M5: Amniotic Fluid (Part 2: Specimen Collection, Handling and Processing, Color and Appearance)

Question 1

Method of specimen collection of amniotic fluid

Answer 1

Amniocentesis

Question 2

is recommended for neural tube defects when screening blood tests such as:
* maternal serum alpha-fetoprotein test are abnormal
* to detect genetic disorders to evaluate the health of the fetus

Answer 2

Amniocentesis

Question 3

INDICATIONS FOR AMNIOCENTESIS

T or F

Amniocentesis is recommended for screening neural tube defects

Answer 3

T

Question 4

INDICATIONS FOR AMNIOCENTESIS

Fetal body measurements taken with what which accurately estimate the gestational age of the fetus and provide an assessment of the size and growth of the fetus throughout pregnancy to diagnose and manage intrauterine
growth retardation

Answer 4

Ultrasonography

Question 5

INDICATIONS FOR AMNIOCENTESIS

Fetal body measurements taken with ultrasonograph which are helpful in determining what (2) factors?

Answer 5

• Size and growth of fetus
• Diagnose and manage intrauterine growth retardation

Question 6

INDICATIONS FOR AMNIOCENTESIS

T or F

Finding abonbormality on ultrasound indicate fetal is normal and tehre is no need for amniocnetesos and laboratory measurements of FLM

Answer 6

F (Finding abnormality on ultrasound indicates potential fetal development problems)

indicate need for amniocentestos and laboratory measurements of FLM (Fetal Lung Maturoity)

Question 7

INDICATIONS FOR AMNIOCENTESIS

• The presence of these in amniotic fluid indicate the genetic material of the fetus and the biochemical substances that the
  fetus has produced
• cells can be separated from the fluid, cultured, and examined for chromosome abnormalities by karyotyping, fluorescence in situ hybridization (FISH), fluorescent mapping spectral karyotyping (SKY), and DNA testing

Answer 7

Fetal epithelial cells

Question 8

INDICATIONS FOR AMNIOCENTESIS

Biochemical substances produced by the fetus can be analyzed by what tool to evaluate the health of the fetus?

Answer 8

Thin layer chromatography

Question 9

INDICATIONS FOR AMNIOCENTESIS

is a safe procedure, particularly
when performed after the 14th week of gestation

Answer 9

amniocentesis

Question 10

INDICATIONS FOR AMNIOCENTESIS

usually collected at
approximately 16 weeks’ gestation

Answer 10

Fluid for chromosome analysis

Question 11

INDICATIONS FOR AMNIOCENTESIS

are performed
near the end of the second trimester

Answer 11

intrauterine growth retardation

Question 12

INDICATIONS FOR AMNIOCENTESIS

performed later in
the third trimester

Answer 12

fetal distress and maturity

Question 13

INDICATIONS FOR AMNIOCENTESIS

Match

a. 14th week of gestation
b. 16 weeks of gestation
c. end of 2nd trimester
d. later in 3rd trimester

Fluid for Chromosome analysis

Tests for Intrauterine growth retardation

Amniocentesis

Tests Fetal distress and maturity

Answer 13

Fluid for Chromosome analysis b. 16 weeks of gestation

Tests for Intrauterine growth retardation c. end of 2nd trimester

Amniocentesis a. 14th week of gestation

Tests Fetal distress and maturity d. later in 3rd trimester

Question 14

INDICATIONS FOR AMNIOCENTESIS

Summary of indications for amniocentesis

Answer 14

1. NTDs
2. Abnormal serum AFP
3. Detect genetic disorders
4. Evaluate fetus’ health
5. Abnormal ultrasound
6. Detect intrauterine growth retardation

Question 15

INDICATIONS FOR AMNIOCENTESIS

Fetal epithelial cells are separated, cultures, and examined for chromosome abnormalities by using what (4) methods?

Answer 15

1. Karyotype
2. FISH
3. SKY
4. Dna testing

Question 16

COLLECTION

Amniotic fluid is obtained by needle aspiration into the amniotic sac, a procedure called?

Answer 16

Amniocentesis

Question 17

COLLECTION

In amniocentesis, needle is aspirated into?

Answer 17

amniotic sac malamang

Question 18

COLLECTION

The procedure most frequently performed is?

Answer 18

transabdominal amniocentesis

Question 19

COLLECTION

What other equipment should be used for guidance for the physician to locate fetus and placenta to safely perform amniocentestsis?

Answer 19

Continuous ultrasound

Question 20

COLLECTION

A thin, hollow needle is inserted through the mother’s abdomen into the mother’s (blank) and into the (blank) to apirate the amnioti fluid

Answer 20

A thin, hollow needle is inserted through the mother’s abdomen into the mother’s uterus and into the amniotic sac to apirate the amnioti fluid

Question 21

COLLECTION

A maximum of how many mL of amniotic fluid is collected in sterile syringes?

