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AUBF > M5: Amniotic Fluid (Part 1: Physiology) > Flashcards

M5: Amniotic Fluid (Part 1: Physiology) Flashcards

1
Q

T or F

Although the testing of amniotic fluid is frequently associated with microscopic analysis, the clinical laboratory also performs several significant tests on amniotic fluid

A

F (Although the testing of amniotic fluid is frequently associated with cytogenic analysis, the clinical laboratory also performs several significant tests on amniotic fluid

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2
Q

Amniotic fluid is a product of ?

A

fetal metabolism

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3
Q

Amniotic fluid is a product of fetal metabolism that provide information about metabolic processes taking place when?

(2)

A
  • During
  • Progress of fetal maturation
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4
Q

PHYSIOLOGY

Is present in the amnion which is a membranous sac that surrounds the fetus

A

Amniotic fluid

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5
Q

PHYSIOLOGY

  • A membrane composed of cuboidal cells
  • Metabolically active and is involved in the exchanges of water and chemicals between the fluid, the fetus, and the maternal circulation
  • Produces peptides, growth factors, and cytokines
A

Amnion

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6
Q

PHYSIOLOGY

Amnion is a mebrane composed of what cells?

A

cuboidal cells

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7
Q

PHYSIOLOGY

T or F

Amnion is metabollically active and is involved in exchanges of plasma and chemicals between the fluid, fetus and maternal circulation

A

F (involved in exchanges of water and chemicals between the fluid)

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8
Q

PHYSIOLOGY

Amnion, involved in exchange of water and chemicals occurs between what (3) components?

A
  • fluid
  • fetus
  • maternal circulation
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9
Q

PHYSIOLOGY

Amnion produces what (3) constituents?

A
  • Peptides
  • Growth factor (GF)
  • Cytokines
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10
Q

PHYSIOLOGY

Familiarize the primary functions of amniotic fluid

A
  • Provide a protective cushion for the fetus
  • Allow fetal movement
  • Stabilize the temperature to protect the fetus from extreme temperature changes
  • Permit proper lung development
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11
Q

PHYSIOLOGY

Which does not belong to primary functions of amniotic fluid

i. Provide a protective cushion for the fetus
ii. Restricts fetal movement
iii. Stabilize the temperature to protect the fetus from extreme temperature changes
iv. Delays proper lung development

a. i, ii, iv
b. i and iii only
c. i, ii, iii, iv
d. ii, iv only
e. none

A

d. ii, iv only

ii. Restricts fetal movement - amniotic fluid allows fetal movement

iv. Delays proper lung development amniotic fluid permits flung development

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12
Q

VOLUME

regulated by a balance between
the production of fetal urine and lung fluid and the absorption from fetal swallowing and intramembranous flow.

A

Amniotic fluid volume

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13
Q

VOLUME

Amniotic fluid volume is regulated by a balance between:

(1) production of (blank) and (blank)

sorry nabubura pag underscore

A

production of fetal urine and lung fluid

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14
Q

VOLUME

Amniotic fluid volume is regulated by a balance between:

(2) (blank) from fetal swallong

sorry nabubura pag underscore

A

absorption from fetal swallowing

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15
Q

VOLUME

Amniotic fluid volume is regulated by a balance between:

(3) (blank) flow

sorry nabubura pag underscore

A

intramembranous flow

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16
Q

VOLUME

is the absorption of amniotic fluid
water and solutes into the fetal vascular system

A

Intramembranous flow

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17
Q

VOLUME

What happens to the volume of amniotic fluid as fetus grows

A

Volume increases

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18
Q

VOLUME

T or F

Amniotic fluid volume decrease = fetus further grows

A

F (amniotic fluid volume increase = fetus further grows

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19
Q

Volume of AF at 12 weeks of gestation?

A

60 mL

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20
Q

T or F

The amount of amniotic fluid increases in quantity throughout pregnancy

A

T

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21
Q

VOLUME

The amount of amniotic fluid increases in quantity throughout pregnancy, reaching a peak of what volume range during 3rd trimester

A

800-1,200 mL

this then gradually decreases prior to delivery

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22
Q

VOLUME

Amniotic fluid increases or decreases prior to delivery of baby?

