Lab values

Question 1

WBC counts during pregnancy

Answer 1

• Rises progressively during pregnancy
• 1 tri - mean 8000/mm3 (normal range 5100-9900mm³)
• 2nd and 3rd tri - mean 8500/mm³ (normal range 5600-12000mm³ )
• Labor - may increase to 20,000-30,000/mm³

Question 2

MCV interpretation

Answer 2

Question 3

Anemia criteria

Answer 3

• 1st + 3rd tri
  
  • Hgb < 11 g/dl
  • Hct < 33%
• 2nd tri
  
  • Hgb < 10.5 g/dl
  • Hct < 32%

*IOM recommend lowering Hgb cut off for African Americans by 0.8 g/dL

Question 4

Normal Serum Iron Levels

Pregnant vs non-pregnant

Answer 4

• Pregnant: 40 - 175 µg/dl
• Non-pregnant: 60 - 150 µg/dl

Question 5

TIBC

Pregnant vs non-pregnant

Answer 5

Total iron binding capacity

Useful to evaluate for iron deficiency and iron overload

• Pregnant: 216 - 400 µg/dl
• Non-pregnant: 300 - 360 µg/dl

Question 6

Transferrin sat

Pregnant vs non-pregnant

Answer 6

• Pregnant: 16 - 60%
• Non-pregnant: 20 - 50%

Question 7

Serum ferritin

Pregnant vs non-pregnant

Answer 7

Iron storage protein, serum levels correlate with body’s iron stores – decreased in iron deficiency

• Pregnant: > 10 µg/dl
• Non-pregnant: 40 - 200 µg/dl

Question 8

Hemoglobin electrophoresis

Answer 8

• Screening test to identify abnormal hemoglobins
• Separation of hemoglobinsby variable rates of migration in an electrical field
• • Elevated A2: seen in beta thalassemia carriers
• Sickle cell trait: HgbA and S with > 50% A
• Elevated F: hereditary persistence of hgbF

Question 9

Components of a BMP vs CMP

Answer 9

BMP = basic metabolic panel (aka CHEM-7)

• Sodium
• Potassium
• CO2/Bicarbonate
• BUN
• Creatinine
• Glucose
• Calcium (sometimes)

CMP = complete metabolic panel (aka CHEM-12)

• All BMP components
• AST (aspartate aminotransferase)
• ALT (alkaline aminotransferase)
• Albumin
• Bilirubin
• Alkaline phosphatase