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AUBF Lecture Final Term > AMNIOTIC FLUID > Flashcards

AMNIOTIC FLUID Flashcards

1
Q

T or F
Doctors are the only one allowed to collect Amniotic Fluid

A

T
(specifically OBGYNE)

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2
Q

Amniotic Fluid is found around the developing fetus inside a membranous sac called?

A

amnion

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3
Q

Main Function of AF

A

– Serves to cushion and protect the developing fetus
– Also serves a key role in the exchange of water and molecules between the fetus and the maternal circulation
…….Source of water for the baby

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4
Q

The laboratory performs several crucial tests on amniotic fluid to?

A

assess the status of the fetus.

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5
Q

(4) The laboratory performs several crucial tests on AF

A
  1. Test to diagnose genetic and congenital disorders before birth
  2. Test to detect fetal distress from hemolytic disease of the newborn (HDN) or from infection
  3. Test to assess fetal lung maturity
  4. Assessment of the ability of the fetus to survive early delivery
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6
Q

Amniotic fluid is formed from the?

A

placenta

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7
Q

Volume of amniotic fluid increases steadily throughout the pregnancy up to a maximum of?

A

1100-1500 mL

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8
Q

The maximum volume throughout the pregnancy occurs at what week at gestation?

A

36 weeks of gestation

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9
Q

As the baby matures

A

more amniotic fluid is produced by the mother

(so Volume and maturity = directly proportional)

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10
Q

When fetal urine production begins, the chemical composition of the amniotic fluid changes.

This leads to increased production of?

A

creatinine

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11
Q

At commencement of fetal urine production, fetal swallowing of amniotic fluid begins and this regulates the?

A

formation of fetal urine

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12
Q

source of nutrients for the baby (especially water)

A

Amniotic fluid

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13
Q

How the baby takes up nutrients and water inside the womb

A

Intramembranous fluid transfer

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14
Q

amniotic fluid suffix

A

amnios

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15
Q

Decreased fetal swallowing resulting in increased amniotic fluid volume

> 2000 mL or >2L

A

POLYHYDRAMNIOS

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16
Q

Decreased amounts of amniotic fluid

Can occur with premature rupture of the membranes and Congenital malformations

<1000 mL or <1L

A

OLIGOHYDRAMNIOS

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17
Q

termed as the Collection of amniotic fluid

A

AMNIOCENTESIS

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18
Q

Injection of syringe into the abdominal walls of patient

A

Transabdominal

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19
Q

Through the vagina

A

Transvaginal

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20
Q

Needle aspiration is introduced into the amniotic sac, usually? (what type of spec. collection method)

A

transabdominally

(with simultaneous use of ultrasound)

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21
Q

The addition of __________ has helped to make the procedure safer especially if performed between __ and __ weeks of gestation for genetic studies.

A

ultrasound

15 and 18 weeks

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22
Q

Amount collected of AF is usually

A

10-20 mL (max of 30)

(with collection into several different syringes to prevent the contamination of all specimens with the blood from initial puncture)

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23
Q

What container is used for the AF specimen?

A

sterile plastic specimen containers

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24
Q

_______ containers are less desirable as cells have more tendency to adhere to the glass surface

and Consistency and morphology of cellular elements are affected

A

Glass containers

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25
Q

Normal Amniotic Fluid
color/appearance

A

COLORLESS to PALE YELLOW

Slightly turbid due to Fetal cells (Vernix and Hair)

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26
Q

protective coating that forms on baby’s skin in utero(wapa naanak)

A

Vernix

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27
Q

a natural moisturizer and has antibacterial properties

A

Vernix

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28
Q

(3) Storage of AF

A

A. Specimen for Cell Culture and Chromosomal Studies
B. Specimen for phospholipid analysis
C. Specimen for chemical analysis

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29
Q

Identify what STORAGE type is mentioned

Stored at Room temperature to keep the fetal cells alive

A

Specimen for Cell Culture and Chromosomal Studies

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30
Q

Identify what STORAGE type is mentioned

Transported on ice and centrifuged at 500g and the supernatant saved for testing.

If blood is present, specimen should be centrifuged to prevent hemolysis from altering the test results

A

Specimen for phospholipid analysis

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31
Q

Anything involved with lipid and chemical procedures, all specimens should be?

A

preserved/refrigerated

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32
Q

Identify what STORAGE type is mentioned

  • Stored at any length of time but must be centrifuged.
A

Specimen for chemical analysis

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33
Q

If samples for chemical analysis need to be stored more than 24 hours, they must be?

A

frozen

34
Q

Microscopic test to differentiate amniotic fluid from maternal urine.

A

Fern Test

35
Q

(2) Fern Test Can be used to test if the patient is:

A
  1. Pregnant
  2. There is premature rupture of the amniotic fluid
36
Q

Fern test is done in a way where

A

Vaginal fluid is spread out on a glass slide and allowed to dry at room temperature.

37
Q

The slide of Fern test is observed for

A

The slide is observed for fern-like crystals that are a positive screen test for amniotic fluid.

