Amniotic Fluid Flashcards
1
Q
Found in the membranous sac that surrounds the fetus providing a cushion for protection
A
Amniotic fluid
2
Q
cushion for protection
A
Amnion
3
Q
FUNCTIONS OF AMNIOTIC FLUID:
A
- provide protective cushion
- allow fetal movement
- stabilize temperature for fetal
- permits lung development
4
Q
Regulated by the balance between the production of ____________ and __________
A
fetal urine and lung fluid
5
Q
Volume ______________. (increases/decrease) on the course of pregnancy
A
increases
6
Q
Volume increased amniotic fluid:
A
800-1200mL
7
Q
Volume app 800-1200ml during the
A
3rd trimester
8
Q
During the first trimester: amniotic fluid is derived from
A
Maternal circulation (35mL)
9
Q
After the first trimester: the volume is approximately
A
1L
10
Q
Is the major contributor of amniotic fluid
A
Urine
11
Q
Start and regulates the increase in the fluid from fetal urine
A
Fetal swallowing
12
Q
Increased Amniotic fluid volume caused:
A
Acute hydramnios
Chronic hydramnios
13
Q
Decreased Amniotic fluid volume: caused
A
Oligohydramnios
14
Q
VOLUME during first trimester:
A
35ml
15
Q
On the latter third to half pregnancy
o Fetus secretes a volume of
A
Lung liquid
16
Q
Abnormal increase of the fluid volume
A
Polyhydramnios
17
Q
Abnormal decrease of the fluid volume
A
Oligohydramnios
18
Q
In polyhydramnios fetus’ failure to swallow the urine indicator of:
A
- fetal distress
- neural tube defect
19
Q
In polyhydramnios fetus’ failure to swallow the urine indicator of: secondary effect
A
- Congenital infection
- urinary tract derformities
20
Q
composition of maternal plasma contains
A
Sloughed fetal cell from skin, digestive system and urinary tract
21
Q
composition of maternal plasma in biochemical substances
A
Bilirubin, lipids, nitrogen compound, protein and enzymes
22
Q
Use to determine fetal age
A
Amniotic fluid creatinine
23
Q
Amniotic fluid creatinine Prior to _______ weeks of gestion
A
36
24
Q
Creatinine levels is:
A
1.5-2.0mg/dl
25
If the creatinine is >2.0 mg/dl creatinine it indicates
Greater than 36 weeks of gestation
26
Early (14-16 weeks) indications
Diagnostic genetic disease
27
Mid trimester indication
- Hemolytic disease of newborn
- neural tube defect
28
3rd trimester indication:
- Hemolytic disease of newborn
- renal maturity
29
SPECIMEN COLLECTION used
Trans-abdominal amniocentesis
30
Trans-abdominal amniocentesis ________ ml amber bottle protect from light
(Bilirubin)
30 ml
31
Discard first ______ ml - contaminated with
maternal blood, tissue fluid and cells (Can
cause false positive result)
3-5ml
32
Discard first 3-5ml - contaminated with
__________ blood, ________ fluid and ________ Can
cause false positive result
maternal blood, tissue fluid and cells
33
Transport with ice if for phospholipid
determination
Fetal lung maturity
34
Trans-abdominal amniocentesis Performed at_____ weeks gestation
14 weeks gestation
35
Trans-abdominal amniocentesis _______ weeks genetic and chromosomal studies
15-18 weeks
36
Used for SPECIMEN HANDLING
Fetal lung maturity test
Cytogenetic studies
37
FETAL LUNG MATURITY TEST Can be kept frozen ________or refrigerator temperature (6-8C) for 72 hours.
(-8C)
38
FETAL LUNG MATURITY TEST Can be kept frozen (-8C) or refrigerator temperature _______for 72 hours.
(6-8C)
39
FETAL LUNG MATURITY TEST Can be kept frozen (-8C) or refrigerator temperature (6-8C) for ______ hours.
72 hrs
40
FETAL LUNG MATURITY TEST Repeat ______________ is not recommended causes distortion of cells and to the result also.
freeze-thawing
41
FETAL LUNG MATURITY TEST _________ is recommended for this method to prevent phospholipid loss.
