in this ppt detail description about the invasive and non invasive procedure during pregnancy. and this ppt is very easy to understand.

1. MODALITIES OF
DIAGNOSIS
INVASIVE &NON
INVASIVE
PREETI SHUKLA
LECTURER
RAMA COOLEGE OF NURSING,
KANPUR

2. INTRODUCTION
Prenatal diagnosis employs a variety of techniques
to determine the health and the condition of unborn
fetus . There are a variety of non invasive and
invasive techniques available for prenatal
diagnosis

3. INVASIVE METHOD
Amniocentesis
Chorionic villus sampling
Pregnancy associated plasma protein A (PAPP-A)
Maternal serum alpha –fetoprotein
Maternal serum beta-HCG
Maternal serum estradiol
Inhibin A

4. AMNIOCENETESIS

6. NON INVASIVE METHOD
Ultrasonography
2 dimensional ultrasound(2D)
3 dimensional ultrasound(3D)
Doppler ultrasound
Non stress test

8. ULTRASONOGRAPHY
This is a non-invasive procedure that is harmless to
both the fetus and the mother. High frequency
sound waves are utilized to produce visible images
of the baby. The developing embryo can first be
visualized at about 6 weeks gestation.

9. Hard tissue gives bright white dots eg . Bone
Soft tissue gives – shades of gray
Fluid filled areas – no reflection i.e. black color.

10. PURPOSES:
 To determine presence and location of pregnancy.
 To detect multiple pregnancy
 To identify need for follow up testing.
 Confirming fetal viability.
 Identify fetal abnormality.
 Measurement of Crown Rump length of embryo.

11. Two methods:
Transvaginal ultrasonography
Trans abdominal ultrasonography
1. Trans vaginal ultrasonography
It is used during first trimester because the uterus,
gestational sac, embryo, ovaries and fallopian
tube are deep in to the pelvis in first trimester

12. TRANS ABDOMINAL
ULTRASONOGRAPHY
PURPOSES:
To confirm fetal viability.
To evaluate fetal anatomy.
Estimation of gestational age.
Assess the progress of fetal growth

13. Types of TAS
Doppler ultrasound
Color Doppler ultrasound.
1. Doppler ultrasound
it is to assess the blood flow. The wave is
directed at correct angle to a moving target as with
blood flowing through vessel and frequency of echoes
changes, as the cardiac cycle through systole and
diastole.

14. 3D /4D ULTRASOUND

15. Pelvic ultrasound
Vascular ultrasound
 Musculaskeletal ultrasound

16. CARDIOTOCOGRAPHY

17. It is used for recording the fetal heart beat and the
uterine contraction during in pregnancy especially
in 3rd trimester
The machine used for monitoring is called
cardiotocograph and also called the electronic
fetal monitor

18. METHOD:
External measurements:
Two transducer are used externally by strapping to the
externally to the abdominal wall
One measure the fetal heart rate
Second transducer measure the uterine contraction
Internal measurements:
Requires certain degree of cervical dilatation. Pressure
catheter is inserted into the uterine cavity. Scalp electrode is
attached to the head of the fetus to measure the pulse

19. NON STRESS
TEST

20. DEFINITION
It is a continuous electronic
fetal monitoring of FHR with
recording of fetal movement
in cardiotocography and
wellness of fetus.

21. PURPOSES
Assessment of fetal wellbeing.
To evaluate the ability of fetal heart rate
to accelerate
To know oxygen supply to fetus
To know the metabolic condition of fetus

22. INDICATION
MATERNAL:
Hypertension
Post dated maturity
Maternal age 35 or more
Trauma
Vaginal bleeding in 2nd &3rd trimester
Diabetes

23. FETAL:
• Decreased fetal movement
• IUGR
• Oligohydromnious / polyhyrdomnias

24. INTERPRETATION
REACTIVE:
When 2 or more acceleration of
more 15 beats /min above the
baseline &longer than 15 sec in
duration are present in 20 mints
observation

25. NON REACTIVE
Less than 2 acceleration or acceleration that peak
at less than 15 bpm above the baseline and less
than 15 seconds at their base with or without fetal
movements

26. UNSATISFACTORY TEST
A tracing that cannot be
interpreted because of poor
quality of fetal heart tracing
 NST needs to be repeated in 2-3
hours

28. PROCEDURE
 Mother placed in semi fowlers position to prevent
supine hypotension. Apply external electronic fetal
monitoring equipment to abdomen to detect FHR,
fetal movement and contraction.

29. CONTRACTION STRESS TEST

30. CONTRACTION STRESS TEST
It is suggestive in NST findings are non
reactive. It involves the recording of
FHR, stress induced uterine contraction.
This test is done only during uterine
contraction.

31. PURPOSES
To find out the frequency, duration and
intensity of contraction.
To identify fetal heart rate and oxygen
supply to fetus.
To find out the fetal distress.

32. PROCEDURE
Make mother in semi fowlers, lateral position.
FHR and pattern must be evaluated in relation to
uterine contraction.
3 contractions of atleast 40 sec each and occurring
within 10 minutes period are required to interpret the
contraction.

33. STRESS TEST METHOD
Nipple Stimulation
Oxytocin Challenge Test (OCT)

34.  Nipple stimulation method:
Advice the mother to brash palm across the nipple
through her clothing for 2 minutes. Stop if contraction
begins. It is repeated after 5 minutes rest period if no
contraction occur.
 IV infusion of oxytocin:
If nipple stimulation does not result in adequate
contraction IV infusion of oxytocin is used to stimulate
the uterine contraction. Administration of oxytocin
similar to that for induction of Labor.

35. INTERPRETATION
 Positive
 Negative
 Hyper stimulation
Suspicious
unsatisfactory

36. SUMMARIZATION
At the end of the teaching I summarized the topic
which include::
Introduction of the prenatal diagnosis
Invasive method
Ultrasonography
Cardiotocography
NST
CST

37. CONCLUSION
Invasive and non invasive prenatal diagnosis
most commonaly performed to assess the
embryo fetal chromosome and also gaining
the information about the embryo.

38. BIBLIOGRAPHY
Dutta Dc Textbook of obstetrics, ‘and gynecology 7th
edition , new central agency page no 235-236
Jacob Anamma , Textbook of obstetrics and gynecology
3rd edition Jaypee brother publisher145-146
Kamari Neelam , Textbook of obstetrics and gynecology
7th edition page no 237-238
Myles ,Textbook for Midwives ,15th edition CHURCHILL
living stone elsvier page no234-237