A

decreases

palabas na

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23
Q

VOLUME

(Polyhydramnios or Oligohydramnios?)

Amniotic fluid volume
greater than 1200 ml

Failure of the fetus to begin
swallowing

Seen in:
* fetal distress/fetal structural anomalies
* cardiac arrythmias
* neutral tube disorders/defects
* congenital infections
* chromosome abnormalities

A

Polyhydramnios

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24
Q

VOLUME

(Polyhydramnios or Oligohydramnios?)

Amniotic fluid volume
less than 800 ml

Increased AF swallowing

Seen in:
* premature rupture of amniotic membrane
* urinary tract deformities
* membrane leakage
* congenital malformations
* umbilical cord compression

A

Oligohydramnios

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25
Q

VOLUME

(Polyhydramnios or Oligohydramnios?)

Amniotic fluid volume greater than 1200 ml

A

Polyhydramnios

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26
Q

VOLUME

(Polyhydramnios or Oligohydramnios?)

Failure of the fetus to begin
swallowing

A

Polyhydramnios

kasi masyadong marami na

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27
Q

VOLUME

(Polyhydramnios or Oligohydramnios?)

fetal distress/fetal structural anomalies

A

Polyhydramnios

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28
Q

VOLUME

(Polyhydramnios or Oligohydramnios?)

cardiac arrythmias

A

Polyhydramnios

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29
Q

VOLUME

(Polyhydramnios or Oligohydramnios?)

neutral tube disorders/defects

A

Polyhydramnios

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30
Q

VOLUME

(Polyhydramnios or Oligohydramnios?)

congenital infections

A

Polyhydramnios

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31
Q

VOLUME

(Polyhydramnios or Oligohydramnios?)

chromosome abnormalities

A

Polyhydramnios

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32
Q

VOLUME

(Polyhydramnios or Oligohydramnios?)

Amniotic fluid volume less
than 800 ml

A

Oligohydramnios

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33
Q

VOLUME

(Polyhydramnios or Oligohydramnios?)

Increased AF swallowing

A

Oligohydramnios

kasi onti lang af so need niya more, hence iincrease niya pagswallow

sana all

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34
Q

VOLUME

(Polyhydramnios or Oligohydramnios?)

premature rupture of amniotic membranes

A

Oligohydramnios

35
Q

VOLUME

(Polyhydramnios or Oligohydramnios?)

premature rupture of amniotic membranesurinary tract deformities

A

Oligohydramnios

36
Q

VOLUME

(Polyhydramnios or Oligohydramnios?)

membrane leakage

A

Oligohydramnios

37
Q

VOLUME

(Polyhydramnios or Oligohydramnios?)

congenital
malformation

A

Oligohydramnios

38
Q

VOLUME

(Polyhydramnios or Oligohydramnios?)

umbilical cord compression

A

Oligohydramnios

39
Q

VOLUME

  • approximately 35 mL of amniotic fluid is derived primarily from the maternal circulation

What stage of pregnancy

A

1st trimester

40
Q

VOLUME

1st trimester

a. 35 ul of AF
b. derived from maternal circulation
c. both
d. NOTA

A

b. derived from maternal circulation

a should be 35 mL of AF to be correct

41
Q

VOLUME

  • fetus secretes a volume of lung liquid necessary to expand the lungs with growth

What stage of pregnancy

A

2nd trimester or latter third to half of pregnancy

42
Q

VOLUME

During each episode of fetal respiratory movement what process occurs which then (1) bathes lungs (2) wash pumonary and alveolar content

A

lung movement of fetus secretes lung liquid and enters amniotic fluid

which then (1) bathes lungs (2) wash pumonary and alveolar content

43
Q

VOLUME

Each episode of fetal respiratory movement secretes lung liquid enetrs amniotic fluid which

a. bathe lungs
b. wash pulmonary and alveolar contents (such as lecithin, sphingomyelin, phosphatidyl glycerol)
c. both
d. NOTA

A

c. both

44
Q

VOLUME

What pulmonary and elveolar contents does lung liquid wash?

