amniotic fluid Flashcards by LUIMER RAMOS

: AMNIOTIC FLUID
- Found in the

amnion

How well did you know this?

Not at all

Perfectly

mainly delivered from the maternal
circulation which contributes approximately 35 mL of
amniotic fluid

First trimester:

How well did you know this?

Not at all

Perfectly

mainly come from fetal urine
(major contributor of amniotic fluid volume after first
trimester)

Succeeding trimesters

How well did you know this?

Not at all

Perfectly

(major contributor of amniotic fluid volume after first
trimester)

fetal urine

How well did you know this?

Not at all

Perfectly

excessive accumulation of amniotic fluid

Polyhydramnios

How well did you know this?

Not at all

Perfectly

assessment of fetal pulmonary maturity or
fetal hemolytic disease

Third Trimester

How well did you know this?

Not at all

Perfectly

General Collection:safely performed after the __ week of
gestation

14th

How well did you know this?

Not at all

Perfectly

decrease in amniotic fluid; caused by
increased fetal swallowing, urinary tract deformities, and
membrane leakage

Oligohydramnios

How well did you know this?

Not at all

Perfectly

t is also associated with fetal structural anomalies,
cardiac arrythmias, congenital infections, and
chromosomal abnormalities.

Polyhydramnios:

How well did you know this?

Not at all

Perfectly

Indicates fetal distress associated with neural tube
defects

Polyhydramnios

How well did you know this?

Not at all

Perfectly

assessment of
genetic defects and chromosomal analysis

Second Trimester (16th week of gestation):

How well did you know this?

Not at all

Perfectly

Associated with congenital malformations, premature
rupture of amniotic membranes, and umbilical cord
compression that may result decelerated heart rate and
fetal death

Oligohydramnios:

How well did you know this?

Not at all

Perfectly

: involves needle aspiration of amniotic fluid
through transabdominal amniocentesis or vaginal
amniocentesis

Amniocentesis

How well did you know this?

Not at all

Perfectly

Maximum of__ ml using sterile syringes (discard first __
ml because it might be contaminated with maternal blood,
tissue fluid, and cells

30 mL; 2-3 mL

How well did you know this?

Not at all

Perfectly

20
th to 42nd Weeks of Gestation

Fetal lung maturity
Fetal distress
Rh HDN
Infection

How well did you know this?

Not at all

Perfectly

color: meconium (first defecation of the fetus)

Dark-green

How well did you know this?

Not at all

Perfectly

increased amniotic fluid volume

Hydramnios

How well did you know this?

Not at all

Perfectly

color: bilirubin, hemolytic disease of the newborn

Yellow:

How well did you know this?

Not at all

Perfectly

placed on ice and refrigerate prior to
testing, refrigerated up to 72 hours prior to testing

Fetal Lung Maturity:

How well did you know this?

Not at all

Perfectly

maintained at room or ref
temperature, to prolong the life cells to be studied

Cytogenetic studies:

How well did you know this?

Not at all

Perfectly

must be protected from light at all times
(amber bottles)

Bilirubin analysis

How well did you know this?

Not at all

Perfectly

separate from cells immediately using
centrifugation or filtration

Chemical testing

How well did you know this?

Not at all

Perfectly

normal color of amniotic fluid

colorless

How well did you know this?

Not at all

Perfectly

color: fetal death

dark red brown

How well did you know this?

Not at all

Perfectly

color: : traumatic collection, abdominal trauma, intra-amniotic hemorrhage

Blood-streaked

decreased amniotic fluid volume

Oligohydramnios:

amniotic fluid urea level

3.5mg/DL

amniotic fluid creatine level

30mg/dL

Maternal urine urea level

10mg/dL

maternal urine creatinine level

300 mg/dL

serves as the control or basis for lecithin increase

Sphingomyelin:

found in the lungs, it allows the alveoli to open for the fetus to properly inhale and exhale

Surfactant:

L:S After 36th week of gestation:

Lecithin > Sphingomyelin

It determines the total surfactant in the lungs

Test for Fetal Lung Maturity

L/S Ratio indicates fetal lung maturity

> 2.0

Foam Stability Index : indicates fetal lung immaturity

Value of < 47

most frequent complication of early delivery caused by the lack of lung surfactant

Respiratory distress syndrome

Lung surfactant that may be assayed in place of L/S Ratio - Production similar to lecithin except for diabetic mothers (delayed)

Phosphatidylglycerol/Phosphatidylinositol

Considered as the reference method

Lecithin/Sphingomyelin Ratio

Normal L/S ratio

: 2:1

maintains alveolar stability

Lecithin:

Semiquantitative measure of the amount of surfactants present

Foam Stability Index

L:S Up to 26th week of gestation:

Lecithin < Sphingomyelin

L:S 36th week of gestation:

Lecithin = Sphingomyelin

Measures the change in microviscosity which decreases in the presence of phospholipids - Uses fluorescence polarization (Abbott TDx Analyzer) and albumin as the internal standard

Microviscosity

L/S Ratio;; indicates fetal lung immaturity

< 1.6

Assayed using TLC or Amniostat-FLM (this uses antisera specific for phosphatidylglycerol and is not affected by specimen contamination with blood)

Phosphatidylglycerol/Phosphatidylinositol

Lamellar Bodies indicated fetal lung maturity

> 32,000/m:

Shaking amniotic fluid with 95% ethanol for 15 seconds - (+) Result: presence of bubble for 15 minutes

Foam/Shake Test

optical density of bilirubin peak

peak @ 450 nm)

Foam Stability Index; indicates fetal lung maturity

Value of ≥ 47

decreased fluorescence, high polarization

Dye-albumin

ellar Bodies - Lamellar bodies containing surfactants and produced by

Type II pneumocytes

longer fluorescence, low polarization

- Dye-surfactant

Used for the evaluation of hemolytic disease of the newborn caused by Rh or ABO incompatibilities

Bilirubin Analysis

Normal pregnancy: bilirubin?

decreases

bilirubin plotted on

Liley graph

Performed for the detection of neural tube defects

Alpha-fetoprotein

congenital absence of all or a major part of the brain

Anencephaly

zone bilirubin severely affected → intervention required (deliver/treat)

Zone 3

zone bilirubin non-affected/mildly affected → observe for fetal stress

Zone 1

highest AFP concentration

12th to 15th week of gestation:

AFP concentration declines

After 15th week of gestation:

congenital cleft of the spinal column - Produced by the fetal liver and are present in amniotic fluid and maternal serum

Spina bifida

AFP: indicates abnormal result

MoM > 2.0: i

zone bilirubin moderately affected → requires close monitoring and treatment

Zone 2:

Increases as the baby nears term and concentration is 1.5 to 2.0 mg/dL prior to 36th week of gestation

Creatinine Concentration

Precaution: sample should not be contaminated with blood

Acetylcholinesterase Level

Component of nerve tissue that is elevated in amniotic fluid in neural tube defects

Acetylcholinesterase Level

Used as a confirmatory test for an elevated AFP

Acetylcholinesterase Level

Creatinine Concentration is measured by

Jaffe’s reaction

Creatinine Concentration ; indicates that the pregnancy is over 36 weeks

>2.0 mg/dL