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Liz's Clinical Chemistry Module 2 > Pregnancy and Amniotic Fluid > Flashcards

Pregnancy and Amniotic Fluid Flashcards

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1
Q

Four functions of the placenta

A
  1. keeps maternal and fetal circulation systems separate
  2. Nourishes the fetus
  3. Eliminates fetal waste
  4. Produces hormones vital to pregnancy
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2
Q

Protein that stimulates the ovary to produce progesterone in order to protect the pregnancy

A

Human Chorionic Gonadotropin

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3
Q

Protein hormone that has potent growth and lactogenic properties

A

Placental lactogen

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4
Q

These steroid hormones ensure appropriate development of endometrium, uterine growth, adequate uterine blood supply and preparation of the uterus for labor

A

Estrogens (estradiol, estriol, esterone) and progesterone

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5
Q

Two functions of amniotic fluid

A
  1. Cushions baby against possible injury

2. Helps maintain a constant temperature

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6
Q

How many days after conception can hCG can detected in the serum?

A

B/w 8 and 11 days

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7
Q

When does normal doubling time of hCG in early pregnancy occur?

A

About two days in early pregnancy

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8
Q

When do hCG levels peak in a normal pregnancy?

A

Near the end of the first trimester

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9
Q

Describe hCG levels and its doubling time in an ectopic pregnancy

A

hCG concentration is less in ectopic pregnancies and the doubling time is nearly always greater than 2 days

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10
Q

Serum ____ concentrations are often low in mothers w/ abnormal pregnancies

A

Progesterone

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11
Q

Symptoms of pre-eclampsia

A

Hypertension, proteinuria, and edema

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12
Q

Symptoms of eclampsia

A

Convulsions, rapid and sustained rise in blood pressure, DIC, and intravascular deposition of fibrin w/ subsequent end-organ damage

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13
Q

What does HELLP stand for?

A

Hemolysis, Elevated Liver enzymes, Low Platelet counts

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14
Q

Symptoms of HELLP syndrome

A

Thrombocytopenia, DIC, epigastric pain, malaise, nausea, vomiting, headache, LD/ALT/AST elevated; treatment is delivery

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15
Q

Chromosomal abnormality present in Down Syndrome

A

3 copies of c’some 21 (Trisomy 21)

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16
Q

Chromosomal abnormality in Edward’s syndrome

A

Extra copy of c’some 18 (Trisomy 18)

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17
Q

Four tests in the “quad marker screen”

A

Alpha-Fetoprotein, hCG, unconjugated estriol (E3), and dimeric inhibin A (InA)

18
Q

Relative estriol, hCG, AFP, and dimeric inhibin A quad marker results associated w/ Down Syndrome

A

Estriol: ~25% lower
hCG: 2x higher
AFP: ~25% lower
Inhibin A: lower

19
Q

Relative estriol, hCG, and AFP quad marker results in Trisomy 18

A

All are lower

20
Q

Anomaly detected via the detection of increased maternal serum AFP

  • Mean AFP = 1.00
  • Mean AFP = 3-4
  • Mean AFP = 4-7
A

Neural tube defects

  • Mean AFP of 1.00 → unaffected fetus
  • Mean AFP of 3-4 → open spina bifida
  • Mean AFP of 4-7 → anencephaly
21
Q

Effect of surfactant in the lungs in fetal lung prematurity

A

Surfactant permits gaseous exchange; lack of surfactant produces neonatal respiratory distress syndrome (RDS)

22
Q

Reduces surface tension in teh alveoli of the lungs

A

Surfactant

23
Q

W/o surfactant at the alveolar lining-air interface what happens to alveoli?

A

The alveoli would collapse w/ each inspiration before oxygen/CO2 exchange can occur

24
Q

Two screening tests for fetal lung maturity

A
  1. Lecithin/Sphingomyelin (L/S) ratio
  2. Phosphatoidylglycerol (PG) and phosphatidylinositol (PI)
  3. Foam stability index
  4. Lamellar body count
25
Q

Two major surfactants in the human lung

A

Phospholipids: lecithin (L) and phosphatidylglycerol (PG)

26
Q

Where are lecithin and PG stored?

A

In lamellar bodies

27
Q

Risk of newborns that will have RDS according to FLM test

A

If the amniotic fluid L/S ratio is <2%, 20-25% of newborns will have RDS

28
Q

These are about the same size as platelets and can be counted using standard hematology analyzer

A

Lamellar bodies

29
Q

A lamellar body count of > ____/mL in amniotic fluid is considered mature

A

60,000

30
Q

This test is an indirect measurement of the bilirubin concentration in the amniotic fluid where the bilirubin has a max absorbance at 450nm; used as a marker of the severity of fetal hemolysis (HDN)

A

Delta A450 test

31
Q

Low fluid volume in intrauterine growth retardation and anomalies of the fetal urinary tract

A

Oligohydramnios

32
Q

High fluid volume in maternal diabetes mellitus, multifetal pregnancy, anencephaly, or spina bifida

A

Polyhydramnios

33
Q

3 amniotic fluid tests used to assess fetal distress

A
  1. bilirubin spectral scan (Liley Plot)
  2. AFP
  3. DNA analysis for chromsomal abnormalities
34
Q

What is the significance of an abnormal Liley Plot and what does it look like?

A

There is a sharp peak at 450nm which indicates bilirubin is in the amniotic fluid; informs us how severe HDN is

35
Q

Function of the AFP amniotic fluid test

A

To assess neural tube disorders (e.g., spina bifida, anencephaly)

36
Q

An L/S ratio of > ___ together w/ the presence of PG may suggest mature fetal lung development

A

2.0

37
Q

Performed by mixing equal volumes of amniotic fluid w/ ethanol, followed by vigorous shaking. If foam is produced, adequate surfactants are present

A

The shake test/foam stability test

38
Q

An FSI ≥ ____ correlates w/ fetal pulmonary maturity and is analogous to an L/S ratio of 2.0

A

0.48

39
Q

Membrane that covers the embryo and fills w/ amniotic fluid creating the amniotic sac

A

Amnion

40
Q

Membrane that exists during pregnancy b/w developing fetus and mother

A

Chorion

41
Q

Membrane enclosing the fetus; afterbirth; plexus in the ventricles of the brain where CSF is produced

A

Choroid plexus

42
Q

Protein produced by fetal cells, found at the interface of hte chorion and decidua; adhesive that binds the fetal sac to the uterine lining

A

Fetal fibronectin

Liz's Clinical Chemistry Module 2 (9 decks)

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