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AUBF > M5: Amniotic Fluid (Part 3: Tests for Fetal Distress) > Flashcards

M5: Amniotic Fluid (Part 3: Tests for Fetal Distress) Flashcards

1
Q

TESTS FOR FETAL DISTRESS

What are the (2) tests for fetal distress

A
  1. Hemolystic disease of the fetus and newborn (HDN)
  2. Neural Tube Defects (NTD)
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2
Q

TESTS FOR FETAL DISTRESS

  • Happens when the blood type of the mother is not compatible with the fetus
  • Oldest routinely performed laboratory test on amniotic fluid
  • Evaluates the severity of the fetal anemia
    produced by HDN
A

HDN

Hemolytic Disease of the Fetus and Newborn

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3
Q

TESTS FOR FETAL DISTRESS

T or F

HDN’s incidence has been increasing rapidly since there are not development of methods

A

F (HDN’s incidence is decreasing rapidly due to development of method which prevent anti-Rh antibody production in post partum mothers)

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4
Q

TESTS FOR FETAL DISTRESS

New methods of decreasing HDN incidence aims to prevent?

A

anti-Rh antibody production in post-partum mothers

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5
Q

TESTS FOR FETAL DISTRESS

During 1st pregnancy, if the mother is Rh- and the baby is Rh+, What happens to pregnancy and placenta

A

Pregnancy is safe
Placenta is intact

safe pa pag 1st baby aw panganay momints

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6
Q

TESTS FOR FETAL DISTRESS

T or F

The baby is safe as long as placenta is not destroyed

HDN

A

T

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7
Q

TESTS FOR FETAL DISTRESS

occurs during gestation, delivery of the placenta, or a previous pregnancy when fetal red blood cells enter into the maternal circulation and stimulate the mother to produce antibodies to the
antigen

HDN

A

Initial exposure to foreign red cell antigens

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8
Q

TESTS FOR FETAL DISTRESS

Initial exposure to foreign red cell antigens cause mother to stimulate what?

hdn

A

production of antibodies against antigen of baby

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9
Q

TESTS FOR FETAL DISTRESS

Upon giving birth, the placenta?

HDN

A

detaches

point when the mother is already exposed to the Rh
antigen, thus producing Rh antibodies

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10
Q

TESTS FOR FETAL DISTRESS

During 2nd pregnancy, once the body of the mother hasbeen triggered to produce Rh antibodies against D antigen,
these antibodies will?

HDN

A

attach to the fetal cells of the 2nd baby

especially when the baby is Rh+

results to anemia of baby

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11
Q

TESTS FOR FETAL DISTRESS

Once antibodies are present in fetal circulation, it binds to what? leading to?

HDN

A

antibodies bind to antigen of fetal cells, leading to destruction of cells and anemia

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12
Q

TESTS FOR FETAL DISTRESS

State the process of HDN or familiarize

A
  1. DURING 1ST PREGNACY: baby is still safe
  2. AFTER BIRTH: mother exposed to Rh antigen -> producing antibodies
  3. DURING 2ND PREGNANCY: Antibodies of mother attack acells of baby leading to anemia
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13
Q

TESTS FOR FETAL DISTRESS

During 1st pregnancy, After birth, During 2nd pregnancy

Fetal blood enters maternal circulation via placenta

Choose

HDN

A

During 1st pregnancy

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14
Q

During 1st pregnancy, After birth, During 2nd pregnancy

IgG antibodies remain in mother’s circulation, Baby remains safe

Choose

HDN

A

During 1st pregnancy

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15
Q

During 1st pregnancy, After birth, During 2nd pregnancy

Mother produces antibodies against baby rh antigen

Choose

HDN

A

After birth

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16
Q

During 1st pregnancy, After birth, During 2nd pregnancy

IgG antibodies cross placenta destryong fetal rh antigen RBCs

Choose

HDN

A

During 2nd pregnancy

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17
Q

TEST FOR HDN

What is the test/parameter used for detection of HDN?

A

Bilirubin

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18
Q

TEST FOR HDN

(2) methods to visualize bilirubin

A

Liley Graph, Queenan curve

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19
Q

TEST FOR HDN

T or F

The destruction of fetal red blood cells results in the appearance of the red blood cell degradation product, conjugated bilirubin in amniotic fluid

A

F (The destruction of fetal red blood cells results in the appearance of the red blood cell degradation product, unconjugated bilirubin in amniotic fluid)

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20
Q

TEST FOR HDN

T or F

Amount of bilirubin = extent of hemolysis/danger of anemia to fetus

A

T

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21
Q

TEST FOR HDN

Amniotic fluid bilirubin is measured by?

A

Spectrophotometric analysis using serial dilutions

22
Q

TEST FOR HDN

The optical density (OD) of the fluid is measured in intervals between?

A

365 and 550 nm

the readings plotted on semilogarithmic graph paper

23
Q

TEST FOR HDN

In normal fluid, OD is higest/peak and decreases at what nanometer?

A

highes peak at 365 nm
decreases linearly at 550 nm

illustrated by a straight line

24
Q

TEST FOR HDN

When bilirubin is presnet, what is the rise in OD seen?

