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Mercy CLS 7/8: Coagulation/Body Fluids > Body fluids—Maternal-fetal > Flashcards

Body fluids—Maternal-fetal Flashcards

1
Q

functions of amniotic fluid

A
  • 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
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2
Q

Thin white waxy coating that covers newborn babies’ skin

A

vernix

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3
Q

sources of amniotic fluid production

A

fetal urine
lung fluid
maternal circulation

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4
Q

During the first trimester, the approximately —— mL of amniotic fluid is derived primarily from the maternal circulation

A

35

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5
Q

Increased amniotic fluid peak at ——- mL in the third trimester is the result of fetal urine

A

800-1200

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6
Q

Lung fluid adds lung ———– to amniotic fluid; used as a measure of lung maturity

A

surfactants

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7
Q

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

A

polyhydramnios

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8
Q

Decreased amniotic fluid from increased fetal swallowing, urinary tract deformities, and membrane leakage
<800 mL

A

Oligohydramnios

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9
Q

used for fetal cytogenetic analysis

A

sloughed fetal cells in amniotic fluid

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10
Q

Presence of CSF in amniotic fluid indicates…

A

neural tube defects

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11
Q

fetal age estimation

A

creatinine

<36 weeks = 1.5 to 2.0 mg/dL
>36 weeks = >2.0 mg/dL

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12
Q

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

A

find out if fluid is amniotic or maternal urine

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13
Q

distinguish amniotic fluid from maternal urine

A

Amniotic fluid has <3.5 mg/dL creatinine and <30 mg/dL urea

Values as high as 10 mg/dL for creatinine and 300 mg/dL for urea may be found in urine

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14
Q

fern test

A

specimen air dries on glass slide; examined microscopically for “fern-like” amniotic fluid crystals

distinguishes amniotic fluid from urine

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15
Q

indications for amniocentesis at 15-18 weeks

A
  • Mother’s age of 35 or older at delivery
  • Family history of genetic diseases
  • Earlier pregnancy or child with birth defects
  • Parent is a carrier of a metabolic disorder
  • Elevated maternal serum alpha-fetoprotein
  • Abnormal triple marker screening test
  • Previous child with a neural tube disorder
  • Three or more miscarriages
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16
Q

indications for amniocentesis at 20-42 weeks

A
  • Fetal lung maturity
  • Fetal distress
  • HDN caused by Rh blood type incompatibility
  • Infection
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17
Q

max —- mL amniotic fluid collected

discard…

A

30

first 2-3 mL

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18
Q

Protect amniotic specimens from light for bilirubin analysis for ——– at all times

A

HDFN

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19
Q

Deliver ———- amniotic fluid tests on ice; refrigerate or freeze up to 72 hours if needed

A

FLM

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20
Q

———- amniotic fluid specimens kept at room temperature or 37°C to prolong cell life

A

cytogenetic

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21
Q

normal amniotic fluid appearance

A

colorless, with slight to moderate turbidity from cells

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22
Q

dark green, mucus-like material in amniotic fluid

A

meconium

fetal distress

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23
Q

dark red-brown amniotic fluid

A

fetal death

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24
Q

measured in amniotic fluid to determine extent of hemolysis taking place in HDFN

A

unconjugated bilirubin

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25
Q

Bilirubin causes OD rise at its maximum absorbance level of ——– nm; difference between baseline and this peak is the ——–

A

450
ΔA450

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26
Q

used to evaluate bilirubin in amniotic fluid

Plots ΔA450 against gestational age

A

Liley graph

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27
Q

Consists of three zones based on hemolytic severity

A

Liley graph

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28
Q

liley graph zone I

A

mildly affected fetus

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29
Q

liley graph zone II

A

requires careful monitoring

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30
Q

liley graph zone III

A

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

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31
Q

produced by the fetal liver prior to 18 weeks’ gestation

A

alpha-fetoprotein (AFP)

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32
Q

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

A

AFP

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33
Q

normal AFP values are based on ———– and the lab uses…… to evaluate

A

gestational age

multiples of the median (MoM)

34
Q

abnormal AFP

A

more than 2x MoM

35
Q

Follow abnormal AFP with —————-; more specific for neural disorders

A

fluid amniotic acetylcholinesterase (AChE)

36
Q

most common complication of early delivery

A

respiratory distress syndrome (lack of lung surfactant)

37
Q

FLM reference method

A

lecithin-sphingomyelin ratio (L/S)

38
Q

the primary component of the lung surfactants

increases at a slow and steady rate until the 35th week of gestation, when there is a noticeable increase, resulting in the stabilization of the fetal lung alveoli

