hCG & Amniotic Fluid Flashcards
What is the meaning of hCG?
human chorionic gonadotropin
What is the standard hCG range at 3 weeks of pregnancy?
5-50 mIU/mL
What is the standard hCG range at 17-24 weeks of pregnancy?
4,060-165,400 mIU/mL
What is the standard hCG range at 6 weeks of pregnancy?
1,080-56,500 mIU/mL
What is the standard hCG range at 4 weeks of pregnancy?
5-426 mIU/mL
What is the standard hCG range at 9-12 weeks of pregnancy?
25,700-288,000 mIU/mL
What is the standard hCG range at 25-40 weeks of pregnancy?
3,640–117,000 mIU/mL
What is the standard hCG range at 13-16 weeks of pregnancy?
13,300-254,000 mIU/mL
What is the standard hCG range at 7-8 weeks of pregnancy?
7,650-229,000 mIU/mL
What is the standard hCG range at 5 weeks of pregnancy?
18-7,340 mIU/mL
What do pregnancy tests detect in urine?
hormone called human chorionic gonadotropin (hCG)
This is essential for the function of the corpus luteum
human chorionic gonadotropin (hCG)
This hormone is produced by the placenta from the time at which the embryo attaches to the uterine
human chorionic gonadotropin (hCG)
What is the structure that produces the hormone progesterone and estrogen?
corpus luteum
In a pregnancy test, hCG binds to?
mobile antibodies
hCG is detectable in urine as early as?
14 days or 2 weeks
What pregnancy test method is not commonly used nowadays?
Agglutination Inhibition Assay for hCG
Do not interpret the pregnancy test result for more than _____ because it might result to false positive
5 minutes
In later stages of fetal development the amniotic fluid can contain?
Fetal urine & fetal cells
Aside from providing a protective cushion for the fetus, what are the other functions of the amniotic fluid?
- allows fetal movement
- stabilizes temperature (to protect the fetus from extreme temperature changes)
- exchange of nutrients, water, and chemical substances between the mother and fetus
- permits proper lung development
In this condition there is excessive amniotic fluid accumulates in the uterus during pregnancy. Amniotic fluid volume is greater than 1200 mL
polyhydramnios
In this condition, there is too little amniotic fluid around the baby during pregnancy. Amniotic fluid volume is less than 800 mL
oligohydramnios
These are lung surfactants that serve as an index of fetal lung maturity
lecithin, sphingomyelin, and phosphatidyl glycerol
What hormone prevents the occurrence of menstruation?
Progesterone
What organ triggers the release of hCG?
Placenta
Found in the amnion, a membranous sac surrounding the fetus
Amniotic fluid
Normal volume of amniotic fluid
500 – 2500 mL term
Amniotic fluid is formed by?
- Metabolism of fetal cells
- Transfer of water across the placental membrane
- Fetal urine (later stage of development)
Collection of amniotic fluid guided by ultrasound
Amniocentesis
When collecting amniotic fluid it should be not more than _____ or it may cause premature labor or rapture membranes
20 mL
In agglutination inhibition assay, if the reaction produces a visible clumping it is a?
negative reaction: not pregnant
In agglutination inhibition assay, if the reaction produces no visible clumping it is a?
positive reaction: pregnant
Since amniocentesis is not a routine test, what are the indications or basis for performing amniocentesis?
- Suspected chromosomal abnormalities
- Metabolic disorders (e.g. diabetes)
- Neural tube defects
- HDN (Hemolytic Disease of the Newborn) where the blood of the mother and the fetus is
incompatible - Determine gestational age
- Infection (to determine genetic disorders)
- Fetal maturity
This test helps determine if the amniotic fluid is intact and is also used to differentiate amniotic fluid from cervical mucus in cases where amniotic fluid is suspected to be leaking
Fern test
How do you differentiate cervical mucus and amniotic fluid in a fern test?
Amniotic fluid tends to produce a more delicate pattern, compared to a thick and wide arborization pattern seen in dried cervical mucus
To test if premature birth is possible what tests should you do?
Gestational age (creatinine) and Fetal maturity (L/S ratio and Phosphatidyl glycerol)
It is a blood disorder that occurs when the blood types of a mother and baby are incompatible.
Hemolytic disease of the newborn (HDN) or erythroblastosis fetalis
Fluid for fetal lung maturity (FLM) tests should be placed in _____ for delivery to the laboratory and kept ______ until tested.
ice and refrigerated, respectively
Specimens for bilirubin testing must be immediately protected from?
light
How do you protect the amniotic fluid from light for bilirubin testing?
By placing the specimens in amber-colored tubes, wrapping the collection tube in foil, or using a black plastic cover for the specimen container
Specimens for cytogenetics studies or microbial studies must be processed at ________ and maintained at _________.
room temperature and body temperature (37 degrees Celsius incubation), respectively
Why do you have to keep the amniotic fluid for cytogenetic studies at room or body temperature?
To prolong the life of the cells needed for analysis
What is the clinical significance if the amniotic fluid is colorless?
Normal
What is the clinical significance if the amniotic fluid is dark green in color?
Meconium
What is the clinical significance if the amniotic fluid is blood-streaked?
traumatic-tap, abdominal trauma, intra-amniotic hemorrhage
What is the clinical significance if the amniotic fluid is yellow in color?
Hemolytic disease of the newborn HDN)
What is the clinical significance if the amniotic fluid is dark red-brown in color?
Fetal death :’((
Its presence in the amniotic fluid indicates that the baby is past due and needs to be delivered already
Meconium
A lipid produced at a constant rate after about 26 weeks of gestation
Sphingomyelin
A primary component of the surfactants that make up the alveolar lining and account for alveolar stability. Relatively low and constant rate until the 35th week of gestation
Lecithin
L/S ratio of _____ indicates a safer delivery in terms of fetal maturity.
2.0
Essential for adequate lung maturity and can
be detected after 35 weeks of gestation
Phosphatidyl glycerol
This detects neural tube defects
Alpha fetal protein
This is used to detect chromosomal
abnormalities and metabolic defects
Cytogenetic analysis
The significance of this test is to detect hemolytic disease of the newborn
Bilirubin scan
What is the normal value of L/S ratio?
2.0
What is the normal value of bilirubin scan?
0.025 mg/dl
What is the normal value of creatinine?
1.3-4.0 mg/dl
What is the normal value of Alpha fetal protein?
4.0 mg/dl
What is the normal value of Phosphatidyl glycerol?
Present lang sha :”)
This is no longer performed because there are more scientific tests (like L/S ratio and Phosphatidyl glycerol)
Foam test
In the foam test, how many percent of ethanol do you add to the amniotic fluid?
95%
In the foam test, how long do you shake the sample?
15 seconds (vigorous shaking)
In the foam test, how long do you allow to sit the sample undisturbed?
15 minutes
What do you observe in the foam test?
Presence of continuous line of bubbles around the outside edge
Foam stability index
≥0.47 (indicates fetal lung maturity)
These surfactants are found in the alveoli and assess fetal lung maturity
L/S ratio and Phosphatidyl glycerol
This is also linked to early pregnancy symptoms such as nausea and vomiting
human chorionic gonadotrophin (hCG)
The highest concentration of 95% ethanol that is able to support a ring of foam is known as?
Foam stability index
This is also detected in the mother’s blood so performing amniocentesis is not necessary.
Alpha fetal protein
These are biochemical substances in the amniotic fluid that can be tested to determine the health or maturity of the fetus
bilirubin, lipids, enyzmes, electrolytes, urea, creatinine, uric acid, proteins, and hormones
