Amniotic Fluid Flashcards
Major Volume Contributor after 1st Trimester
Feta Urine
Method of Collection
Amniocentesis
Specimen Collection
Method of Collection:
Volume:
Specimen Collection
Method of Collection: Amniocentesis
Volume: 30mL @ 14th week gestation
Fetal Assessment
Genetic Defects:
Fetal Lung Maturity:
HDN:
Fetal Assessment
Genetic Defects: 2nd Trimester - Dow Syndrome
Fetal Lung Maturity: 3rd Trimester
HDN: 3rd Trimester
Assessed in 3rd Trimester
FLM
HDN
Assessed in 2nd Trimester
Genetic Defects - Trisomy 21
Color Appearance
Colorless: Yellow: Green; Red: Dark Red Brown:
Color Appearance
Colorless: Normal Yellow: HDN Green: Meconium Red: Traumatic Tap Dark Red Brown: Fetal Death
Normal Color of Amniotic Fluid
Colorless
Color - HDN
Yellow
Color - Red
Traumatic Tap
Color - Dark Red Brown
Fetal Death
INCREASED Fetal Swallowing of Urine
OLIGOhydramnios
DECREASED Fetal Swallowing of Urine
POLYhydramnios
Quadruple tests prior to performing amniocentesis
AFP
Unconjugated Estriol
hCG
Inhibin A
Amniotic Fluid vs. Maternal Urine
Protein:
Glucose:
Creatinine:
Urea:
Amniotic Fluid
Protein: +
Glucose: +
Creatinine: <3.5mg/dL
Urea: <30 mg/dL
Maternal Urine
Protein: -
Glucose: -
Creatinine: >10 mg/dL
Urea: >300 md/dL
Specimen Handling
HDN:
FLM:
Cytogenetic Study:
Specimen Handling
HDN: Protected from Light
FLM: Iced
Cytogenetic Study: Room Temp (37C)
Anhydramnios
Decreased volume amniotic fluid in amniotic sac
Amniotic fluid is immediately protected from light to preserve _________
Bilirubin
Reference Method to Test for FLM
L/S ratio
Interpret:
L/S Ratio. >2.0
Mature Fetal Lung
Measured in Amniostat - FLM
Phosphatidyl glycerol
Positive Result - Foam Shake Test
(+) Bubbles/Effervescence
Foam Shake Test
Antifoaming agent:
Result:
Interpretation:
Foam Shake Test
Reagent: 95% Ethanol
Result: Bubble
Interpretation: FLM
Lamellar Body Count in Adequate FLM
> /= 32, 000/uL
OD 650
Lamellar Body
Tests for HDN/Fetal Distress
Bilirubin
Test results for Fetal Distress (Bilirubin) is plotted in ___________
Liley Graph
Liley Graph
Zone 1: None/Mild - ___________________
Zone 2: Moderately - _________________
Zone 3: Severely - _______________
Liley Graph
Zone 1: None/Mild - No required intervention
Zone 2: Moderately - Close Monitoring
Zone 3: Severely - Requires Intervention - Exchange Transfusion
Danger Zone
Zone 2
Situation: Neonatal bilirubin exceeded 2nd zone
Remedy: ________________
Requires Intervention
Situation: Neonatal bilirubin exceeded 1st zone
Remedy: ________________
Close Monitoring
Test used to detect ruptured amnion
Fern Test
Fern Test
Significance:
Result:
Fern Test
Significance: Ruptured amnion, Early Pregnancy
Result: Fern-like Crystals
Neural Tube Defect
Screening:
Confirmatory:
Neural Tube Defect
Screening: AFP - increased
Confirmatory: Acetylcholinesterase - decreased
Neural Tube Defect
Increased:
Decreased:
Neural Tube Defect
Increased: AFP
Decreased: Acetylcholinesterase
Assess/Tests for Fetal Age
Creatinine
AFP is Increased in
Neural Tube Defect
AFP is Decreased in
Down Syndrome
OD 450
Bilirubin
Confirmatory Test for Neural Tube Defect
Acetylcholinesterase
Creatinine Level
Prior to 36 weeks gestation: 36 weeks (9 months):
Creatinine Level
Prior to 36 weeks gestation: 1.5 - 2.0 mg/dL 36 weeks (9 months): > 2.0
9 month old - Creatinine Level
> 2.0
Pregnancy Testing - POCT
Specimen: Principle: Sensitivity: Detected: Anti-hCG source:
Pregnancy Testing - POCT
Specimen: First Morning Principle: Enzyme Immunoassay Sensitivity: 2-5 mIU/L Detected: B-hcg Anti-hCG source: Rabbit
Most specific for subunit for Hcg
Beta subunit
Hcg bioassays
Male Frog:
Female Frog:
Hcg bioassays
Male Frog: Hogben
Female Frog: Galli Mainini
Hcg peaks at _____________
1st trimester
Microviscosity is amniotic fluid is measured by _________
Flourescence Polarization
FLM in Microviscosity
> 55 mg/grams of albumin
Internal Standard
Microviscosity:
L/S ratio:
Internal Standard
Microviscosity: ALBUMIN
L/S ratio: SPINGOMYELIN