A

lecithin

39
Q

increases at a slow rate until around the 26th week where it can level out and eventually decreases around week 32-35

A

sphingomyelin

40
Q

L/S ratio is —— prior to week 35 and rises to —— or greater for alveolar stability after week 35

A

1.6
2.0

41
Q

preterm delivery is considered safe with an L/S ratio of —— or higher

A

2.0

42
Q

method of measuring L/S ratio

A

thin-layer chromatography

43
Q

Lung surface lipid detected after 35 weeks gestation

A

phosphatidyl glycerol (PG)

44
Q

PG normally parallels lecithin, except in ————– (delayed), so must be included in L/S ratio

A

diabetics

45
Q

————– is an immunologic agglutination test for PG that can replace the L/S ratio

A

Amniostat-FLM

46
Q

Blood and meconium do not interfere with…

A

amniostat-FLM

47
Q

simple bedside test used for FLM

A

foam stability

48
Q

Foam stability

Amniotic fluid is mixed with ————, shaken for ————, and allowed to sit undisturbed for ————

A

95% ethanol
15 seconds
15 minutes

49
Q

foam test result indicating good FLM

A

A continuous line of bubbles around the outside edge

alcohol is antifoaming agent; fluid overcomes it

50
Q

foam stability index indicating FLM

A

> 47

51
Q

semiquantitative modification of foam test

A

0.5 mL amniotic fluid added to increasing amounts of 95% ethanol

52
Q

storage form of surfactant

A

lamellar bodies

53
Q

lamellar bodies enter amniotic fluid at —– weeks

A

26

54
Q

The number of lamellar bodies correlates with the…

A

amount of phospholipid present in the fetal lungs

55
Q

lamellar body OD of ——- at 650 nm correlates with L/S ratio of 2.0 and the presence of PG

A

150

56
Q

lamellar body count can be obtained using the …

A

platelet channel of automated hematology analyzers

57
Q

cannot perform ——- count if fluid is contaminated with blood, meconium or mucus

A

lamellar body

58
Q

lamellar body count indicating FLM

A

> 32,000/uL

59
Q

Detects fetal fibronectin in cervical swabs to assess the risk of preterm labor for individuals

A

Rapid fFN

60
Q

Detects if the amniotic fluid membranes have ruptured

Monoclonal

A

amnisure

61
Q

Detects if the amniotic fluid membranes have ruptured

Monoclonal and polyclonal

A

ROM plus+

62
Q

Preterm delivery is <—- weeks gestation

A

37

63
Q

preterm delivery symptoms

A

uterine contractions, change in discharge, vaginal bleeding, backache, abdominal discomfort, pelvic pressure, and cramping

64
Q

preeclampsia triad

A

Hypertension
Proteinuria
Edema

65
Q

If mother develops ———, the conditions is called eclampsia

A

convulsions

66
Q

cause and cure of preeclampsia

A

diseased placenta

delivery

67
Q

Detects PAMG-1 protein marker of the amniotic fluid

A

amnisure

68
Q

Sample must be tested within 30 minutes of collection

Blood & fecal matter creates false positive

A

amnisure

69
Q

Sample must be run within 6 hours of collection

Up to 10% blood is ok

A

ROM Plus+

70
Q

Detects…
- Alpha-fetoprotein (AFP)
- Insulin-like growth factor-binding protein-1 (IGFBP-1)
- Placental protein 12 (PP12)

A

ROM plus+

71
Q

Positive test without PROM indicates risk for delivery within 48 hours

A

ROM plus+

72
Q

Detection of fetal fibronectin in cervicovaginal secretions

A

rapid FFN

73
Q

Risk of preterm delivery in 7-14 days from the time of swab if positive

A

rapid FFN

74
Q

patient must have intact amniotic membranes and be less than 3 cm dilated to use

A

rapid FFN

75
Q

Singleton pregnancy

A

22-30 weeks + 6 days gestation

76
Q

isoform of fibronectin and is a complex adhesive glycoprotein

A

FFN

77
Q

confined to the extracellular matrix of the region defining the junction of the maternal decidua (uterine lining) and the chorion (fetal sac) within the uterus

A

FFN

78
Q

elevated in cervical secretions during the first 24 weeks of a normal pregnancy

Not understood why (growth of the placenta?)

A

FFN

79
Q

Detection between 24-34 weeks is associated with preterm delivery in symptomatic and asymptomatic pregnancies

A

FFN

80
Q

functional layer of the endometrium of the pregnant mom’s uterus

A

decidua

Mercy CLS 7/8: Coagulation/Body Fluids (9 decks)

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