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Chem II > Pregnancy And Prenatal Testing > Flashcards

Pregnancy And Prenatal Testing Flashcards

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1
Q

1st trimester

A

Day of conception - 12 weeks

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2
Q

When is the start of gestation?

A

First day of the last menstrual period

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3
Q

2nd trimester

A

13 - 26 weeks

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4
Q

3rd trimester

A

26 week - delivery

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5
Q

Conception

A

Used as an indication of development from the date the sperm fertilizes the ovum

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6
Q

Gestation

A

Used as an indication of fetal development from the last period

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7
Q

Ovulation

A

Ovum released from the ovary to fallopian tube

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8
Q

Zygote

A

Ovum that has been fertilized in the fallopian tube by sperm

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9
Q

Blastocysts

A

Cluster of 50-60 cells with a cavity to form the yolk sac. Goal of implantation into uterine wall

5 days past fertilization

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10
Q

Placenta

A

Functional surface between the mother and fetus that secretes hormones and growth factors into the mother with physiological effects

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11
Q

Embryo

A

Cluster of cells once implantation occurs

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12
Q

Organogenesis

A

Create organs by embryo, takes 10 weeks

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13
Q

Development at 10 weeks

A

Organs developed, heartbeat, regular arm and leg movement, 8cm long, 13 grams

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14
Q

Development at 2nd trimester

A

Rapid growth, moves freely, hiccups, can yawn, genitalia become visible and functionally release sex hormones

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15
Q

Development at 26th week

A

Most premature births can survive if sufficient prenatal care is available

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16
Q

Development at 3rd trimester

A

Fetus gains 200 g/week (7oz), eyes open and blink, practice breathing, sucking reflex at 34weeks

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17
Q

When does delivery occur?

A

38-42 weeks

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18
Q

What happens to progesterone and estrogen at delivery?

A

Progesterone will rapidly drop and estrogen will rise as progesterone drops.

Progesterone continues to increase throughout pregnancy to maintain pregnancy

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19
Q

Development in the last 4 weeks

A

Mainly for muscle development, building fat storage, practicing movements required for life after delivery

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20
Q

What happens to plasma volume during pregnancy?

A

Steadily increases 50-85%. Directly proportional to the weight of the fetus in the 3rd trimester

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21
Q

Renin-Angiotensin-Aldosterone System is ____ during pregnancy.

A

Activated
(underfilling of arteries and release of relaxin)

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22
Q

What happens to calcium in the mother’s body during pregnancy?

A

Decreases. The fetus needs free calcium, and if there is insufficient calcium in the mother’s circulation, calcium will be released from the mother’s bones.

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23
Q

As GFR increases, filtration of creatinine, uric acid, and BUN ___, causing a ___ in plasma levels

A

Increase

Decrease

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24
Q

How is hyperventilation compensated in the mother’s body?

A

Mild, fully compensated respiratory alkalosis

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25
Q

Why is the mother’s immune system altered during pregnancy?

A

To prevent an immune response from paternal antigens in fetus. Pro-inflammatory response is decreased

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26
Q

What is the purpose of (beta)HCG assessment?

A

Early detection of pregnancy?

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27
Q

What is the expected trend of HCG levels throughout pregnancy?

A

Doubles every 24 hours until 8th week, peak at 10th week, decreases until 16 weeks, stabile thereafter

28
Q

HCG levels can take ___ to ___ days to return to normal post pregnancy

A

7 - 60 days

29
Q

What can cause a false negative in point of care pregnancy testing?

A

Too early, dilute urine, hook effect for very high hCG levels

30
Q

What can cause a false positive in point of care pregnancy testing?

A

Medications (aspirin, carbamazepine, methadone), sitting too long, untrained eye

31
Q

Point of care pregnancy testing is a (qualitative/quantitative) test

A

Qualitative

32
Q

T/F:

Hyperglycosylated hCG in early pregnancy is detected in point of care CLIA waived at home test

A

FALSE

Not detected in early pregnancy

33
Q

T/F:
There is no reference range for pregnancy related quantitative maternal serum b-hCG

A

TRUE

But 20 is a common cut off for pregnancy

34
Q

What can cause false positives in serum immunoassay methodologies?

A

Heterophilic ab, rheumatoid factors, IgA deficiency, chronic renal failure, end-stage renal disease, exogenous hCG consumed

35
Q

What can cause false negatives in serum immunoassay methodologies?

