Serum Screening In Pregnancy

Question 0

Cranial versus Caudal neural tube defect?

Open neural tube defect?

Answer 0

Anencephaly versus spina bifida

Neural Tube defect not covered by skin

Question 1

Alpha-fetoprotein – made by? Analogous to?

Answer 1

Fetal yolk sac then G.I. tract and Fetal liver;

adult albumin

Question 2

Combination trisomy screen measures?

Answer 2

AFP, Beta hCG, inhibin-A, unconjugated Estriol

Question 3

AFP passes into maternal circulation through?

Answer 3

Chorioamniotic membranes

Question 4

Levels of AFP suspicious for neural tube defects?

Answer 4

2-2.5 multiples of the median

Question 5

Causes of elevated maternal serum AFP?

Answer 5

1. Gestations - Underestimation of the gestational age, multiple gestations, Oligohydramnios
2. Holes - neural tube defects, abdominal wall defects, skin defects
3. Cystic hygroma
4. Sacrococcygeal teratoma

Question 6

Causes of low maternal serum AFP?

Answer 6

1. Overestimation of gestational age
2. Trisomies
3. Molar pregnancies
4. Feral Demise

Question 7

Lab value elevated in down syndrome?

Answer 7

Beta hCG

Question 8

First trimester down syndrome screening combines?

Answer 8

Pregnancy-associated plasma protein (PAPP-A) and beta-hCG with sonogram

Question 9

Nuchal translucency?

Answer 9

Echolucent area seen in back of fetal neck

Question 10

Most common cause of abnormal screening?

Answer 10

Wrong dating

Question 11

Ultrasound signs of down syndrome?

Answer 11

1. Thickened nuchal fold
2. Shortened femur length
3. Echogenic bowel

Question 12

Fetal loss rate from amniocentesis? Complications?

Answer 12

.5%

ROM, chorioamnionitis

Question 13

Pregnancies with an elevated maternal serum AFP are at an increased risk for?

Answer 13

1. Stillbirth
2. Growth Restriction
3. Preeclampsia
4. Placental abruption