birth defect. Amniocentesis is also performed during the third trimester if there is a risk of premature birth to determine fetal lung development and assess if the mother has chorioamnionitis, which is infection of the amniotic fluid.
Amniocentesis is ordered if an integrated test is positive, indicating that the fetus has a high chance of having a birth defect. This test includes alpha-fetoprotein (AFP), estriol, inhibin A, and human chorionic gonadotropin (hCG). It is also ordered if parents are carriers of a genetic trait that is likely to be passed on to the fetus. These include cystic fibrosis, Duchenne muscular dystrophy, sickle cell anemia, thalassemia, hemophilia, and Tay-Sachs disease.
Amniocentesis is also performed to determine if the fetus is Rh positive when the mother has the Rh factor. This tests the amniotic fluid for increased bilirubin levels after the twentieth week of gestation, which indicates that the fetal blood cells are being attacked by the mother’s antibodies.
Amniocentesis does not identify all birth defects. There are many birth defects that are not revealed by amniocentesis.

6. Cordocentesis Test
The cordocentesis test assesses the oxygen level in fetal blood, assesses for fetal anemia, and if the fetus is Rh positive.

Understanding the Cordocentesis Test
If amniocentesis or other tests reveal that the fetus might have anemia, the health provider may order a cordocentesis to confirm the finding, typically in the second trimester. A cordocentesis is the sampling of fetal blood from the umbilical cord to determine if the fetus has a blood disorder or is Rh positive. The blood sample is also used to assess the oxygen level in fetal blood.

7. Sweat Test
The sweat test assesses for cystic fibrosis.

Understanding the Sweat Test
The sweat test is administered to a newborn between the age of 2. days and 5. months old to assess if the newborn might have cystic fibrosis. Children who have cystic fibrosis have increased sodium chloride in their sweat. The sweat test measures the amount of chloride in sweat.

8. Chorionic Villus Sampling (CVS) Test
The chorionic villus sampling (CVS) test assesses for fetal genetic disorders.

Understanding the Chorionic Villus Sampling Test
The placenta contains chorionic villi, which are tiny growths that contain the same genetic material as the fetus. CVS is a procedure where a sampling of chorionic villi is biopsied between the tenth and twelfth weeks of gestation and examined to determine if the fetus has a genetic disorder. There are two methods used to biopsy the chorionic villus:
. Transabdominal: A needle is inserted through the abdomen.
. Transcervical: A needle is inserted through the cervix.
Chorionic villus sampling is performed earlier in gestation than amniocentesis.

9. Karyotyping
The karyotyping test assesses for fetal genetic disorders.

Understanding the Karyotyping Test
Karyotyping is a test that determines the number and quality of chromosomes in a cell and is used to detect possible genetic disorders. Tissue samples for karyotyping are typically taken during CVS or amniocentesis.

10. Cervical Cerclage (Weak Cervix)
The cervical cerclage prevents premature opening of the cervix.

Understanding the Cervical Cerclage
If the patient has an incompetent cervix, the cervix might open prior to the thirty-seventh week of gestation and could result in premature birth. The health care provider may perform a cervical cerclage, which is a procedure to close the cervix, to assure that the cervix remains closed until after the thirty-seventh week of gestation.
The cervix must be manually opened before the patient goes into labor; otherwise, the health care provider may perform a cesarean section.

11. Galactosemia Test
The galactosemia test is ordered to screen for galactosemia.

Understanding the Galactosemia Test
A newborn who has galactosemia may experience seizures, brain damage, and mental retardation if its body is unable to convert galactose, which is found in breast milk and formula, into glucose. This is because the newborn lacks three enzymes needed for this process. The galactosemia test determines if these enzymes are present in the newborn’s blood.
These enzymes can also be detected in a urine sample.

Basic Questions
Maternity Tests

1. Why would the health care provider order the biophysical profile (BPP) test?
The biophysical profile (BPP) test is performed to assess fetal movement, fetal heart rate, volume of amniotic fluid, muscle tone, and fetal breathing rate.

2. When is the BPP test performed?
The BPP test is commonly performed in the last trimester of pregnancy, although the health care provider may perform this test earlier and more frequently in high-risk pregnancies.