A

Hook effect

36
Q

T/F:

AFP can pass from placenta to maternal bloodstream

A

TRUE

37
Q

What is the concentration trend of AFP?

A

Rise at the end of the first trimester and fall after 32 weeks

38
Q

Where is AFP produced?

A

Yolk sac first and then parenchymal cells in the fetal liver

39
Q

What is the significance of maternal AFP (MS-AFP) test?

A

Screening marker for fetal abnormalities, fetal distress, indicator of pregnancy health.

(General marker for spina bifida and anencephaly for the fetus and preeclampsia and risk of perinatal death for the mother)

40
Q

What affects MS-AFP levels?

A

Age, body mass, ethnicity, gestational age

41
Q

What is Multiples of Median (MoM)

A

(Mother’s AFP)/(Median of reference range)

Compares patient’s AFP serum to the median of the reference range. Helps overcome variable that an influence results.

42
Q

What is the reference range of MoM AFP?

A

0.5 - 2.0 MoM

43
Q

What can cause a false positive in MoM

A

Multiple pregnancy, incorrect calculation of fetal gestation, gestational diabetes, tobacco smoke exposure, lab techniques

44
Q

Why would you perform fetal amniotic fluid AFP testing?

A

When MS-AFP is higher than expected and you aren’t finding an answer through ultrasounds. Be careful to avoid fetal or maternal contamination as blood will interfere.

45
Q

Specimen types for AFP

A

Serum, Urine, or amniotic fluid

46
Q

What is the predominant estrogen in pregnancy and where is it synthesized?

A

Estriol (E3) and it is synthesized in the placenta

47
Q

What is E3 screening most used for?

A

Screening for trisomy 21 (Down’s syndrome) and trisomy 18 (Edward’s syndrome)

48
Q

T/F:
The triple and quadruple screen test is used as a diagnostic test

A

FALSE

Screening purposes only

49
Q

Pregnancy Associated Plasma Protein A (PAPP-A)

A

Valuable 1st trimester screening test. Low concentration in trisomy 13, 18, 21, and Turner syndrome

50
Q

Progesterone

A

Important for establishing and maintaining healthy pregnancy. Steroid produced by placenta. Monitor in suspected high risk spontaneous/natural fetal abortion

51
Q

Gestational diabetes (GDM) affects __% of all pregnancies

A

10%

52
Q

Levels that define GDM (meet or exceed these levels)

Fasting:
1Hr:
2Hr:
3Hr:

A

Fasting: 95mg/dL
1Hr: 180mg/dL
2Hr: 155mg/dL
3Hr: 140mg/dL

53
Q

Positive Fetal Fibronectin is indicative of what?

A

That the patient will likely go into labor within 7-14 days

54
Q

Neural Tube Defects

A

One of the most common birth defects. It occurs wen the neural tube does not close completely

55
Q

Spina Bifida

A

Occurs when fusion is not complete along the spinal cord of the developing fetus

56
Q

Down Syndrome

A

Usually 3 copies of chromosome 21, 5% due to translocation

57
Q

Maternal age severely ___ the risk of having a fetus with Down Syndrome

A

Increases

58
Q

Trisomy 18

A

Occurs when the fetus has an extra copy of chromosome 18

59
Q

Isoimmunization

A

Involves fetal hemolytic disorder. Mom is against baby

60
Q

Isoimmunization most often occurs when mother is Rh ___ and is carrying a Rh ____ fetus

A

Mother: Negative

Fetus: Positive

61
Q

Pre-Term delivery

A

Fetus is delivered earlier than the 37th week of gestation

62
Q

What is the most common problem seen in pre-term delivery

A

Respiratory Distress Syndrome: a lack of pulmonary surfactant

63
Q

Pre-Eclampsia

A

Hypertension, proteinuria, and edema in the 2nd and 3rd trimester that occurs in 5% of pregnancies. Only cure is delivery

64
Q

Hyperemesis Gravidarum

A

“Morning Sickness”

70% of pregnancies. Wide range in severity

65
Q

Ectopic pregnancy

A

Trophoblastic cells prematurely attaching to the lining of the fallopian tube instead of attaching to the uterine endometrium.

Must surgically remove

66
Q

Analyte deficiency

A

Calcium deficiency during 2nd and 3rd trimesters

Relative iodine deficiency

Chem II (12 decks)

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