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Aubf Finals > Amniotic Fluid > Flashcards

Amniotic Fluid Flashcards

1
Q

A membranous sac that surrounds the fetus

A

AMNION

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2
Q
  • Provides protective cushion for fetus
  • Allows fetal movement
  • Stabilizes fetal temperature exposure
  • Permits proper lung development
  • Exchanges water and chemicals among the fluid, fetus, and maternal circulation

(PASPE)

A

AMNIOTIC FLUID

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3
Q

The 5 under of Fetus in Amniotic Sac

A

Chorion
Placenta
Amniotic cavity
Umbilical cord
Amnion

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4
Q

Volume production

A

Fetal urine, lung fluid, maternal circulation

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5
Q

During the trimester, in what ml of the approximately amniotic fluid is derived primarily from the maternal circulation

A

35 ml

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6
Q

Increased amniotic fluid peak at what ml in the third trimester is the result of fetal urine?

A

800 - 1200 ml

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7
Q

is regulated by increased fetal swallowing

A

Increased urine

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8
Q

Adds lung surfactants to amniotic fluid; used as a measure of lung maturity

A

Lung fluid

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9
Q

Excess amniotic fluid from failure of fetus to swallow > 1200 ml

A

Polyhydramnios

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10
Q

Neural tube disorders, structural/chromosomal abnormalities, cardiac arrhythmias, infections

A

Polyhydramnios

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11
Q

Decreased amniotic fluid from increased fetal swallowing, membrane leakage > 800ml

A

Oligohydramnios

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12
Q

Umbilical cord compression

A

Oligohydramnios

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13
Q

Composition similar to maternal plasma with sloughed fetal cells

  • Cells are used for cytogenetic analysis
A

Chemical composition

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14
Q

It is used for cytogenetic analysis

A

Cells

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15
Q

The fluid also contains biochemical substances that are produced by the

A

Fetus, bilirubin, lipids, enzymes, electrolytes, urea, creatinine, uric acid, proteins, hormones

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16
Q

What is the 3 of fetal urine increases?

A

Creatinine, urea, uric acid

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17
Q

How many age fetal can be estimated by creatinine?

A

< 36 weeks = 1.5 - 2.0 mg/dl
> 36 weeks = 2.0

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18
Q

Needed to determine premature membrane rupture or accidental puncture of maternal bladder from ________

A

Amniocentesis

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19
Q

The presence of glucose, protein, or both is associated more closely with ______

A

Amniotic fluid

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20
Q

Amniotic fluid has ____ mg/dl

Creatinine and urea has ____ mg/dl

Values as high as ____ mg/dl for creatinine and ____ mg/dl for urea may be found in urine

A

<3.5 mg/dl

<30 mg/dl

10 mg/dl

300 mg/dl

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21
Q

Specimen air dries on glass slide; examine microscopically for “FERN-LIKE” amniotic fluid crystals

A

Fern test

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22
Q

Indications for amniocentesis

A

Abnormal screening blood test

Abnormal chromosome analysis and history of genetic disorders

Abnormal ultrasound for fetal body measurements

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23
Q

Later pregnancy for possible early delivery

A

Fetal lung maturity, disease of newborn (HDN) Infection

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24
Q

Collection of fetal epithelial cells in amniotic fluid indicate the ______

A

Genetic material of the fetus

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25
Q

The 4 examined for chromosome abnormalities

A

Karyotyping
Fluorescence in situ hybridization (FISH)
Fluorescence mapping spectral karyotyping
DNA testing

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26
Q

Biochemical substances that the fetus has produced

A

Analyzed by thin layer chromatography

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27
Q

Amniocentesis: needle aspiration of fluid from amniotic sac

A

Transabdominal amniocentesis

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28
Q

Maximum of what ml collected in sterile syringes

A

30 ml

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29
Q

Discard first __ to __ ml for contamination

A

2 - 3 ml

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30
Q

Protect specimens from light for bilirubin analysis for HDN at all times

A

Amber tubes or black plastic tube covers

31
Q

Perform all handling procedures immediately and deliver to laboratory promptly

A

Amber tubes to protect bilirubin integrity

32
Q

Deliver fetal lung maturity (FLM) tests on ice ; refrigerate or freeze up to ___ hours if needed.

