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Clin Lab > Diagnosis and Monitoring of Pregnancy > Flashcards

Diagnosis and Monitoring of Pregnancy Flashcards

1
Q

What hormones increase during pregnancy?`

A
  • Estrogens
  • Progesterone
  • Human placental lactogen
  • Human chorionic gonadotropin
  • Prolactin
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2
Q

What does increased estrogen levels stimulate?

A
  • Gluconeogenesis
  • Cholesterol production
  • Plasma proteins (fibrinogen)
  • Cortisol production
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3
Q

How much does plasma volume increase during normal pregnancy?

A

50%

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4
Q

______ increases more than ______ causing the hematocrit to fall by 15%

A

Plasma volume

-Red cell volume

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5
Q

What does the placenta produce

A
  • HCG
  • Alkaline phosphatase
  • Creatine Kinase
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6
Q

______ will double by the time of delivery

A

Alkaline phosphatase

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7
Q

What will happen to glomerular filtration rate, BUN, and Cr during pregnancy

A

GFR will increase about 50%

-Causes decreased BUN and Cr

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8
Q

Describe glucose and protein excretion during pregancy

A
  • Urine glucose

- Protein excretion

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9
Q

What do lab tests for pregnancy test for to diagnose pregancy

A

-Trophoblastic tissue

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10
Q

What do the cells of the placenta produce that is detected in a pregnancy test?

A

HCG

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11
Q

What are other things that can produce HCG that is not a fetus

A
  • Hyditidiform mole (tumor of the uterus)
  • Choriocarcinoma (malignant tumor of the placenta)
  • Germ cell tumors (tumor of the ovary)
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12
Q

What other cancers produce HCG levels

A
  • Breast cancer

- Large cell carcinoma of the lung

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13
Q

When does the production of HCG begin during pregnancy?

A

-as soon as the trophoblast cells are formed

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14
Q

When do blood levels of typically rise after implantation

A

4-6 days after fertilization

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15
Q

When do blood levels of HCG become detectable

A

8-10 days after fertilization (3-3.5 weeks after last menstrual period)

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16
Q

HCG rises in a _______ fashion during the first trimester of pregnancy

A

Geometric

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17
Q

HCG will ______ every 48 hours in a normal pregnancy

A

Double

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18
Q

In pregnancy abnormalities such as Down syndrome, hemolytic disease, HCG levels are _____ than normal

A

Higher

19
Q

When do plasma levels of HCG peak in a normal pregnancy?

A

8-12 weeks

20
Q

Is HCG usually tested in urine or blood

A

Urine- it is cheaper

21
Q

Total urine HCG excretion parallels _______

A

Plasma concentration

22
Q

What can cause falsely negative urine HCG levels

A

-Dilute urine

23
Q

What can cause falsely positive HCG levels

A
  • Proteinuria

- UTI

24
Q

When is blood HCG levels tested

A
  • When quantitative info is needed
  • Unsure of LMP
  • Physical exam
  • Plasma levels will become positive less than one week before urine HCG
25
Q

What percentage of pregnancies occur outside of the uterus

A

1.5%

26
Q

Describe the plasma HCG levels in an ectopic pregnancy

A

Rises more slowly, and before 6 weeks gestation, HCG levels will fail to double

27
Q

What percentage of pregnancies end in spontaneous abortion?

A

25%

28
Q

Describe plasma HCG levels in a spontaneous abortion

A
  • Usually below the 95th percentile for gestational age

- and falls in measurements 2 days apart

29
Q

What is used to detect anemia and screen for thalassemia

A

Hematocrit/hemoglobin

30
Q

What are included in prenatal screening tests

A
  • Hematocrit/hemoglobin
  • Bacteruria
  • Rh and red cell antibody
  • Immunity for rubella and varicella
31
Q

What else are included in prenatal screening tests?

A
  • Syphilis
  • Hep B antigen
  • Chlamydia
  • HIV
  • Thyroid (TSH and T4)
  • TB, gonorrhea, herpes, BV, trichomoniasis, Hep C
32
Q

When can Rh sensitization occur?

A

Occur if Rh- mom carries an Rh + baby

33
Q

What happens at delivery with an Rh - mom

A
  • The Rh+ childs RBC leak into the maternal circulation and can stimulate the production of anti-Rh antibodies
  • These antibodies cross the placenta and attack the RBC for future pregnancies
34
Q

Rh problems are preventable by…

A

Injecting mom with anti-Rh antibodies

-masks the moms immune system and prevents sensitization

35
Q

Describe a-fetoprotein

A
  • Fetal liver and yok sac produce a large number of these
  • Present at 100 times larger concentration that in an adult
  • A small amount crosses the placenta and mixes with maternal AFP concentration
36
Q

Fetal abnormalities cause ________ amounts of AFP to cross the placenta and leak into amniotic fluid

A

Increased

37
Q

What are 2 other factors that increase AFP levels

A
  • Gestational age

- Number of infants present

38
Q

When is AFP tested?

A

at 16 weeks gestation

39
Q

If AFP are elevated, what is the follow up test?

A
  • Amniocentesis

- 3D or 4D ultrasound

40
Q

What is included in a QUAD screen

A
  • AFP
  • HCG
  • Estriol
  • Inhibin A
41
Q

When is pulmonary surfactant released?

A

34-36 weeks but it can be stimulated by cortisol at earlier ages

42
Q

What are the major lipids in surfactant?

A
  • Lecithin

- Sphingomyelin

43
Q

What is a healthy ratio of lecithin and sphingomyelin

A

2:1 = lung maturity

Clin Lab (23 decks)

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