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CLS 304 > Chapter 12 Amniotic Fluid > Flashcards

Chapter 12 Amniotic Fluid Flashcards

1
Q

Liquid product of fetal metabolism

A

Amniotic fluid

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2
Q

Amniotic fluid is present in the

A

Amnion

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3
Q

Membrane that surrounds the fetus

A

Amnion

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4
Q

What is the purpose of the sac (5)

A
  • Provides a protective cushion
  • allows fetal movement
  • stabilizes the temperature to protect fetus from extreme temperature changes
  • permits proper lung development
  • allows for exchange of water and chemicals
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5
Q

What is tested to determine if C-section can be performed

A

Lung development

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6
Q

Label

A
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7
Q

Reasons one might have an amniocentesis performed at 14-18 weeks (5)

A
  • Being 35 or older; risk of birth defects/Down syndrome
  • having a previous child or pregnancy with a birth defect
  • abnormal blood triple or quadruple screening (AFP)
  • family history of genetic disorders (cystic fibrosis, tay-sachs, sickle cell, hemophilia, Huntington chorea, muscular dystrophy)
  • > 3 miscarriages
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8
Q

Reasons one might have an amniocentesis performed past 20 weeks (2)

A
  • Fetal lung maturity

- fetal distress: HDN or infection

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9
Q

How is amniotic fluid formed

A

First produced by amnion and placenta. Then fetus plays active role to balance composition and production

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10
Q

Mechanism involved with balancing amniotic fluid (4)

A
  • Intestinal absorption following fetal swallowing of fluid
  • Capillary exchange in pulmonary system as alveoli of fetal lungs develop
  • water and electrolytes removed and replaced by products of fetal urination
  • maternal exchange remove waste products and adds water, nutrients and electrolytes
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11
Q

Variation of what 3 things indicate fetal distress

A

Fetal urine, lung fluid, and maternal circulation

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12
Q

During first thmester approx. 35mL of amniotic fluid is derived from

A

Maternal circulation

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13
Q

At 37 weeks ammotle fluid peak at 800 to 1200mL. Increased urine is regulated by

A

Fetal swallowing

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14
Q

Lung fluid adds what to amniotic fluid to measure lung maturity

A

Lung surfactants

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15
Q

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

A

Polyhydramnios

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16
Q

Polyhydramnios cause

A

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

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17
Q

Decreased amniotic fluid from increased fetal swallowing, membrane leakage <800 mL

A

Oligohydramnios

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18
Q

Oligohydrammos causes

A

Umbilical cord compression

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19
Q

Amniotic fluid composition

A

Similar to maternal plasma with sloughed fetal cells

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20
Q

Amniotic fluid contains biochemical substances produced by fetus such as (9)

A

Bilinibin, lipids, enzymes, electrolytes, urea, creatinine, uric acid, proteins, hormones

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21
Q

Fetal urine increases (3)

A

Creatinine, urea, uric acid

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22
Q

Fetal age can be estimated by

A

Creatinine

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23
Q

Age when creatinine level is 1.5 to 2.0 mg/dL

A

<36 weeks

24
Q

Age when creatinine level is >2.0

A

> 36 weeks

25
Q

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

A

Maternal urine vs. amniotic fluid

26
Q

<3.5 mg/dL creatinine and <30 mg/dL urea

A

Amniotic fluid

27
Q

Values as high as 10 mg/dL for creatinine and 300 mg/dL for urea

A

Urine

28
Q

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

A

Amniotic fluid

29
Q

Maternal urine vs. Amniotic fluid measure

A

Creatinine, glucose, protein, urea

30
Q

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

A

Fern test

31
Q

How is an amniocentesis collected

A

Needle aspiration into amniotic sac under ultrasound guidance: transabdominal or vaginal

32
Q

When should an amniocentesis be collected and how much

A

No more than 30 mL after 14th week of gestation

33
Q

How should samples be stored for testing

A

Keep at room temp and separate cells for genetic testing. Place on ice and refrigerate for fetal/lung FLM tests. Protect from light for bilirubin testing (HDN)

34
Q

Centngage or filter fluid only for what test

A

Fetal lung maturity (FLM) tests

35
Q

Color for normal appearance

A

Colorless to very pale yellow

36
Q

Color for traumatic tap, abdominal trauma, intra-amniotic hemorrhage

A

Blood-streaked

37
Q

Color for bilirubin present, hemolytic disease newborn (HDN)

A

Yellow to amber

38
Q

Color for meconium (fetal bowel movement)

A

Dark green

39
Q

Color for fetal death

A

Dark red-brown

40
Q

Tests for neural tube defects (4)

A
  • Alpha-fetoprotein (AFP) produced by the fetal liver prior to 18 weeks gestation
  • 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
  • measure maternal blood first, then amniotic fluid
41
Q

What happens to a mom that has 2 babies with Rh+ blood while she has Rh-

A

First pregnancy= fetal blood enters maternal circulation and Rh antibodies form
Second pregnancy= Rh antibodies destroy fetal Rh+ RBCs

42
Q

Most common complication of early delivery

A

Respiratory distress syndrome (RDS)

43
Q

Lack of lung surfactant keeps

A

The alveoli open during inhaling and exhaling

44
Q

Decreases the surface tension on the alveoli so the lungs can inflate more easily

A

Surfactant

45
Q

Amniotic fluid bilirubin measured in spectrophotometric instrument for activity at 450 OD tests for

A

Hemolytic disease newborn (HDN)

46
Q

Alpha-fetoprotein (AFP) increase tests for

A

Neural tube defects: anencephaly and spinal bifida. Also possibility of multiple pregnancy

47
Q 
Surfactant measurements:
- lecithin-sphingomyelin ratio (L/S)
- phosphatidyl glycerol
- foam shake test
- microviscosity decrease
- lamellar bodies
Test for
A

Determination of fetal lung maturity (FLM) for respiratory distress syndrome (RDS). L/S ratio >2.0 is desirable

48
Q

Represent a storage form of surfactants responsible for FLM

A

Lamellar phospholipids

49
Q

Lamellar phospholipids are produced and secreted by

A

Type II pneumocytes of the fetal lungs

50
Q

Amniotic fluid lamellar bodies are measured by

A

Automated cell counters using the platelet methodology

51
Q

A count of greater than 32,000 lamellar bodies represents

A

Adequate fetal lung maturity

52
Q

Range of lamellar bodies in 3rd trimester

A

50,000 to 200,000

53
Q

Produced by the placenta and acts as the glue that attaches the placenta to the uterine wall. Also acts as a lubricant aiding in the passage of the newborn through the vaginal canal

A

Fetal fibronectin

54
Q

What kind of collection detects fetal fibronectin

A

Cervicovaginal

55
Q

Fetal fibronectin can be used to predict

A

Pre-term delivery

CLS 304 (8 decks)

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