A

lecithin,
sphingomyelin, and phosphatidyl glycerol

into the amniotic fluid surrounding the fetus

45
Q

VOLUME

These (3) lung surfactants serve as an index of fetal lung
maturity

A

lecithin,
sphingomyelin, and phosphatidyl glycerol

46
Q

VOLUME

  • fetal urine is the major contributor to the amniotic fluid volume
  • Fetal swallowing of the amniotic fluid begins and regulates the increase in fluid from the fetal urine

What stage of pregnancy

A

After the first trimester

47
Q

VOLUME

After the first trimester, this is the major contributor to the amniotic fluid volume

A

fetal urine

48
Q

VOLUME

This act regulates the increase in fluid from the fetal urine

A

Fetal swallowing

of amniotic fluid

49
Q

VOLUME

T or F

The fetus swallows amniotic fluid, which is absorbed through the gastrointestinal tract and reexcreted by the kidneys from the blood into fetal urine and back into
amniotic fluid

A

T

kadiri

50
Q

CHEMICAL COMPOSITION

is the ultimate source of amniotic fluid water
and solutes

A

placenta

51
Q

CHEMICAL COMPOSITION

Amniotic fluid has a composition similar to that of what, which contains a small amount of sloughed fetal cells from the skin, digestive system, and urinary tract.

A

composition similar to maternal plasma

52
Q

CHEMICAL COMPOSITION

  • has a composition similar to that of the maternal plasma
  • contains a small amount of sloughed fetal cells from the skin, digestive system, and urinary tract
A

Amniotic fluid

53
Q

CHEMICAL COMPOSITION

Part of composition of amniotic fluid which provide the basis for cytogenetic
analysis

clue: cyto

A

Sloughed cells

54
Q

CHEMICAL COMPOSITION

Familiarize the biochemical substances produced by fetus that are in amniotic fluid

A

bilirubin, lipids, enzymes, electrolytes, urea, creatinine, uric acid, proteins, hormones

55
Q

CHEMICAL COMPOSITION

Condition which allow fetal cerebrospinal fluid to enter the amniotic fluid directly

A

Neural tube defects

56
Q

CHEMICAL COMPOSITION

(2) biochemical markers for neural tube defects

A

Alpha-fetoprotein, Acetylcholinesterase

57
Q

CHEMICAL COMPOSITION

T or F

A portion of the fluid arises from the fetal respiratory tract, fetal urine, the amniotic membrane, and the umbilical cord

A

T

58
Q

CHEMICAL COMPOSITION

The chemical composition of amniotic fluid changes when what begins?

A

when fetal urine production begins

59
Q

CHEMICAL COMPOSITION

When fetal urine production begins, themical composition of amniotic fluid changes, what the the components that are increased?

A
  • Creatinine
  • Urea
  • Uric acid

CUU

60
Q

CHEMICAL COMPOSITION

When fetal urine production begins, themical composition of amniotic fluid changes, what the the components that are decreased?

A
  • Glucose
  • Protein
61
Q

CHEMICAL COMPOSITION

These components are affected as fetal urine production begins

a. creatinine, urea, uric acid
b. glucose and protein
c. electrolytes, enzymes, hormes, metabolic end products
d. all
e. NOTA

A

d. all

electrolytes, enzymes, hormes, metabolic end products but are of little clinical significance ok?

62
Q

CHEMICAL COMPOSITION

Measurement of amniotic fluid creatinine has been used to
determine?

A

fetal age

63
Q

CHEMICAL COMPOSITION

  • This is when amniotic fluid creatinine level ranges between 1.5 and 2.0 mg/dL

fetal age

A

before 36 weeks’ gestation

64
Q

CHEMICAL COMPOSITION

  • This is when amniotic fluid rises above 2.0 mg/dL

fetal age

A

greater than 36 weeks

65
Q

DIFFERENTIATING MATERNAL URINE FROM AMNIOTIC FLUID

Differentiating maternal urine from amniotic fluid is important to dtermine what (2)

A
  • possible premature membrane rupture
  • accidental puncture of maternal bladder during specimen collection
66
Q

DIFFERENTIATING MATERNAL URINE FROM AMNIOTIC FLUID

What are the (4) parameters in chemical analaysis which helps to differentiate maternal urine from amniotic fluid?

