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AUBF2 > Amniotic Fluid > Flashcards

Amniotic Fluid Flashcards

1
Q

This a colorless to Pale-yellow fluid found in the membranous sac around the fetus called as AMNION

A

AMNIOTIC FLUID

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2
Q

What are the functions of Amnionic Fluid?

A

FUNCTIONS:
1. Cushion for fetus
2. Allows fetal movement
3. Stabilizes temperature
4. Proper lung development

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3
Q

What is the normal value of Amniotic Fluid?

A

NORMAL VOLUME: 800 to 1,200 mL [3rd trimester]

Note:
▪ Increases throughout pregnancy
▪ Gradually decreases before delivery

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4
Q

What is the ultimate source of amniotic fluid water and solutes?

A

PLACENTA

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5
Q

What trimester does a 35 mL is derived from the circulation coming from the mother?

A

1st trimester

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6
Q

After the 1st trimester, the major constituent of amniotic fluid is?

A

FETAL URINE

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7
Q

The fetus already released LUNG FLUID, which may contribute to the volume of the amniotic fluid

A

During the 3rd trimester:

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8
Q

During the 3rd trimester of pregnancy, fetus release what kind of fluid? Which contributes to the volume of the amniotic fluid?

A

LUNG FLUID

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9
Q

The normal volume of the amniotic fluid is regulated by the balance of:
Production of:

A

Fetal urine and Lung fluid

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10
Q

The normal volume of the amniotic fluid is regulated by the balance of:

Absorption of Amniotic fluid by:

A

▪ Fetal swallowing
▪ Intramembranous flow

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11
Q

▪ ↑ in the normal volume of amniotic fluid
▪>1,200mL
▪ ↓ fetal swallowing of urine
▪ Neural tube defects

A

POLYHYDRAMNIOS

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12
Q

▪ ↓ in the normal volume of amniotic fluid
▪ <800mL
▪ ↑ fetal swallowing of urine
▪ Membrane leakage
▪ Urinary tract deformities*

A

OLIGOHYDRAMNIOS

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13
Q

Deformities in Urinary Tract impairs urination thus

A

Decreases urine output [decreased urine output also indicates decreased amniotic fluid]

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14
Q

What is the method collection of Amniotic Fluid?

A

Amniocentesis

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15
Q

This safe to perform among pregnant women on the 14th week of gestation [early 2nd trimester]

A

Amniocentesis

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16
Q

Amniocentesis is safe to perform among pregnant women on the what time frame?

A

14th week of gestation [early 2nd trimester]

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17
Q

The MAXIMUM VOLUME of Amniocentesis is?

A

30 mL

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18
Q

The first 2 to 3 mL is discarded because it may be contaminated with:

A

▪ Maternal Blood
▪ Tissue Fluid
▪ Cells

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19
Q

Can be assessed for Chromosomal Studies e.g. Trisomy 21 / Down Syndrome

A

16th week / 2nd Trimester Amniocentesis

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20
Q

Assessment of Fetal Lung Maturity and Fetal Hemolytic Disease

A

3rd Trimester Amniocentesis

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21
Q

The specimen must be placed on ICE during delivery
IF not performed immediately, must be refrigerated

A

Test for Fetal Lung Maturity (FLM)

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22
Q

Must the kept at room temperature or Body temperature

A

Test for Cytogenetic Studies / Microbial Studies

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23
Q

For detection of Bilirubin, a photosensitive analyte thus, it must be protected from light by using:
▪ Amber colored bottle
▪ Foil
▪ Black Plastic cover

A

Test for HDN

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24
Q

For detection of Bilirubin, a photosensitive analyte thus, it must be protected from light by using:

A

▪ Amber colored bottle
▪ Foil
▪ Black Plastic cover

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25
Q

There may be a possibility of _________ of the urinary bladder of the mother

A

accidental puncture

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26
Q

PROTEIN (+)
GLUCOSE (+)
UREA <30 mg/dL
CREATININE <3.5 mg/dL

A

Amniotic Fluid

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27
Q

PROTEIN (-)
GLUCOSE (-)
UREA >30 mg/dL
CREATININE >10 mg/dL

A

Maternal Urine

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28
Q

Why Protein and Glucose are less reliable as compared to Urea and Creatinine?

