Lab values / normal ranges Flashcards
When do you refer for anaemia
Hb < 90
not responding to treatment
what is normal Hb range
110 1st trimester/ 105 in 2nd and 3rd
140
what are normal ferritin levels
what levels indicate “absent iron stores”
what should be considered if ferritin very high (>100)
what is requirement to confirm ferritin levles
normal= >30
‘absent iron stores’ = <15
>100- check inflammation, organ disease
>
check absence of inflammation ( CRP>5 )
what is normal platelets level
what is level indicating possible PE / HELLP/ thrombocytopenia
normal >150
<100 could be PE/ HELLP/ thrombocytopenia
what is normal HbA1c level
normal = <40
41-50 = “prediabetic” - 1 week prick testing / do OGTT @24wks
>50 likely diabetic
what is diagnosis of GDM - GTT
OGTT-
Fasting BGL >5.5
2HR POST prantil> 9.0
What is diagnosis of GDM- polycose
> 7.8
What are normal lactates for fetal blood sampling
<4
how do we check for inflammation
CRP <5
Gold tube
Blood types
- which blood group can accept blood from anyone (universal recipient)
- which group can give blood to anyone (universal donor)
AB POS
O pos
what bilirubin level do you consult
> 250 (48hrs)
300 (anytime)
what bishop score indicates “unfavourable uterus”
<6
what is tested in bishops score
position
length
consistency
dilation
station (relative to spines)
what is tested in apgar score
appearance (colour) - blue + pale / body pink, limbs blue / all PInk
pulse- absent / <100 / >100
grimace (response to stimuli)- none / grimace / cry
activity (tone)- limp / some flexion/ active
respiratory effort -none / slow irregular / good, cry
what is normal range of neonatal BGL’s
BGL >2.6mmol
what is blue blood tube for
Coag screen
what is gold blood tube for
LFT + Rnl
CRP
Ferritin
B2
Viral studies (hepatitis syphylis, HIV)
What is lavender blood tube for
CBC (Hb, platelets, haemotocrit, HbA1c, kleihauer, ACTH)
What is haemotocrit
% of blood that is RBC’s
kleihauer test
indication tube colour positive value
indication- tests for presence of fetal cells in maternal serum
tube - CBC
positive = >6
What is fetal fibronectin
What is pink blood tube for
Group and Hold, cross match, Blood group, Antibody screen, Coombs
What is a coombs test
what colour tube
what is it - taken from cord bloods to test for presence of “foreign” antibodies
indication- maternal neg blood group / jaundice
Pink tube
cord bloods
NORMAL
cord lactates ≤ 4.1 mmol/ L (Rising lactates = fetal acidosis)
ph > 7.1 (note - LOW pH = acidity caused by excess CO2)
fetal fibronectin
indication
when
How to take test
how to interpret results
indication- screening test for women with suspected preterm labour (24-36wks)
How-
Vaginal swab-
take before any digital exam/ other swabs- this can artificially stimulate more fibronectin to be released.
Don’t use lubricant
Results influenced by bleeding, recent intercouse
Negative test- high neg predictive value (likely to be accurate)
positive test- low predictive value (<30% of women that have positive result, actually birth within 7days)
marginal cord insertion- how close is placenta to internal os
<20mm
what gestation can you start using CTG
28 wks
what APGAR = “infant depression”
What is referral
< 6 @ 10mins = TRANSFER “moderate”
<6 @ 1min + not improving @10mins= EMERGENCY “severe”
HEART RATE
what is normal FHR / neonatal HR
maternal
110-160 bpm
60-100 bpm
Resp rate
normal neonatal + maternal
neonatal = 40-60 rpm
maternal = 12-20rpm
Normal temp
neonatal
36.5-37.5
what is normal / abnormal neonatal weight loss in first week
normal = <10% weight loss (make a plan if 7-10%)
abnormal = >10% weight loss
What is tested in booking bloods (tube colours )
Gold- Ferritin, viral (hepatitis B, Syphilis, HIV, Rubella immunity)
Lavender- CBC, Hb, haematocrit, HbA1c
Pink- blood group, antibody
Chlamydia - women <25yrs
Vit D- not recommended to routinely test
What is positive PCR
> 30
How do you calculate artifical milk amount
total vol in 24hrs =[ weight (kg) x 60ml ]/ 8 (assume 3hourly feeds)
blood cultures
what are these taken for?
what it does- blood test to check for presence of bacteria- can indicate risk of sepsis
indication- suspected sepsis
BMI
What is healthy BMI range, and recommended weight gain
What is overweight BMI + recommended gain
what is obese BMI + recommended gain
BMI 18-25 / 11.5-16KG gain
BMI 25-30 / 7-11.5
BMI >30 / 5-9KG
Vitamin D
what is level of ‘insufficiency’ + ‘deficiency’
<50 = insufficiency
<25= deficiency
afebrile
NOT feverish
dysuria
pain when urinating
pyuria
pus in urine
diuretic
increase urination
anti diuretic
what drug has this effet
reduce urination
oxytocin
maternal temp- what is pyrexia?
pyrexia- >38 (with/without fetal tachycardia)
Rubella- what levels indicate ‘immune’
> 10 = ‘detected’
5-9 = ‘equivocal’
<5 = not immune
hep B- what is tested
Antigen
WBC
normal range
Indicative of UTI
> 300- Normal
>1000- UTI
order of blood
bBrgPPG
blood culture bottles
pale blue (coag studies)
dark blue
red (virology / immunology)
green (renal / liver )
purple (CBC)
Pink (G&S, Cross match)
Grey (Glucose)
when is hcg detected after fertilisation
blood- 9 days after fertilisation
urine- 10-12 days
which cord vessel provides best information on fetal condition
arterial (blue)- this is blood that has just left fetus
venous blood (REd) provides additioanl info
large difference betwee A/V ph can indicate RECENT problem (eg. cord compression)
small difference: longstanding problem
what may Dryness in vagina (i.e. during VE) indicate?
pyrexia
human milk vol requirements
day 1
day 2
day 3
day 4
1) 2-10ml
2) 5-15ml
3) 15-30ml
4) 60ml
describe landmarks for palpation
40 - slightly below xiphisternum
36 wks- xiphisternum
30 wks- half way between umbilicus and xiphisternum
24 weeks- just above umbilicus
16 wks- below umbilicus
12 weeks- just above pubic symphysis
Systolic vs diastolic blood pressure
After ventricular systole, When arteries fill with blood and there is max pressure
Ventricular diastole, when arteries have least amount of blood
Systolic vs diastolic blood pressure
After ventricular systole, When arteries fill with blood and there is max pressure
Ventricular diastole, when arteries have least amount of blood
when do you test for hyperglycaemia (no risk factors)
24-28wks
how do we calculate EDD
LMP + [7 days +9mths] / + [7 days - 3mths] / 280 days
what is thrombocytopenia
low platelet count (<100)
when can a woman become pregnant postpartum?
day 21
what is mean cell vol (MCV) + mean cell haemaglobin (MCH)
MCV-average size of RBCs (low MCV = microcytic cells)
MCV increases slighly in pregnancy so unreliable until IDA established
MCH= amount of hb in cells.
Low MCH = “hypochromic” cells- pale
if MCV + MCH both low- urgent iron supplements required
(could be IDA, thalassaemia)
what iron asesssment required for woman that is vegetarian/vegan
check b12 + folate levels
for potential megaloblastic anaemia
(low Hb, normal ferritin) = high MCV, low Mhb
what is haematocrit
% of RBC’s in blood
