4 - Table Flashcards
must be assessed for preterm delivery tests determine the total surfactant in the fetal alveoli
Fetal Lung Maturity
normally appears in mature lungs and allows alveoli to remain open throughout the normal cycle of inhal and exhalation
Surfactants
most frequent complication of early delivery Caused by lack of lung surfactants
Respiratory Distress syndrome
reference method
Lecithin/Sphingomyelin Ratio
: maintains alveolar stability
Lecithin
primary component
Lecithin
: serves as the control or basis for lecithin increase
Sphingomyelin
Lecithin/Sphingomyelin Normal ratio:
2:1
Up to 26th week of gestation:
Lecithin < Sphingomyelin
36th week of gestation:
Lecithin = Sphingomyelin
After 36th week of gestation:
Lecithin > Sphingomyelin
L/S Ratio < 1.6:
Respiratory Distress syndrome
Lung surfactant that may be assayed in place of L/S Ratio
Phosphatidylglycerol/
Phosphatidylinositol
Production similar to lecithin except for diabetic mothers (delayed)
Phosphatidylglycerol/
Phosphatidylinositol
Assayed using thin-layer chromatography or Amniostat-FLM
Phosphatidylglycerol/
Phosphatidylinositol
- uses antisera specific for phosphatidylglycerol
Amniostat-FLM
shaking amniotic fluid with 95% ethanol for 15 seconds
Foam/Shake Test
(+) Result: presence of continuous bubbles around the outside edge for 15 minutes
Foam/Shake Test
Semiquantitative measure of the amount of surfactants present
Foam Stability Index
Procedure: amniotic fluid + increasing amount of 95% ethanol
Foam Stability Index
Foam Stability Index Value of (?): indicates fetal lung maturity
≥ 47
Foam Stability Index Value of (?): immature lungs
< 47
Measures the change in (?) which decreases in the presence of phospholipids
Microviscosity
Principle: Fluorescence polarization
Microviscosity
Presence of (?) decreases the microviscosity of amniotic fluid
phospholipids
Microviscosity : Internal Standard
Albumin
Microviscosity Value of (?): indicates fetal lung maturity
≥ 55
are lamellated phospholipids that represent storage form of surfactant
Lamellar bodies
The number of lamellar bodies present in the amniotic fluid correlates with the amount of phospholipid present in the fetal lungs=
RESISTANCE PULSE COUNTING
Lamellar Bodies=FETAL LUNG MATURITY
32,000/MI
+ lamellar bodies increases (?) of amniotic fluid
OD
- Infection of Mother and fetus
TESTS FOR FETAL DISTRESS
- Bilirubin analysis
TESTS FOR FETAL DISTRESS
- Alfafetoprotein(AFP) Test
TESTS FOR FETAL DISTRESS
- Acetylicholinesterase level
TESTS FOR FETAL DISTRESS
- Creatinine concentration
TESTS FOR FETAL AGE
Used for the evaluation of hemolytic disease of the newborn caused by Rh or ABO incompatibilities
Bilirubin Analysis
: bilirubin decreases
Normal pregnancy
: bilirubin increases as a result of fetal red cell destruction
HDN
Principle: optical density of bilirubin (peak @ 450 nm) plotted on a Liley graph
Bilirubin Analysis
Performed for the detection of neural tube defects
Alpha-fetoprotein
Produced by the fetal liver and are present in amniotic fluid and maternal serum
Alpha-fetoprotein
Alpha-fetoprotein : highest AFP concentration
12th to 15th week of gestation
Alpha-fetoprotein : After 15th week of gestation
AFP concentration declines
Alpha-fetoprotein: indicates abnormal result
MoM > 2.0
Used as a confirmatory test for an elevated AFP
Acetylcholinesterase Level
Precaution: sample should not be contaminated with blood
Acetylcholinesterase Level
Increases as the baby nears term and concentration is 1.5 to 2.0 mg/dl prior to 36th week of gestation
Creatinine Concentration
Measured by Jaffe’s reaction
Creatinine Concentration
Creatinine Concentration level that indicates that the pregnancy is over 36 weeks
> 2.0 mg/dl
serum-like fluids formed as ultrafiltrates of plasma which provide lubrication if the cavities where they are found
SEROUS FLUIDS
Primary causes of effusions include:
increased hydrostatic pressure (congestive heart failure)
decreased oncotic pressure (hypoproteinemia)
increased capillary permeability (inflammation and infection)
absorption of fluid into the lymphatic system
Two Membranes of Serous Cavities:
( Parietal Membrane
( Visceral Membrane
: lines the cavity
( Parietal Membrane
: forms a sac around the organs
( Visceral Membrane
If an alteration in the hydrostatic and oncotic pressure in the capillaries of the cavities happens, there will be an increase in fluid volume known as an
EFFUSION
accumulation of serous fluid
EFFUSION
: serous effusions that result from disturbance of the fluid production and regulation between serous membranes
TRANSUDATE
: purulent effusions that form in any body cavity as a result of an inflammatory process
EXUDATE
Force that pushes fluid out of blood capillaries
INCREASED HYDROSTATIC PRESSURE
Force that pushes fluid into blood capillaries
DECREASED ONCOTIC PRESSURE
Chronic/Congenital Heart Failure
INCREASED HYDROSTATIC PRESSURE
Salt and fluid retention
INCREASED HYDROSTATIC PRESSURE
Nephrotic syndrome
DECREASED ONCOTIC PRESSURE