A

450 nm

wavelength of maximum bilirubin absorption

25
Q

TEST FOR HDN

The difference between the OD of the theoretic baseline and the OD at 450 nm represents the?

A

Amniotic fluid bilirubin
concentration

difference in OD/absorbance difference at 450 nm (“A450)

26
Q

TEST FOR HDN

The theoretic baseline depends on?

A

age of gestation

27
Q

TEST FOR HDN

Difference in OD is also referred to as ?

A

Absorbance difference at 450 nm (“A450)

28
Q

TEST FOR HDN

  • Difference in OD/Absorbance
    difference at 450 nm (“A450) is plotted on this
  • Determine severity of hemolytic siease
  • Divided into three zones

What method of detection/visualtization

A

Liley graph

29
Q

TEST FOR HDN: BILIRUBIN

plots the “A450 against gestational age and is divided into three zones that represent the extent of hemolytic severity

What method of detection/visualtization

A

Liley graph

30
Q

TEST FOR HDN: BILIRUBIN

Values falling in this zone indicate no more than a mildly
affected fetus

Liley graph: 3 zones

31
Q

TEST FOR HDN: BILIRUBIN

  • Values indicate moderate hemolysis and require careful monitoring
  • anticipating an early delivery or exchange transfusion upon delivery

Liley graph: 3 zones

32
Q

TEST FOR HDN: BILIRUBIN

  • Values indicates severe hemolysis and suggests a severely affected fetus
  • induction of labor or intrauterine exchange transfusion

Liley graph: 3 zones

33
Q

TEST FOR HDN: BILIRUBIN

What zone does value fall based on intervention?

require careful monitoring anticipating an early delivery or exchange transfusion upon delivery

Liley graph: 3 zones

34
Q

TEST FOR HDN: BILIRUBIN

What zone does value fall based on intervention?

require careful monitoring anticipating an induced labor or intrauterine exchange transfusion upon delivery

Liley graph: 3 zones

35
Q

TEST FOR HDN: BILIRUBIN

What zone does value fall based on intervention?

No intervention since normal

Liley graph: 3 zones

36
Q

TEST FOR HDN: BILIRUBIN

  • amniotic fluid ΔA450 values at 14 to 40
    weeks’ gestation
  • More specific and detailed in terms of the week of gestation

What method of detection/visualtization

A

Queenan curve

37
Q

TEST FOR HDN: BILIRUBIN

If specimens are not protected from light, there will be markedly decreased values within time frame of?

Queenan curve

A

as little as 30 minutes of exposure to light

38
Q

TESTS FOR FETAL DISTRESS

Increased levels of alpha-fetoprotein (AFP)

A

Neural Tube Defects

39
Q

TESTS FOR FETAL DISTRESS

  • is the major protein produced by the fetal liver during early gestation (prior to 18 weeks)
  • found in the maternal serum due to the combined fetal-maternal circulations and in the amniotic fluid from diffusion and excretion of fetal urine

NTD

A

AFP (Alpha-fetoprotein)

40
Q

NEURAL TUBE DEFECTS

Increased levels of AFP are found in?

(2)

A

Maternal serum and Amniotic fluid

primarily maternal serum

when the skin fails to close over the neural tissue

41
Q

NEURAL TUBE DEFECTS

Normal value for AFP?

42
Q

NEURAL TUBE DEFECTS

are based on the week of gestational age,
as the fetus produces maximal AFP between 12 and 15 weeks’ gestation after which levels in amniotic fluid begin to decline

A

Normal values

43
Q

NEURAL TUBE DEFECTS

maximal AFP produced by fetus is during when?

A

between 12 and 15
weeks’ gestation

after which levels in amniotic fluid begin to decline

44
Q

NEURAL TUBE DEFECTS

Maternal serum and Amniotic fluid are reported in terms of?

A

multiples of the median (MoM)

45
Q

NEURAL TUBE DEFECTS

is the laboratory’s reference level for a given week of gestation

46
Q

NEURAL TUBE DEFECTS

T or F

A value two times the median value is considered
abnormal for both maternal serum and amniotic fluid

47
Q

NEURAL TUBE DEFECTS

Increased levels of alpha-fetoprotein (AFP) in maternal and amniotic fluid indicates NTD specifically what (2) neural tube defects

A

Anencephaly and Spina
bifida

48
Q

NEURAL TUBE DEFECTS

when a baby’s spine and spinal cord does not develop properly in the womb, causing a gap in the spine

A

Spina
bifida

49
Q

NEURAL TUBE DEFECTS

a fatal condition where a baby is born without parts of the brain and skull.

A

Anencephaly

50
Q

NEURAL TUBE DEFECTS

NTD are detected by what (3) methods?

A
  • Maternal serum alpha-fetoprotein (MSAFP) blood test
  • High-resolution ultrasound
  • Amniocentesis

Mom, High, Ako

51
Q

NEURAL TUBE DEFECTS

  • Measurement followed after elevated amniotic fluid AFP levels
  • More specific for neural tube disorders than
    AFP (provided it is not performed on a bloody specimen)
A

Amniotic Acetylcholinesterase (AChE)

52
Q

T or F

Amniotic acetylcholinesterase (AChE) is more specific than aFP, provided it is not perfromed on bloody specimen since blood has AChE

AUBF (45 decks)

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