Filtration
42
CYTOGENETIC STUDIES
o Maintained at room temperature or at body temperature of
25-37C
43
Amniotic Fluid Test Significance: Detection of:
- hemolytic disease of newborn
- fetal lung maturity
- fetal lung hypoxia
- fetal disorder
- cytogenetic disorder
- chromosomal abnormalities
44
Normal appearance:
Colorless to Pale yellow
45
Clinical correlation appearance
Fetal death
Meconium
Hemolytic disease of newborn
Hemorrhage
46
Abnormal appearance
Yellow
Dark green
Dark red- brown
Blood streak
47
Point of reference Amniotic fluid creatinine
3.5mg/dl
48
Point of reference Amniotic fluid urea
30 mg/dl
49
Point of reference Amniotic fluid glucose
Present
50
Point of reference Amniotic fluid protein
Present
51
Point of reference Maternal urine creatinine
10 mg/dl
52
Point of reference Maternal urine urea
300mg/dl
53
Point of reference Maternal urine glucose
Absent
54
Point of reference Maternal urine protein
Absent
55
Primary surface fluid if lungs
Lecithin
56
Produced at relatively low & constant rate
until 35th week of gestation
Lecithin
57
Produced at constant rate after about 26th week of gestation
Sphingomyelin
58
Essential fluid for adequate lung maturity
Phosphatidyl glycerol
59
Measurement by spectrophotometric analysis & plotted in the
Liley curve or lily’s curve
60
mildly affected fetus zone
Zone I
61
Zone that requires careful monitoring
zone II
62
Zone that severely affected
may require
of labor or intrauterine
induction
exchange transfusion
Zone III
63
Surface fluids of the Lungs
Lecithin
Sphingomyelin
Phosphatidyl glycerol
64
Represent the measurement and reading of bilirubin from amniotic fluid plotted by spectrophotometer
Liley curve
65
Measurement used for bilirubin determination
Lily’s curve
66
• For establishment and determination of antibody titer
Lily’s curve
67
Most commonly Rh-negative mothers
Hemolytic disease of neeborn
68
Fetal cells with antigens enter maternal circulation and cause production of maternal antibodies
Hemolytic disease of newborn
69
Maternal antibodies cross the placenta and destroy fetal cells with the corresponding antigen
Hemolytic disease of newborn
70
Good indicator for the presence of infection
Leukocyte esterase reagent strip
71
Determine neural tube disorders
Alpha fetoprotein
72
Major protein produced by the fetal liver & found in the
maternal serum
Alpha fetoprotein
73
Confirmatory test for neural tube
disorders
Acetylcholinesterase test
74
Common neural tube defect in newborn
Anencephaly and spinal bifida
75
Completely open brain and spinal cord
Craniorachiachisis
76
Open brain and luck of skull vault
Anencephaly
77
Reference method to measure fetal lung maturity
Lecithin/sphingomyelin ration
78
Primary component of the phospholipids that make up the majority of the alveolar lining & account for alveolar stability
Lecithin
79
Lipidthatisproducedataconstantrateafter aboutthe 26th weeks of gestation serving as a control on which to base the rise in Lecithin.
Sphingomyelin
80
Analytical errors: fetal maturity analysis
Over centrifugation
Blood contamination
Imprecision of TLC
Meconium
81
Essential for adequate fetal lung maturity
Phosphatidyl glycerol/ phosphatidylinositol
82
Immunologic agglutination test for phosphatidyl glycerol
Amniostat fetal lung maturity
83
Provides rapid method for assessment of lung maturity
Amniostat fetal lung maturity
84
Mechanical screening test to measure the individual lung surface lipid
concentration
Foam test
85
Good correlation with L/S Ratio
Foam stability index
86
Depend on longevity of bubbles (ethanol-antifoaming agent)
Foam stability index
87
Simple shake test
Foam stability index
88
Foam stability index aka
Simple shake test
Manual foam stability index
89
Reagent use in foam stability index
95% ethanol
90
Antifoaming agent used
Ethanol
91
Utilize fluorescence polarization between lipids & albumin for fetal lung maturity
TDx-FETAL LUNG MATURITY
92
Detects fetal age
Creatinine
93
The count correlates with the amount
of phospholipids present in fetal lung
Lamellar bodies count
94
FETAL RED CELLS & MATERNAL RED CELLS: stain used
Kleihauer-betke stain
95
Red, refractile, large cells, resistant to alkali
Fetal rbc
96
Uncolored ghost cells or dull red, poorly
stained, sensitive to alkali
Maternal rbc
97
colorless when stained
Maternal blood
98
Purple-pink when stain
Fetal blood
