Amniotic fluid Flashcards by pattie o.

hCG production

Syncytiotrophoblast cells of placenta

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hCG peak

1st trimester (blood, urine, amniotic fluid)

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hCG subunit shared

Alpha (hCG, LH, FSH, TSH)

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hCG specificity

Beta subunit

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Pregnancy test principle

Enzyme immunoassay

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Pregnancy test specimen

1st morning urine

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Pregnancy kit cutoff

25 mIU/mL

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Anti-hCG source

Rabbit

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False-positive pregnancy test causes

Molar pregnancy, LH surge, hematuria, proteinuria, malignancies, postpartum, herbal meds, perimenopause, ovarian failure

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False-negative pregnancy test causes

Early/late testing, dilute/adulterated urine, ectopic pregnancy, missed abortion

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Hogben test

Female frog; positive: oogenesis

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Galli-Mahini test

Male frog; positive: spermatogenesis

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Friedmann test

Virgin rabbit; positive: corpora lutea/hemorrhagica

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Ascheim-Zondek test

Immature mice; positive: ovarian hyperemia

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Hyperemia in Preg test is also seen in

Kupperman/Kelso (virgin rat)

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ELISA sensitivity

Positive at 10 days conception

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Pregnancy urine SG

≥1.015

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Amniotic fluid source

Placenta

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Amniotic fluid functions

Cushion fetus, stabilize temp, movement, lung development

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Amniotic fluid normal volume

800–1200 mL (3rd trimester)

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1st trimester fluid source

Maternal circulation (35 mL)

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Polyhydramnios causes

Decreased swallowing, NTDs, anomalies, infections

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Oligohydramnios causes

Increased swallowing, membrane leakage, urinary deformities, malformations, premature membrane rupture, cord compression

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Amniocentesis collection

30 mL in sterile syringe

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Genetic defect assessment

2nd trimester amniocentesis (trisomy 21/Down syndrome)

Fetal lung maturity/HDN assessment

3rd trimester

Quadruple screen tests

Alpha-fetoprotein, HCG, unconjugated estriol (E3), inhibin A

FLM specimen handling

Ice delivery, refrigerated/frozen, filtration to prevent phospholipid loss

Cytogenetic study handling

Room temp or 37°C

HDN test specimen handling

Protect from light

Reliable fluid ID

Urea <30 mg/dL, creatinine <3.5 mg/dL

Fern test

Detect PROM/early pregnancy (fern crystals in dried vaginal fluid)

Yellow amniotic fluid

HDN

Dark green amniotic fluid

Meconium (first bowel movement)

Dark red-brown amniotic fluid

Fetal death

RDS test

Fetal lung maturity

RDS cause

Surfactant insufficiency (phospholipid production)

Surfactant function

Decrease surface tension, allow easier alveoli inflation

RDS reference method

L/S ratio

Alveolar stability

Lecithin

L/S ratio control

Sphingomyelin

L/S measurement

TLC

Mature lungs L/S ratio

≥2.0

False positive L/S ratio

Blood or meconium presence

Phosphatidyl glycerol test

Amniostat-FLM

Amniostat advantage

Not affected by blood/meconium

Phosphatidyl glycerol in diabetics

Delayed production

Foam stability test

Positive: foam/bubbles (mature lungs)

Microviscosity measurement

Fluorescence polarization

Type II pneumocytes produce surfactants stored as

Lamellar bodies

Lamellar body count can be measured using

Optical scatter (diameter similar to platelet)

Adequate FLM in LBC

>32,000/ uL

Lamellar bodies O.D absorbance at

650 nm

O.D equivalent to L/S ratio >/= 2.0 in presence of PG

>0.150

Prior to 36 weeks gestation, fetal amniotic fluid creatinine

1.5 to 2.0 mg/dL

At 36 weeks gestation, amniotic fluid creatinine

>2.0 mg/dL

Test for HDN optical density

450 nm

Normal absorbance of amniotic fluid

Increased at 365 nm, decreased at 550 nm

Increased O.D at 450 nm indicates

HDN

Liley graph Zone I result

Non-affected or mildly affected fetus

Liley graph Zone II result

Moderately affected fetus (requires monitoring)

Liley graph Zone III result

Severely affected fetus (requires intervention)

Queenan curve shows absorbance values from

14-40 weeks of gestation

Lowest zone in Queenan curve

Rh negative (unaffected) fetus

Indeterminate and Rh positive zones in Queenan curve

Increasing hemolytic severity

Intrauterine death risk zone

High risk of mortality

Interferences for absorbance in amniotic fluid

Cells, meconium, debris, hemoglobin (peaks at 410nm)

To remove hemoglobin interference in absorbance

Add chloroform

Spina bifida characteristic

Incomplete closing of backbone and spinal cord membranes

Anencephaly characteristic

Absence of major brain, skull, and scalp portions

Screening test for NTDs

Alpha fetoprotein

AFP in NTDs

Increased

AFP in Down syndrome (T21)

Decreased

Confirmatory test for NTDs

Acetylcholinesterase

Tests for chromosomal abnormalities

Karyotyping, FISH, SKY

Major protein produced by fetal liver before 18 weeks

AFP

Amniotic fluid Flashcards

(76 cards)