Day 10 - Newborn & Maternal Testing

Question 1

These two hormones increase during pregnancy…

Answer 1

hCG

Estriol
-a weak estrogen

Question 2

hCG pregnancy testing is done to detect this subunit… Why?

Answer 2

Beta subunit (specific)

hCG, FSH, LH all share same alpha subunit (nonspecific)

Question 3

What is an ectopic pregnancy?

Answer 3

When embryo plants in Fallopian tubes rather than the uterus

Question 4

Fetal liver produces this protein that’s elevated in adults with cancer…

Answer 4

AFP (alpha-fetoprotein)

Question 5

What is detection of AFP in the amniotic fluid an indicator of?

Answer 5

Neural tube defects (spina bifida, anencephaly)

Question 6

What is the triple screening test for Down’s syndrome? Values are each (high or low)?

Answer 6

hCG = high

AFP = low

Unconjugated estriol = low

Question 7

The new gold standard to test if a fetus’s lungs are developed enough to breathe on their own is this test…

Answer 7

Lamellar body count (LBC)

• amniotic fluid specimen
• surfactant bodies that can be counted

Question 8

What is the traditional test for fetal lung maturity? A ratio of ___ indicates deficiency

Answer 8

Lecithin and Sphinomyelin (LS)

• phospholipids, secreted as surfactants
• allow lungs to expand

< 1.5

Question 9

At birth, the baby has mostly conjugated or unconjugated bilirubin? Why?

Answer 9

Unconjugated

Liver not yet fully developed

Question 10

Jaundice in a newborn is due to excess… Excessive levels can damage this organ… Treatment is…

Answer 10

Bilirubin

Brain, causing kernicterus

Sunlight/phototherapy

Question 11

California mandates these 4 newborn screening tests…

Answer 11

PKU

Free T4 - congenital hypothyroidism

Galactosemia - no liver enzyme to digest galactose. Stop breastfeeding

Hemoglobinopathy - sickle cell, hemoglobin abnormalities

Question 12

A PKU positive mother can cause this to her fetus… How can the mother avoid this?

Answer 12

Neurological damage

Low phenylalanine diet

Question 13

Blood rich in oxygen and nutrients going to the developing fetus is via the… Blood poor in oxygen going from the fetus back to the mother is via the…

Answer 13

Umbilical vein

Umbilical artery

Question 14

Are the levels of each of the following higher or lower in the umbilical vein compared to the umbilical artery: pH, CO2, O2

Answer 14

pH = higher

CO2 = lower

O2 = higher

Question 15

Cord compression can initially cause this condition in the baby… Prolonged oxygen deprivation/anoxia before birth or trauma during delivery can cause…

Answer 15

Respiratory acidosis

Metabolic acidosis

Question 16

Metabolic acidosis in fetuses or babies is due to buildup of…

Answer 16

Lactic acid

-from fermentation due to poor O2 delivery

Question 17

This type of specimen can be used in a newborn to analyze blood gases… What happens to the pH and CO2 if there’s a delay in testing?

Answer 17

Umbilical cord

• blood gas testing done during emergencies
• newborn not yet in hospital’s system, specimen may not be properly labeled
• cord blood reflects the last moment of intra-uterine life for baby

pH lowers
CO2 increase