Diagnosis and Monitoring of Pregnancy Flashcards Preview

Clin Lab > Diagnosis and Monitoring of Pregnancy > Flashcards

Flashcards in Diagnosis and Monitoring of Pregnancy Deck (43):
1

What hormones increase during pregnancy?`

-Estrogens
-Progesterone
-Human placental lactogen
-Human chorionic gonadotropin
-Prolactin

2

What does increased estrogen levels stimulate?

-Gluconeogenesis
-Cholesterol production
-Plasma proteins (fibrinogen)
-Cortisol production

3

How much does plasma volume increase during normal pregnancy?

50%

4

______ increases more than ______ causing the hematocrit to fall by 15%

Plasma volume
-Red cell volume

5

What does the placenta produce

-HCG
-Alkaline phosphatase
-Creatine Kinase

6

______ will double by the time of delivery

Alkaline phosphatase

7

What will happen to glomerular filtration rate, BUN, and Cr during pregnancy

GFR will increase about 50%
-Causes decreased BUN and Cr

8

Describe glucose and protein excretion during pregancy

-Urine glucose
-Protein excretion

9

What do lab tests for pregnancy test for to diagnose pregancy

-Trophoblastic tissue

10

What do the cells of the placenta produce that is detected in a pregnancy test?

HCG

11

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)

12

What other cancers produce HCG levels

-Breast cancer
-Large cell carcinoma of the lung

13

When does the production of HCG begin during pregnancy?

-as soon as the trophoblast cells are formed

14

When do blood levels of typically rise after implantation

4-6 days after fertilization

15

When do blood levels of HCG become detectable

8-10 days after fertilization (3-3.5 weeks after last menstrual period)

16

HCG rises in a _______ fashion during the first trimester of pregnancy

Geometric

17

HCG will ______ every 48 hours in a normal pregnancy

Double

18

In pregnancy abnormalities such as Down syndrome, hemolytic disease, HCG levels are _____ than normal

Higher

19

When do plasma levels of HCG peak in a normal pregnancy?

8-12 weeks

20

Is HCG usually tested in urine or blood

Urine- it is cheaper

21

Total urine HCG excretion parallels _______

Plasma concentration

22

What can cause falsely negative urine HCG levels

-Dilute urine

23

What can cause falsely positive HCG levels

-Proteinuria
-UTI

24

When is blood HCG levels tested

-When quantitative info is needed
-Unsure of LMP
-Physical exam
-Plasma levels will become positive less than one week before urine HCG

25

What percentage of pregnancies occur outside of the uterus

1.5%

26

Describe the plasma HCG levels in an ectopic pregnancy

Rises more slowly, and before 6 weeks gestation, HCG levels will fail to double

27

What percentage of pregnancies end in spontaneous abortion?

25%

28

Describe plasma HCG levels in a spontaneous abortion

-Usually below the 95th percentile for gestational age
-and falls in measurements 2 days apart

29

What is used to detect anemia and screen for thalassemia

Hematocrit/hemoglobin

30

What are included in prenatal screening tests

-Hematocrit/hemoglobin
-Bacteruria
-Rh and red cell antibody
-Immunity for rubella and varicella

31

What else are included in prenatal screening tests?

-Syphilis
-Hep B antigen
-Chlamydia
-HIV
-Thyroid (TSH and T4)
-TB, gonorrhea, herpes, BV, trichomoniasis, Hep C

32

When can Rh sensitization occur?

Occur if Rh- mom carries an Rh + baby

33

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

34

Rh problems are preventable by...

Injecting mom with anti-Rh antibodies
-masks the moms immune system and prevents sensitization

35

Describe a-fetoprotein

-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

36

Fetal abnormalities cause ________ amounts of AFP to cross the placenta and leak into amniotic fluid

Increased

37

What are 2 other factors that increase AFP levels

-Gestational age
-Number of infants present

38

When is AFP tested?

at 16 weeks gestation

39

If AFP are elevated, what is the follow up test?

-Amniocentesis
-3D or 4D ultrasound

40

What is included in a QUAD screen

-AFP
-HCG
-Estriol
-Inhibin A

41

When is pulmonary surfactant released?

34-36 weeks but it can be stimulated by cortisol at earlier ages

42

What are the major lipids in surfactant?

-Lecithin
-Sphingomyelin

43

What is a healthy ratio of lecithin and sphingomyelin

2:1 = lung maturity