A

If the mother has conditions e.g. Proteinuria or Glucosuria, Maternal Urine may be False Positive (+)

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29
Q

Detects ruptured amniotic membranes

A

FERN TEST

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30
Q

What is specimen used in FERN TEST?

A

Vaginal Fluid

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31
Q

What are the procedures in FERN TEST?

A

PROCEDURE:
1. Spread on a glass slide
2. Allowed to air dry at room temperature
3. Observe under the microscope

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32
Q

Amniotic Fluid appears as Fern Like Crystals

A

Due to protein and NaCl present on Amniotic Fluid

33
Q

AMNIOTIC FLUID COLOR: Colorless to Pale- Yellow

A

Normal

34
Q

AMNIOTIC FLUID COLOR: Blood-Streaked

A

Traumatic tap
Abdominal Trauma
Intra-amniotic Hemorrhage

35
Q

AMNIOTIC FLUID COLOR : Yellow

A

↑ Bilirubin [HDN]

36
Q

AMNIOTIC FLUID COLOR: Dark Green

A

Meconium
[1st fetal bowel movement]

37
Q

AMNIOTIC FLUID COLOR: Dark Red-brown

A

Fetal Death / Fetal Demise

38
Q

What are the test in AMNIOTIC FLUID?

A

Test for HDN
Test for Neural Tube Defects
Test for Fetal Lung Maturity
Test for Fetal Age

39
Q

Anti-D antibodies that can destroy large numbers of fetal RBCs

Results in RBC degradation product e.g. Bilirubin

A

HDN / ERYTHROBLASTOSIS FETALIS

40
Q

a.k.a Optical density 450

A

Test for HDN

41
Q

Absorbance of Amniotic Fluid:

A

▪ NORMAL: ↑365 nm, ↓550 nm
▪ HDN: ↑450 nm [maximum bilirubin absorbance]

42
Q

Results on HDN TEST are plotted on a what graph?

A

LILEY GRAPH

43
Q

Nonaffected / mildly affected fetus

A

Zone 1

44
Q

Moderately affected fetus
▪ Close monitoring is required

A

Zone II

45
Q

Severely affected fetus
▪ Requires intervention

A

Zone III

46
Q

What are the interferences on HDN TEST?

A

INTERFERENCES:
▪ Presence of cells / meconium
▪ Presence of debris
▪ Presence of hemoglobin [410 nm peak absorbance]

47
Q

Birth defect where there is incomplete closing of the backbone and membranes around the spinal cord.

A

SPINA BIFIDA / SPLIT SPINE

48
Q

Absence of major portion of the brain and scalp

A

ANENCEPHALY

49
Q

Major protein produced by Fetal Liver during early gestation [18th week]
Screening Test

A

ALPHA-FETOPROTEIN (AFP)

50
Q

AFP is increased in?

A

Spina Bifida, Anencephaly

▪ Both Amniotic Fluid and Maternal Serum increase during pregnancy
▪ AFP will continuously increase if the skin fails to close the Neural Tissues

51
Q

AFP is decreased in?

A

Down Syndrome

52
Q

CONFIRMATORY TEST:
▪ Must not be performed if the sample is bloody
▪ Blood contains AcHE = False ↑ in Amniotic Fluid

A

Acetylcholinesterase (AChE)

53
Q

Most frequent complication of early delivery

7th most common cause of morbidity and mortality among premature infants

A

RESPIRATORY DISTRESS SYNDROME

54
Q

RESPIRATORY DISTRESS SYNDROME is caused by insufficient?