Answer 21

maximum of 30 mL

Question 22

COLLECTION

How many mL should be discarded from the maximum 30ml of amniotic fluid aspirated?

Answer 22

first 2-3 mL

Question 23

COLLECTION

may also be performed; however,
this method carries a greater risk of infection

Answer 23

Vaginal amniocentesis

Question 24

COLLECTION

T or F

first 4-5 mL of amniotic fluid should be discarded as it contains maternal blood, tissue fluid, cells

Answer 24

T

Question 25

# COLLECTION Specimens should be transferred to? | what container

Answer 25

sterile plastic containers

Question 26

# COLLECTION T or F Specimens should be transferred to sterile plastic containers and taken immediately to the laboratory

Answer 26

T

Question 27

# COLLECTION This sample in cases of hemolytic disease of the newborn (HDN) must be protected from light at all times.

Answer 27

Fluid for bilirubin analysis | Bilirubin false decreases upon exposure to light

Question 28

# SPECIMEN HANDLING AND PROCESSING should be placed in **ice** for delivery to the laboratory and kept **refrigerated**

Answer 28

Fluid for fetal lung maturity (FLM) tests

Question 29

# SPECIMEN HANDLING AND PROCESSING * must be immediately protected from light * can be accomplished by placing the specimens in amber-colored tubes, wrapping the collection tube in foil, or by use of a black plastic cover for the specimen container

Answer 29

Specimens for bilirubin testing

Question 30

# SPECIMEN HANDLING AND PROCESSING Specimens for bilirubin testing should be placed in what special tubes?

Answer 30

**amber-colored tubes**, wrapping the collection **tube in foil**, or by use of a **black plastic cover** for the specimen container

Question 31

# SPECIMEN HANDLING AND PROCESSING * must be processed aseptically * maintained at room temperature or body temperature (37°C incubation) prior to analysis to prolong the life of the cells needed for analysis.

Answer 31

Specimens for cytogenetic studies or microbial studies

Question 32

# SPECIMEN HANDLING AND PROCESSING * should be separated from cellular elements and debris as soon as possible to prevent distortion of chemical constituents by cellular metabolism or disintegration * This can be performed using centrifugation or filtration

Answer 32

All fluid for chemical testing

Question 33

# SPECIMEN HANDLING AND PROCESSING How are fluids for chemical testing separated from cellular elements and debris? | (2)

Answer 33

through centrifugation or fliltration

Question 34

# COLOR AND APPEARANCE Normal amniotic fluid color?

Answer 34

colorless

Question 35

# COLOR AND APPEARANCE Amniotic fluid turns into what in later stages of fetal development?

Answer 35

slight to moderate turbidity from cellular debris

Question 36

# COLOR AND APPEARANCE The source of the blood (maternal or fetal) can be determined using what test | for fetal hemoglobin and is important for further case management

Answer 36

Kleihauer-Betke test

Question 37

# COLOR AND APPEARANCE gives the fluid a yellow color and is indicative of red blood cell destruction resulting from HDN

Answer 37

bilirubin

Question 38

# COLOR AND APPEARANCE Bilirubin indicates what condition?

Answer 38

red blood cell destruction resulting from HDN

Question 39

# COLOR AND APPEARANCE * usually defined as a newborn’s first bowel movement, is formed in the intestine from fetal intestinal secretions and swallowed amniotic fluid * dark green, mucus-like material * result of fetal distress

Answer 39

Meconium

Question 40

# COLOR AND APPEARANCE T or F Fetal aspiration of meconium during fetal swallowing is a concern when increased amounts are present in the fluid

Answer 40

T

Question 41

# COLOR AND APPEARANCE is associated with fetal death

Answer 41

very dark red-brown fluid

Question 42

# COLOR AND APPEARANCE Determine the color based on clinical significance Normal

Answer 42

Colorless

Question 43

# COLOR AND APPEARANCE Determine the color based on clinical significance Traumatic tap, abdominal trauma, intra- amniotic hemorrhage

Answer 43

Blood-streaked

Question 44

# COLOR AND APPEARANCE Determine the color based on clinical significance Traumatic tap, abdominal trauma, intra- amniotic hemorrhage

Answer 44

Blood-streaked

Question 45

# COLOR AND APPEARANCE Determine the color based on clinical significance Hemolytic disease of the newborn (bilirubin)

Answer 45

Yellow

Question 46

# COLOR AND APPEARANCE Determine the color based on clinical significance Meconium

Answer 46

Dark-green

Question 47

# COLOR AND APPEARANCE Determine the color based on clinical significance Fetal death

Answer 47

Dark red-brown