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AUBF-Lec-Amniotic fluid Flashcards

1
Q

Primary Function of Amniotic Fluid

A

• Cushion for the fetus
• Allows fetal movement
• Stabilizes temperature
• Proper lung development

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2
Q

AMNIOTIC FLUID VOLUME is from

A

From fetal urine and lung fluid

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3
Q

NORMAL AMNIOTIC FLUID VOLUME

A

800-1,200 mL (3rd trimester)

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4
Q

major contributor to the AF volume after the 1st trimester of pregnancy

A

FETAL URINE

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5
Q

INCREASE AMNIOTIC FLUID VOLUME (>1,200 mL)

A

POLYHYDRAMNIOS

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6
Q

Causes of POLYHYDRAMNIOS

A

Decreased fetal swallowing of urine
Neural tube defects
Others: fetal structural anomalies, cardiac arrhythmias, congenital infections, chromosomal abnormalities

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7
Q

DECREASE AMNIOTIC FLUID VOLUME (<800 mL)

A

OLIGOHYDRAMNIOS

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8
Q

Causes of OLIGOHYDRAMNIOS

A

Increased fetal swallowing of urine Membrane leakage
Urinary tract deformities
Others: congenital malformations, premature amniotic membrane rupture, umbilical cord compression

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9
Q

Method of Collection for AF

A

Amniocentesis (up
tom 30 mL collected in sterile syringe)

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10
Q

Assess genetic defects (Ex. Trisomy 21/Down syndrome)

A

2nd trimester amniocentesis

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11
Q

fetal lung maturity (FLM), Fetal hemolytic disease (HDN)

A

3rd trimester amniocentesis

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12
Q

QUADRUPLE SCREENING TESTS PRIOR TO PERFORMING AMNIOCENTESIS

A

• Alpha-fetoprotein (AFP)
• Human chorionic gonadotropin (hCG) • Unconjugated estriol (UE3)
• Inhibin A

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13
Q

Specimen Handling Test for Fetal Lung Maturity (FLM):

A

• Place on ice on delivery
• Kept refrigerated or frozen
• Filtration=prevents loss of phospholipids

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14
Q

Specimen Handling Test for Cytogenetic studies:

A

Kept at room temperature or at 37°C

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15
Q

Specimen Handling Test for Hemolytic Disease of the Newborn (HDN):

A

Protected from light

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16
Q

Detects ruptured amniotic membranes
Also used to diagnose early pregnancy (Increase estrogen)

A

Fern Test

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17
Q

Fern Test Procedure

A

Specimen (Vaginal Fluid)

Slide (air dry)

(+) Fern-like crystals –Amniotic Fluid

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18
Q

AMNIOTIC FLUID

LESS RELIABLE
• Protein
• Glucose
MORE RELIABLE
• Urea (mg/dL)
• Creatinine (mg/dL)

A

+
+

<30
<3.5

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19
Q

MATERNAL URINE

LESS RELIABLE
• Protein
• Glucose
MORE RELIABLE
• Urea (mg/dL)
• Creatinine (mg/dL)

A

> 300
10

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20
Q

Amniotic fluid color: colorless

A
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21
Q

Amniotic fluid color: blood streaked

A
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22
Q

Amniotic fluid color: yellow

A
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23
Q

Amniotic fluid color: dark green

A
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24
Q

Amniotic fluid color: dark red brown

A
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25
Q

Test for HDN A.K.A

A

OPTICAL DENSITY 450 (OD 450)

26
Q

Absorbance of amniotic fluid:
Normal:
HDN:

A

Normal: Increase at 365nm, Increase at 550nm
HDN: Increase at 450 nm (bilirubin)

27
Q

A.K.A OPTICAL DENSITY 450 (OD 450) Results are plotted on a

A

Liley graph:

28
Q

Liley graph: zone I

A

Nonaffected/mildly affected fetus

29
Q

Zone II:

A

Moderately affected fetus (requires close monitoring)

30
Q

Zone III

A

Severely affected fetus (requires intervention)

31
Q

Use to Assess Spina bifida

A

Test for Neural Tube Defects (NTD)

32
Q

-incomplete closing of the backbone and membranes around the spinal cord

A

Spina bifida

33
Q

absence of the major portion of the brain, skull, and scalp that occurs during embryonic development

A

Anencephaly

34
Q

Screening Test:

A

AFP (Alpha-fetoprotein)

35
Q

AFP (Alpha-fetoprotein) increased in

A

Neural tube defect

36
Q

AFP (Alpha-fetoprotein) decreased in

A

Down syndrome

37
Q

Confirmatory:

A

Acetylcholinesterase

38
Q

-most frequent complication of early delivery

A

Respiratory Distress Syndrome (RDS)

39
Q

7th most common cause of morbidity and mortality in the premature infant

A

Respiratory Distress Syndrome (RDS)

40
Q

caused by insufficiency of lung surfactant (phospholipids) production & fetal lung immaturity

A

Respiratory Distress Syndrome (RDS)

41
Q

Lecithin/Sphingomyelin (L/S) Ratio

Lecithin-
Sphingomyelin-

A

Lecithin- for alveolar stability
Sphingomyelin- serves as a control (due to constant production)

42
Q

*L/S ratio is measured using

A

thin layer chromatography (TLC)

43
Q

Ratio of _____= MATURE FETAL LUNGS

44
Q

Ratio of >2.0= MATURE FETAL LUNGS
* cannot be done on a specimen contaminated by?

A

blood or meconium

45
Q

Immunologic test for phosphatidylglycerol (PG)
Not affected by blood or meconium
Production of PG is delayed among diabetic mothers

A

Amniostat-FLM

46
Q

(+) Foam/Bubbles (presence of ______)= Mature Fetal Lungs

A

phospholipids

47
Q

Foam stability (Foam/Shake Test) procedure

A

Amniotic fluid + Ethanol 􏰀 shake for 15 seconds 􏰀 stand for 15 minutes

48
Q

is a friction experienced by a single particle undergoing diffusion because of its interaction with its environment at the micrometer length scale

A

Microviscosity

49
Q

Microviscosity

Measured by:

____ to ______ ratio is measured

Dye bound to surfactant had ______ fluorescence & ______ polarization

Dye bound to albumin had _______ fluorescence & ______ polarization

A

Measured by: fluorescence polarization
Surfactant to albumin (S/A) ratio is measured
Dye bound to surfactant had longer fluorescence & low polarization Dye bound to albumin had decreased fluorescence & high polarization

50
Q

produce alveolar surfactants stored in the form of lamellar bodies

A

Type II pneumocytes:

51
Q

______ lamellar body count=ADEQUATE FLM

A

> 32,000/uL

52
Q

OD 650nm
Increase lamellar bodies=

A

Increase O.D. (absorbance)

53
Q

O.D of >/= 0.150 is equivalent to:

A

L/S ratio of >/= 2.0 and the presence of PG

54
Q

Bilirubin Scan value

A

A450 >0.025

55
Q

Alpha-fetoprotein value

A

<2 multiples of median (MoM)

56
Q

L/S ratio value

57
Q

Amniostat-FLM value

58
Q

Foam Stability Index value

59
Q

Microviscosity (FLM-TDx) value

A

> /=55 mg/g

60
Q

Optical Density 650nm value

A

> /= 0.150

61
Q

Lamellar body count value

A

> /= 32,000/mL

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