A

LUNG SURFACTANTS [Phospholipids]

55
Q

Main analyte measured in Amniotic Fluid to check for Lung Maturity

It allows the alveoli to open and close during inhalation and exhalation

A

LUNG SURFACTANTS [Phospholipids]

56
Q

TESTS FOR NEURAL TUBE DEFECTS

A

ALPHA-FETOPROTEIN (AFP)

57
Q

TESTS FOR FETAL LUNG MATURITY

A

LECITHIN / SPHINGOMYELIN (L/S) RATIO
AMNIOSTAT-FLM
FOAM TEST / SHAKE TEST
MICROVISCOSITY
LAMELLAR-BODY COUNT
OD 650 nm

58
Q

This the Reference Method

A

LECITHIN / SPHINGOMYELIN (L/S) RATIO

59
Q

Primary component of Lung surfactant; A phospholipid; Low production during the 35th week and below however, after 35th week, its production increases

A

LECITHIN

60
Q

Produced at a constant rate; Control

A

SPHINGOMYELIN

61
Q

↓Lecithin; ↑Sphingomyelin

A

35th week and below

62
Q

↑Lecithin; ↓Sphingomyelin

A

After 35th week

63
Q

<35th week

A

<1.6 L/S Ratio

64
Q

Mature fetal lungs → Preterm delivery is safe

A

≥2.0 L/S Ratio

65
Q

Presence of Blood and Meconium

A

False Increase

66
Q

Immunologic test for PHOSPHATIDYLGLYCEROL

The production of Phosphatidylglycerol is parallel to the production of Lecithin

Advantage: Not affected by Blood and Meconium

Disadvantage: Production is ↓ among Diabetic mothers

A

AMNIOSTAT-FLM

67
Q

A mechanical test in assessing Fetal Lung Maturity

A

FOAM TEST / SHAKE TEST

68
Q

Amniotic Fluid + 95% ethanol ————> stand for 15 mins

A

Shake for 15 seconds

69
Q

Presence of Foam / Bubbles
▪ Indicates sufficient Phospholipid present in the
Amniotic Fluid

A

Mature Fetal Lung

70
Q

A modification of Foam Test

A

FOAM STABILITY INDEX

71
Q

0.5 increasing amount of shake for 15 secs
+ 95% ethanol ————————> Stand for 15 mins
Amniotic Fluid (0.47 - 0.55 mL)

Mature Fetal Lung:

A

A semi-quantitative test

Foam / Bubbles = ≥0.47 indicates MFL

72
Q

Measured by Fluorescence Polarization
Surfactant-to-Albumin (S/A) Ratio is measured:
↑Phospholipid, ↓ Microviscosity
Dye Bound to Albumin: ↓Fluorescence, ↑Polarization
Dye Bound to Surfactant: ↑Fluorescence, ↓Polarization

A

MICROVISCOSITY

73
Q

Stored form of Phospholipid in the fetus

A

LAMELLAR-BODY COUNT

74
Q

This one is produce lung surfactants stored in the form of LAMELLAR BODIES

A

Type II Pneumocytes

75
Q

METHODS: (LAMELLAR-BODY COUNT)
▪ Diameter of Lamellar Bodies is similar to the diameter of Platelets which is why we can use the platelet channel of Hematology analyzer

A

Impedance, Optical Scatter Methods

76
Q

LAMELLAR-BODY COUNT

Adequate Fetal Lung Maturity:

A

> 32,000 /uL

77
Q

↑ Lamellar Bodies = ↑ Optical Density
OD of ≥0.150 is equivalent to:
L/S Ratio: >2.0 [indicates mature fetal lung] Presence of: Phosphatidyl Glycerol

A

OD 650 nm

78
Q

AMNIOTIC FLUID CREATININE

A

TEST FOR FETAL AGE

79
Q

<36 weeks gestation: 1.5 to 2.0 mg/dL
36 weeks gestation: >2.0 mg/dL

A

AMNIOTIC FLUID CREATININE

AUBF2 (11 decks)

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