38
Q

positive fern test

A

Presence of fern-like crystals due to the;

Crystallization of cervical mucus due to increased concentration of protein and electrolytes during pregnancy

39
Q

GROSS EXAM
State the significance colorless AF

A

Normal
- may show slight to moderate turbidity

40
Q

GROSS EXAM
State the significance a Blood Streaked AF

A

Traumatic Tap
Abdominal Trauma
Intra Amniotic Hemorrhage

41
Q

GROSS EXAM
State the significance a Yellow AF

A

Hemolytic Disease of the newborn

42
Q

GROSS EXAM
State the significance a Dark green AF

A

Meconium

43
Q

GROSS EXAM
State the significance a Dark red brown AF

A

Fetal Death

44
Q

1st Phase of Amniotic fluid

A

Development of amniotic fluid = water and electrolytes

45
Q

2nd Phase of Amniotic fluid

A
  • Usually happens on the 12th – 14th week (3rd month)
  • Contains protein, carbohydrates, phospholipids, urea, creatinine
    *Facilitate fetal growth
46
Q

When does the 2nd Phase of Amniotic fluid happen?

A

12th – 14th week (3rd month)

47
Q

What does the 2nd Phase of Amniotic fluid composed of?

A

protein, carbohydrates, phospholipids, urea, creatinine

*Facilitate fetal growth

48
Q

To know if the baby is okay (no genetic disorders nor birth defects)

A

Test for Fetal Lung Maturity

49
Q

TEST FOR FETAL LUNG MATURITY

are lung surfactants

A

Lecithin and Sphingomyelin (L/S Ratio)

50
Q

TEST FOR FETAL LUNG MATURITY

o Lower surface tension within alveoli (prevents alveolar collapse)
o Prevent invasion of certain pathogens
o Mediate immune responses

A

L/S Ratio

51
Q

As the baby matures, L/S ratio?

A

increases

2:1 [normal ratio (L:S)]
*If normal = fetus can be safely delivered with well-functioning lungs

52
Q

PRINCIPLE of L/S Ratio

A

Thin Layer Chromatography

53
Q

DETAILS of L/S Ratio

A

Sphingomyelin is used as internal standard, greatly affected by blood and meconium contamination

54
Q

is used as internal standard, greatly affected by blood and meconium contamination

A

Sphingomyelin

55
Q

NORMAL VALUES of L/S Ratio

A

> 2.0

56
Q

TEST FOR FETAL LUNG MATURITY
PRINCIPLE of Amniostat FLM

A

Agglutination immunoassay

57
Q

DETAILS of Amniostat FLM

A

Uses antisera specific to PHOSPHATIDYLGLYCEROL
o Main substance to detect
o Marker for pulmonary maturity

  • Not affected by blood and meconium contamination
58
Q

NORMAL VALUES of Amniostat FLM

A

Positive

59
Q

TEST FOR FETAL LUNG MATURITY
PRINCIPLE of Foam Stability Index

A

Modified Foam shake

60
Q

DETAILS of Foam Stability Index

A

95% ethanol used as anti-foaming agent

61
Q

NORMAL VALUES of Foam Stability Index

A

> 47

62
Q

TEST FOR FETAL LUNG MATURITY
PRINCIPLE of Microviscosity

A

Fluorescence polarization

63
Q

DETAILS of Microviscosity

A

Albumin used as internal standard

64
Q

NORMAL VALUES of Microviscosity

A

> 55 mg/g

65
Q

TEST FOR FETAL LUNG MATURITY
PRINCIPLE of Lamellar Body Count

A

Resistance pulse counting

66
Q

DETAILS of Lamellar Body Count

A

Uses the platelet channel of hematology analyzers

67
Q

NORMAL VALUES of Lamellar Body Count

A

> 32,000/mL

68
Q

PRINCIPLE of OD at 650nm

A

Spectrophotometry

69
Q

DETAILS of OD at 650nm

A

Requires centrifugation at 2000 g for 10 minutes

70
Q

NORMAL VALUES of OD at 650nm

A

> 0.150

71
Q

If unit si nm (or numbers), principle is always

A

spectrophotometry

72
Q

Identify what test is this

If positive, the baby does not receive enough oxygen

A

Test for Fetal Distress

73
Q

Test for Fetal Distress
(2) How to know when the test is needed?

A
  • There are changes in baby’s heartrate during ultrasound
  • Slow to no movement inside the womb
74
Q

TEST FOR FETAL DISTRESS
PRINCIPLE of Bilirubin

A

Spectrophotometry

75
Q

DETAILS of Bilirubin

A
  • Wavelength plotted on a LILEY GRAPH to determine the severity of HDN.
  • Presence of Hgb and meconium can interfere with the results

*Increased hgb = increased bilirubin

76
Q

NORMAL VALUES of Bilirubin

A

<0.025

77
Q

TEST FOR FETAL DISTRESS
PRINCIPLE of Alpha Fetoprotein (AFP)

A

Immunoassay

78
Q

DETAILS of Alpha Fetoprotein (AFP)

A

Screening test for Neural Tube Defects

79
Q

NORMAL VALUES of Alpha Fetoprotein (AFP)

A

<2.0 MoM

80
Q

TEST FOR FETAL DISTRESS
PRINCIPLE of Acetylcholinesterase (AChE)

A

Spectrophotometry

81
Q

DETAILS of Acetylcholinesterase (AChE)

A

Confirmatory test for NTD and greatly affected by blood contamination

82
Q

NORMAL VALUESof Acetylcholinesterase (AChE)

A

Undetectable

AUBF Lecture Final Term (5 decks)

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