Flashcards in Diagnosis and Monitoring of Pregnancy Deck (43):
What hormones increase during pregnancy?`
-Human placental lactogen
-Human chorionic gonadotropin
What does increased estrogen levels stimulate?
-Plasma proteins (fibrinogen)
How much does plasma volume increase during normal pregnancy?
______ increases more than ______ causing the hematocrit to fall by 15%
-Red cell volume
What does the placenta produce
______ will double by the time of delivery
What will happen to glomerular filtration rate, BUN, and Cr during pregnancy
GFR will increase about 50%
-Causes decreased BUN and Cr
Describe glucose and protein excretion during pregancy
What do lab tests for pregnancy test for to diagnose pregancy
What do the cells of the placenta produce that is detected in a pregnancy test?
What are other things that can produce HCG that is not a fetus
-Hyditidiform mole (tumor of the uterus)
-Choriocarcinoma (malignant tumor of the placenta)
-Germ cell tumors (tumor of the ovary)
What other cancers produce HCG levels
-Large cell carcinoma of the lung
When does the production of HCG begin during pregnancy?
-as soon as the trophoblast cells are formed
When do blood levels of typically rise after implantation
4-6 days after fertilization
When do blood levels of HCG become detectable
8-10 days after fertilization (3-3.5 weeks after last menstrual period)
HCG rises in a _______ fashion during the first trimester of pregnancy
HCG will ______ every 48 hours in a normal pregnancy
In pregnancy abnormalities such as Down syndrome, hemolytic disease, HCG levels are _____ than normal
When do plasma levels of HCG peak in a normal pregnancy?
Is HCG usually tested in urine or blood
Urine- it is cheaper
Total urine HCG excretion parallels _______
What can cause falsely negative urine HCG levels
What can cause falsely positive HCG levels
When is blood HCG levels tested
-When quantitative info is needed
-Unsure of LMP
-Plasma levels will become positive less than one week before urine HCG
What percentage of pregnancies occur outside of the uterus
Describe the plasma HCG levels in an ectopic pregnancy
Rises more slowly, and before 6 weeks gestation, HCG levels will fail to double
What percentage of pregnancies end in spontaneous abortion?
Describe plasma HCG levels in a spontaneous abortion
-Usually below the 95th percentile for gestational age
-and falls in measurements 2 days apart
What is used to detect anemia and screen for thalassemia
What are included in prenatal screening tests
-Rh and red cell antibody
-Immunity for rubella and varicella
What else are included in prenatal screening tests?
-Hep B antigen
-Thyroid (TSH and T4)
-TB, gonorrhea, herpes, BV, trichomoniasis, Hep C
When can Rh sensitization occur?
Occur if Rh- mom carries an Rh + baby
What happens at delivery with an Rh - mom
-The Rh+ childs RBC leak into the maternal circulation and can stimulate the production of anti-Rh antibodies
-These antibodies cross the placenta and attack the RBC for future pregnancies
Rh problems are preventable by...
Injecting mom with anti-Rh antibodies
-masks the moms immune system and prevents sensitization
-Fetal liver and yok sac produce a large number of these
-Present at 100 times larger concentration that in an adult
-A small amount crosses the placenta and mixes with maternal AFP concentration
Fetal abnormalities cause ________ amounts of AFP to cross the placenta and leak into amniotic fluid
What are 2 other factors that increase AFP levels
-Number of infants present
When is AFP tested?
at 16 weeks gestation
If AFP are elevated, what is the follow up test?
-3D or 4D ultrasound
What is included in a QUAD screen
When is pulmonary surfactant released?
34-36 weeks but it can be stimulated by cortisol at earlier ages
What are the major lipids in surfactant?