A

Creatinine, Urea, Glucose, Protein

67
Q

DIFFERENTIATING MATERNAL URINE FROM AMNIOTIC FLUID

Maternal fluid or Amniotic fluid?

Creatinine: As high as 10 mg/dL

Urea: As high as 300 mg/dL

Glucose and Protein: Not present in normal circumstances

pH: Acidic

A

Maternal urine

68
Q

DIFFERENTIATING MATERNAL URINE FROM AMNIOTIC FLUID

Maternal fluid or Amniotic fluid?

Creatinine: <3.5 mg/dL

Urea: <30 mg/dL

Glucose and Protein: More commonly seen under normal circumstances

pH: Alkaline

A

Amniotic fluid

69
Q

DIFFERENTIATING MATERNAL URINE FROM AMNIOTIC FLUID

Maternal fluid or Amniotic fluid?

Levels of creatinine and urea are much lower in?

A

Amniotic fluid

70
Q

DIFFERENTIATING MATERNAL URINE FROM AMNIOTIC FLUID

T or F

Measurement of glucose and protein by a reagent strip is a reliable indicator

A

F (Measurement of glucose and protein by a reagent strip is a less reliable indicator)

because glucose and protein are not uncommon urine constituents during pregnancy

71
Q

DIFFERENTIATING MATERNAL URINE FROM AMNIOTIC FLUID

What are the 3 tests used to diagnose PROM ?

PREMATURE RUPTURE OF MEBRANES

A
  1. pH test
  2. Nitrazine test
  3. Biomarker testing
72
Q

DIFFERENTIATING MATERNAL URINE FROM AMNIOTIC FLUID

  • Can differentiate amniotic fluid from urine and other body fluids
  • Used to evaluate premature rupture of the membranes
  • a vaginal fluid specimen is spread on a glass slide and allowed to completely air dry at room temperature; then it is observed microscopically
  • presence of “fern-like” crystals due to the protein and sodium chloride content is a positive screen for amniotic fluid

Test

A

Fern test

73
Q

Specimen used in fern test?

A

Vaginal fluid specimen

spread on a glass slide and allowed to completely air dry at room temperature; observed microscopically

74
Q

Fern-like crystals are seen in fern test due to presence of what (2) components?

A

Protein, Sodium chloride

fluid

a positive screen for amniotic fluid

75
Q
  • A test for pH
  • If the pH of the fluid being tested turns blue, the pH is greater than 6 and it suggests that the membrane has ruptured

test

A

Nitrazine test

76
Q

Positive result for nitrazine?

A

change to Blue color

suggests membrane has ruptured

77
Q

Vaginal fluid or amniotic fluid?

pH test: 4.5 - 6.0
NItrazine: Negative
Fern test: Non-appearance of fern like crystal

A

Vaginal fluid

78
Q

Vaginal fluid or amniotic fluid?

pH test: 7.1 - 7.3
NItrazine: Positive
Fern test: Appearance of fern like crystal

A

Amniotic fluid

79
Q

WHat are the (3) biomarker testing in amniotic fluid

A
  • AmniSure ROM
  • Actim Prom
  • ROM Plus
80
Q

Priciple: Immunochromatogrpahic test

Biomarkers: Placental alpha macroglobulin (PAMG-1)

(3) biomarker testing in amniotic fluid

A

AmniSure
ROM

81
Q

Priciple: Rapid immunoassay point-of-care test

Biomarkers:
Insulin-likegrowth factor binding protein-1 (IGFBP-1)
Placental protein 12 (pP12)

(3) biomarker testing in amniotic fluid

A

Actim PROM

82
Q

Priciple: Immunoassay

Biomarkers:
Alpha-fetoprotein (AFP)
IGFBP-1

A

ROM Plus

83
Q

Biomarker: IGFBP-1

A. Actim PROM
b. ROM Plus
c. both
d. NOTA

A

c. both

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