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Mercy CLS 7/8: Coagulation/Body Fluids > Body fluids—Maternal-fetal > Flashcards

Body fluids—Maternal-fetal Flashcards

(80 cards)

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1
Q

functions of amniotic fluid

A
  • Provides protective cushion for fetus
  • Allows fetal movement
  • Stabilizes fetal temperature exposure
  • Permits proper lung development
  • Exchanges water and chemicals among the fluid, fetus, and maternal circulation
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2
Q

Thin white waxy coating that covers newborn babies’ skin

A

vernix

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3
Q

sources of amniotic fluid production

A

fetal urine
lung fluid
maternal circulation

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4
Q

During the first trimester, the approximately —— mL of amniotic fluid is derived primarily from the maternal circulation

A

35

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5
Q

Increased amniotic fluid peak at ——- mL in the third trimester is the result of fetal urine

A

800-1200

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6
Q

Lung fluid adds lung ———– to amniotic fluid; used as a measure of lung maturity

A

surfactants

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7
Q

Excess amniotic fluid from failure of fetus to swallow
>1200 mL

A

polyhydramnios

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8
Q

Decreased amniotic fluid from increased fetal swallowing, urinary tract deformities, and membrane leakage
<800 mL

A

Oligohydramnios

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9
Q

used for fetal cytogenetic analysis

A

sloughed fetal cells in amniotic fluid

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10
Q

Presence of CSF in amniotic fluid indicates…

A

neural tube defects

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11
Q

fetal age estimation

A

creatinine

<36 weeks = 1.5 to 2.0 mg/dL
>36 weeks = >2.0 mg/dL

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12
Q

Needed to determine premature membrane rupture or accidental puncture of maternal bladder from amniocentesis

A

find out if fluid is amniotic or maternal urine

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13
Q

distinguish amniotic fluid from maternal urine

A

Amniotic fluid has <3.5 mg/dL creatinine and <30 mg/dL urea

Values as high as 10 mg/dL for creatinine and 300 mg/dL for urea may be found in urine

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14
Q

fern test

A

specimen air dries on glass slide; examined microscopically for “fern-like” amniotic fluid crystals

distinguishes amniotic fluid from urine

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15
Q

indications for amniocentesis at 15-18 weeks

A
  • Mother’s age of 35 or older at delivery
  • Family history of genetic diseases
  • Earlier pregnancy or child with birth defects
  • Parent is a carrier of a metabolic disorder
  • Elevated maternal serum alpha-fetoprotein
  • Abnormal triple marker screening test
  • Previous child with a neural tube disorder
  • Three or more miscarriages
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16
Q

indications for amniocentesis at 20-42 weeks

A
  • Fetal lung maturity
  • Fetal distress
  • HDN caused by Rh blood type incompatibility
  • Infection
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17
Q

max —- mL amniotic fluid collected

discard…

A

30

first 2-3 mL

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18
Q

Protect amniotic specimens from light for bilirubin analysis for ——– at all times

A

HDFN

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19
Q

Deliver ———- amniotic fluid tests on ice; refrigerate or freeze up to 72 hours if needed

A

FLM

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20
Q

———- amniotic fluid specimens kept at room temperature or 37°C to prolong cell life