3. Of what does the BPP test consist?
The BPP test consists of a nonstress test and a fetal ultrasound.

4. What does the BPP test measure?
The BPP test measures breathing movements, body movements, muscle tone, and amniotic fluid volume.

5. What is considered abnormal body movement in the BPP test?
Abnormal body movement in the BPP test is <3. arm, leg, or body movements.

6. What is the purpose of the contraction stress test?
The contraction stress test assesses the health of the placenta and the ability of the fetus to remain healthy during natural childbirth.

7. When might the contraction stress test be ordered?
The contraction stress test might be performed if the result of the BPP is abnormal.

8. Why might a fetus be adversely affected by natural childbirth?
Uterine contractions reduce oxygen to the fetus, which normally does not harm the fetus. However, some fetuses can become negatively affected by the lower oxygen level.

9. How is the contraction stress test performed?
During the contraction stress test, a fetal heart monitor is attached to the mother while the mother is administered oxytocin. Oxytocin is a hormone that induces uterine contractions. The fetal heart rate is expected to decelerate during a contraction and accelerate following the contraction. If the heart rate does not accelerate, the fetus may not remain healthy during natural childbirth.

10. When is the contraction stress test not performed?
This test is not usually performed if the mother in the past has had a caesarean section, placenta previa, placenta abruptio, incompetent cervix, premature rupture of the amniotic membrane, administered magnesium sulfate, or is pregnant with multiple fetuses.

11. When might amniocentesis be performed?
At about the sixteenth week of gestation, the health care provider may perform amniocentesis. Amniocentesis is also performed during the third trimester if there is a risk of premature birth to determine fetal lung development and assess if the mother has chorioamnionitis.

12. Why might the health care provider order an amniocentesis?
Amniotic fluid contains cells shed by the fetus. Fetal cells contain amniotic fluid and are analyzed to determine if the fetus has a birth defect. It is also ordered to assess if the mother has chorioamnionitis, which is infection of the amniotic fluid.

13. How does the health care provider know if fetal blood cells are being attacked by the mother’s antibodies?
Amniocentesis is performed and the amniotic fluid is examined for increased bilirubin levels after the twentieth week of gestation, which indicates that the fetal blood cells are being attacked by the mother’s antibodies.

14. When might amniocentesis be ordered?
Amniocentesis is ordered if an integrated test is positive, indicating that the fetus has a high chance of having a birth defect. This test includes alpha-fetoprotein (AFP), estriol, inhibin A, and human chorionic gonadotropin (hCG). It is also ordered if parents are carriers of a genetic trait that is likely to be passed on to the fetus. These include cystic fibrosis, Duchenne muscular dystrophy, sickle cell anemia, thalassemia, hemophilia, and Tay-Sachs disease.

15. If the amniocentesis is negative, does it mean that the fetus is free from birth defects?
No. Amniocentesis does not identify all birth defects. There are many birth defects that are not revealed by amniocentesis.

16. What is the purpose of the cordocentesis test?
The cordocentesis test assesses the oxygen level in fetal blood, assesses for fetal anemia, and assesses if the fetus is Rh positive.

17. How is the cordocentesis test performed?
A cordocentesis is the sampling of fetal blood from the umbilical cord to determine if the fetus has a blood disorder or is Rh positive. The blood sample is also used to assess the oxygen level in fetal blood.

18. What is the purpose of the sweat test?
The sweat test assesses for cystic fibrosis.

19. How is the sweat test performed?
The sweat test measures the amount of chloride in sweat.

20. When is the sweat test administered?
The sweat test is administered to a newborn between 2. days and 5. months old.

21. When is the chorionic villus sampling (CVS) test performed?
CVS is performed between the tenth and twelfth weeks of gestation.

22. What are chorionic villi?
The placenta contains chorionic villi, which are tiny growths that contain the same genetic material as the fetus.

23. What is the advantage of the CVS test over amniocentesis?
The CVS test can be performed earlier in gestation than amniocentesis.

24. What is a transabdominal CVS test?
A transabdominal CVS test occurs when the sampling of the placenta is taken by inserting a needle through the abdomen.

25. What is a transcervical CVS test?
A transcervical CVS test occurs when the sampling of the placenta is taken by inserting a needle through the cervix.