Maternal Serum Screening COPY Flashcards

1
Q

What are the real implications of the results from a screening test?

A

Positive Test = risk increased
Negative Test = risk decreased

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2
Q

Positive Predictive Value

A

The likelihood a pregnancy is affected when screening indicates a positive or high-risk result

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3
Q

Negative Predictive Value

A

The likelihood a pregnancy is unaffected when screening indicates a negative or low risk result

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4
Q

What does the First Trimester Screen test screen for?

A

Down syndrome
trisomy 18

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5
Q

What are the implications of an increased NT?

A

Increased NT is an independent risk factor for increased risk of aneuploidy, even if analytes are normal.

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6
Q

All of hte anlytes are produced by the placenta in FTS except for…

A

AFP

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7
Q

What are the 2 main analytes tested during FTS and what is their typical pattern?

A

Pregnancy-associated plasma protein A (PAPP-A): Rises throughout pregnancy
Human chorionic gonadotropin (hCG): rises rapidly until 10 weeks gestation then declines

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8
Q

How long is normal, healthy pregnancy?

A

40 weeks

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9
Q

What levels of PAPP-A & hCG are associated with trisomy 18?

A

both are decreased
(all analytes are low in trisomy 18)

hCG is also low during 2nd trimester screen for trisomy 18

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10
Q

What levels of PAPP-A & hCG are associated with Down syndrome?

A

hCG tends to be increased and PAPP-A tends to be decreased

hCG is also high in 2nd trimester for Downs

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11
Q

What value for MoM is considered normal?

A

1

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12
Q

What risk does poorly controlled diabetes pose to a fetus?

A

open neural tube defects

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13
Q

When is AFP ordered and what does its level tell us?

A

Second trimester
Increased AFP is associated with ONTD

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14
Q

Most analytes are made by the placenta, where is AFP made though?

A

the yolk sac, fetal GI tract, and fetal liver

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15
Q

When is the Quad Screen ordered and what conditions is it screening for?

A

2nd trimester
Downs, trisomy 18, ONTD

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16
Q

What pattern on the Quad Screen is indicative of Downs?

A

b-HCG = high
uE3 = low
Inhibin-A = high
AFP = low

17
Q

What pattern on the Quad Screen is indicative of trisomy 18?

A

b-HCG = low
uE3 = low
AFP = low

18
Q

Other than ONTD, what can abnormal AFP levels be indicative of?

A

anencephaly

19
Q

Why is accurate gestational dating so important?

A

So that the lab knows which levels of analytes to expect for comparison, otherwise results are not reliable.

20
Q

What is a normal NT (nuchal translucency) measurement?

A

< 3.0 mm