A

cytogenetic

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21
Q

normal amniotic fluid appearance

A

colorless, with slight to moderate turbidity from cells

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22
Q

dark green, mucus-like material in amniotic fluid

A

meconium

fetal distress

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23
Q

dark red-brown amniotic fluid

A

fetal death

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24
Q

measured in amniotic fluid to determine extent of hemolysis taking place in HDFN

A

unconjugated bilirubin

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25
Bilirubin causes OD rise at its maximum absorbance level of -------- nm; difference between baseline and this peak is the --------
450 ΔA450
26
used to evaluate bilirubin in amniotic fluid Plots ΔA450 against gestational age
Liley graph
27
Consists of three zones based on hemolytic severity
Liley graph
28
liley graph zone I
mildly affected fetus
29
liley graph zone II
requires careful monitoring
30
liley graph zone III
severely affected fetus, may require induction of labor or intrauterine exchange transfusion
31
produced by the fetal liver prior to 18 weeks’ gestation
alpha-fetoprotein (AFP)
32
Increased ------- levels in maternal blood or amniotic fluid indicate possible anencephaly or spinal bifida
AFP
33
normal AFP values are based on ----------- and the lab uses...... to evaluate
gestational age multiples of the median (MoM)
34
abnormal AFP
more than 2x MoM
35
Follow abnormal AFP with ----------------; more specific for neural disorders
fluid amniotic acetylcholinesterase (AChE)
36
most common complication of early delivery
respiratory distress syndrome (lack of lung surfactant)
37
FLM reference method
lecithin-sphingomyelin ratio (L/S)
38
the primary component of the lung surfactants increases at a slow and steady rate until the 35th week of gestation, when there is a noticeable increase, resulting in the stabilization of the fetal lung alveoli
lecithin
39
increases at a slow rate until around the 26th week where it can level out and eventually decreases around week 32-35
sphingomyelin
40
L/S ratio is ------ prior to week 35 and rises to ------ or greater for alveolar stability after week 35
1.6 2.0
41
preterm delivery is considered safe with an L/S ratio of ------ or higher
2.0
42
method of measuring L/S ratio
thin-layer chromatography
43
Lung surface lipid detected after 35 weeks gestation
phosphatidyl glycerol (PG)
44
PG normally parallels lecithin, except in -------------- (delayed), so must be included in L/S ratio
diabetics
45
-------------- is an immunologic agglutination test for PG that can replace the L/S ratio
Amniostat-FLM
46
Blood and meconium do not interfere with...
amniostat-FLM
47
simple bedside test used for FLM
foam stability
48
# Foam stability Amniotic fluid is mixed with ------------, shaken for ------------, and allowed to sit undisturbed for ------------
95% ethanol 15 seconds 15 minutes
49
foam test result indicating good FLM
A continuous line of bubbles around the outside edge | alcohol is antifoaming agent; fluid overcomes it
50
foam stability index indicating FLM
>47
51
semiquantitative modification of foam test
0.5 mL amniotic fluid added to increasing amounts of 95% ethanol
52
storage form of surfactant
lamellar bodies
53
lamellar bodies enter amniotic fluid at ----- weeks
26
54
The number of lamellar bodies correlates with the...
amount of phospholipid present in the fetal lungs
55
lamellar body OD of ------- at 650 nm correlates with L/S ratio of 2.0 and the presence of PG
150
56
lamellar body count can be obtained using the ...
platelet channel of automated hematology analyzers
57
cannot perform ------- count if fluid is contaminated with blood, meconium or mucus
lamellar body
58
lamellar body count indicating FLM
>32,000/uL
59
Detects fetal fibronectin in cervical swabs to assess the risk of preterm labor for individuals
Rapid fFN
60
Detects if the amniotic fluid membranes have ruptured Monoclonal
amnisure
61
Detects if the amniotic fluid membranes have ruptured Monoclonal and polyclonal
ROM plus+
62
Preterm delivery is <---- weeks gestation
37
63
preterm delivery symptoms
uterine contractions, change in discharge, vaginal bleeding, backache, abdominal discomfort, pelvic pressure, and cramping
64
preeclampsia triad
Hypertension Proteinuria Edema
65
If mother develops ---------, the conditions is called eclampsia
convulsions
66
cause and cure of preeclampsia
diseased placenta delivery
67
Detects PAMG-1 protein marker of the amniotic fluid
amnisure
68
Sample must be tested within 30 minutes of collection Blood & fecal matter creates false positive
amnisure
69
Sample must be run within 6 hours of collection Up to 10% blood is ok
ROM Plus+
70
Detects... - Alpha-fetoprotein (AFP) - Insulin-like growth factor-binding protein-1 (IGFBP-1) - Placental protein 12 (PP12)
ROM plus+
71
Positive test without PROM indicates risk for delivery within 48 hours
ROM plus+
72
Detection of fetal fibronectin in cervicovaginal secretions
rapid FFN
73
Risk of preterm delivery in 7-14 days from the time of swab if positive
rapid FFN
74
patient must have intact amniotic membranes and be less than 3 cm dilated to use
rapid FFN
75
Singleton pregnancy
22-30 weeks + 6 days gestation
76
isoform of fibronectin and is a complex adhesive glycoprotein
FFN
77
confined to the extracellular matrix of the region defining the junction of the maternal decidua (uterine lining) and the chorion (fetal sac) within the uterus
FFN
78
elevated in cervical secretions during the first 24 weeks of a normal pregnancy Not understood why (growth of the placenta?)
FFN
79
Detection between **24-34 weeks** is associated with preterm delivery in symptomatic and asymptomatic pregnancies
FFN
80
functional layer of the endometrium of the pregnant mom’s uterus
decidua

Mercy CLS 7/8: Coagulation/Body Fluids (9 decks)

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