33
Q

Cytogenetic specimens kept at room temperature or __•c to prolong cell life

34
Q

For chemical tests to remove debris; filter only for FLM tests

A

Centrifuge or filter fluid

35
Q

What is the normal and appearance of amniotic fluid

A

Colorless with slight to moderate turbidity from cells

36
Q

Traumatic tap, abdominal trauma, intra amniotic hemorrhage

A

Blood streaked

37
Q

Fetal versus maternal blood use

A

Kleihauer - Betke

38
Q

What is the color of bilirubin in amniotic fluid

Hemolytic disease of the newborn (HDN)

A

Bright yellow or yellow

39
Q

What is the color of meconium (first bowel movement) in amniotic fluid

A

Dark green

40
Q

What is the color of fetal death in amniotic fluid

A

Dark red-brown

41
Q

The significance of blood streaked

TIN

A

Traumatic tap
Abdominal trauma
Intra amniotic hemorrhage

42
Q
  • Most commonly rh negative mothers
  • fetal cells with antigens enter maternal circulation and maternal antibodies
  • cross the placenta and destroy fetal cells
43
Q

Bilirubin from RBC destruction appears in the

A

Amniotic fluid

44
Q

The amount of unconjugated bilirubin present correlates with the amount of

A

RBC destruction

45
Q

Spectrophotometric analysis of fluid optical density (OD) between ___ and ___ nm is plotted on semilog paper

A

365 and 550 nm

46
Q

Bilirubin causes OD rise at its maximum absorbance level of ___ nm

47
Q

Plots A450 against gestational age

Consist of three zones based on hemolytic severity

A

Liley graph

48
Q

Mildly affected fetus

49
Q

Requires careful monitoring

50
Q

Severely affected fetus, may require induction of labor or intrauterine exchange transfusion

51
Q

Produced by the fetal liver prior to 18 weeks gestation

A

Alpha - fetoprotein (AFP)

52
Q

Increased levels in maternal blood or amniotic fluid indicate possible anencephaly or spinal bifida

Increased levels are found when skin fails to close over neural tissue

A

Neural tube defects

53
Q

Normal values based on weeks of gestation

A

Maximum AFP 12 - 15 weeks

54
Q

Median is laboratory’s reference level for a given week of gestation

More than two times the median or (MOM) is abnormal

A

Report multiples of the median or (MOM)

55
Q

Follow with fluid amniotic acetylcholinesterase or (ACHE) : more specific for neaural disorders

A

Do not perform on a bloody specimen

56
Q

Most common complication of early delivery is

A

Respiratory distress syndrome (RDS)

57
Q
  • Lack of lung surfactant, which keeps the alveoli open during inhaling and exhaling
  • Surfactant decreases the surface tension on the alveoli so they can inflate more easily
A

Fetal lung maturity (FLM)

58
Q

It is the primary component of the lung surfactants ; increased production occurs after the ___ week

A

Lecithin

35th week

59
Q

Produced at a constant rate after the ___ week and serves as a control for the rise in lecithin

A

Sphingomyelin

60
Q

It is considered safe with an L/S ration of 2.0 or higher

A

Preterm delivery

61
Q

Test is performed using

A

Thin layer chromatography

62
Q

Lung surface lipid phosphatidyl glycerol is also needed for

A

Lung maturity

63
Q

Normally parallels lecithin, except in _____ , so must be included in L/S ration

64
Q

_______ and _______ do not interfere with the test

A

Blood and meconium

65
Q

Perform at the bedside

A

Foam stability

66
Q

Amniotic fluid is mixed with ___% ethanol, shaken for ___ seconds, and allowed to sit undisturbed for ___ minutes

67
Q

Lamellar bodies - Storage form of surfactant - approximately __ % phospholipid and __ % protein

68
Q

Increase in amniotic concentration from 50,000 to 200,000/ml but the end of the

A

Third trimester

69
Q

OD of 150 at 650 nm correlates with L/S ratio of

A

2.0 and the presence of PG

70
Q

Lamellar body diameter ranges in size from

A

1.7 to 7.3 or to 1 to 5 um

71
Q

Can be obtained using the platelet channel of automated hematology analyzers

A

Lamellar body count or (LBCs)

72
Q

The 6 dvantages of LBC

RLWLLE

A

Rapid turnaround time
Low reagent cost
Wide availability
Low degree of technical difficulty
Low volume chinical performance
Excellent clinical performance

73
Q

Protocol for performing LBC

A

Mix the amniotic fluid
Transfer the fluid to a clear test tube
Visually inspect the specimen
Cap the tube and mix the sample for 2 min
Flush the platelet channel
Process the specimen

Aubf Finals (2 decks)

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