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AUBF > M5: Amniotic Fluid (Part 4: Tests for Fetal Maturity) > Flashcards

M5: Amniotic Fluid (Part 4: Tests for Fetal Maturity) Flashcards

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1
Q

(5) parameters measured/detected for fetal maturity

Condition associated with fetal maturity?

A

Respiratory Distress Syndrome (RDS)

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2
Q

(5) parameters measured/detected for fetal maturity?

A
  1. Amount of Surfactant
  2. Lecithin-shingomyelin ratio
  3. Phosphatidyl glycerol
  4. Foam stavility index
  5. Lamellar bodies
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3
Q

(5) parameters measured/detected for fetal maturity

  • aka Hyaline Membrane Disease
  • Most frequent complication of preterm delivery
  • Caused by an insufficiency of lung surfactant production and structural immaturity of the fetal lungs
A

Respiratory distress syndrome

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4
Q

(5) parameters measured/detected for fetal maturity

Normally appears in mature lungs and allows the
alveoli (air sacs of the lung) to remain open throughout the normal cycle of inhalation and exhalation.

A

Surfactant

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5
Q

(5) parameters measured/detected for fetal maturity

keeps the alveoli from collapsing by decreasing
surface tension and allows them to inflate with air more easily

A

Surfactant

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6
Q

(5) parameters measured/detected for fetal maturity

The amount of surfactant in fetal lungs can be estimated by?

A

measuring amount of surfactants in amniotic fluid

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7
Q

(5) parameters measured/detected for fetal maturity

Reference method to which tests of FLM are compared

A

Lecithin-sphingomyelin ratio

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8
Q

(5) parameters measured/detected for fetal maturity

is the primary component of the surfactants
(phospholipids, neutral lipids, and proteins) that make up the alveolar lining and account for alveolar stability

A

Lecithin

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9
Q

(5) parameters measured/detected for fetal maturity

is a lipid that is produced at a constant rate
after about 26 weeks’ gestation; therefore, it can serve as a control on which to base the rise in lecithin

A

Sphingomyelin

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10
Q

(5) parameters measured/detected for fetal maturity

T or F

sphingomyelin only appear in the amniotic fluid in amounts proportional to their concentrations in the fetus

Lecithin-sphingomyelin ratio

A

F (BOTH lecithin and shingomyelin)

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11
Q

(5) parameters measured/detected for fetal maturity

Before or After 35 weeks of gestation?

L/S ratio is usually less than 1.6 because large
amounts of lecithin are not being produced at
this time.

Lecithin-sphingomyelin ratio

A

Before 35 weeks’ gestation

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12
Q

(5) parameters measured/detected for fetal maturity

Before or After 35 weeks of gestation?

Lecithin concentration increases while the
sphingomyelin concentration remains constant

Lecithin-sphingomyelin ratio

A

After 35 weeks of gestation

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13
Q

(5) parameters measured/detected for fetal maturity

The L/S ratio will rise to 2.0 or higher as the lecithin
production increases to prevent alveolar collapse

Lecithin-sphingomyelin ratio

A

After 35 weeks of gestation

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14
Q

(5) parameters measured/detected for fetal maturity

when the L/S ratio reaches 2.0, a preterm
delivery is usually considered to be a relatively safe procedure

Lecithin-sphingomyelin ratio

A

After 35 weeks of gestation

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15
Q

(5) parameters measured/detected for fetal maturity

when the L/S ratio reaches 2.0, this is usually considered to be a relatively safe procedure

Lecithin-sphingomyelin ratio

A

preterm delivery

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16
Q

(5) parameters measured/detected for fetal maturity

when the L/S ratio reaches 2.0, aside from preterm delivery, what is the other indication?

Lecithin-sphingomyelin ratio

A

Indicates fetal maturity

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17
Q

(5) parameters measured/detected for fetal maturity

Results encountered in fluid contaminated with blood or meconium

Lecithin-sphingomyelin ratio

A

Falsely elevated results

both these substances contain lecithin and sphingomyelin

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18
Q

(5) parameters measured/detected for fetal maturity

Quantitative measurement of lecithin and sphingomyelin is performed using?

Lecithin-sphingomyelin ratio

A

thin-layer chromatography (TLC)

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19
Q

(5) parameters measured/detected for fetal maturity

SInce L/S ratio is labor intensive and subject to high CV, what did laboratories replace L/S ratio with?

(2)

A
  • quantitative phosphatidyl glycerol immunoassays
  • lamellar body density procedures
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20
Q

(5) parameters measured/detected for fetal maturity

  • is also essential for adequate lung maturity
    and can be detected after 35 weeks’ gestation
  • normally parallels that of lecithin, but its production is delayed in cases of maternal diabete
A

Phosphatidyl glycerol

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21
Q

(5) parameters measured/detected for fetal maturity

respiratory distress occurs in the
presence of an L/S ratio of?

A

2.0

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22
Q

(5) parameters measured/detected for fetal maturity

must include lecithin, sphingomyelin, and PG to provide an accurate measurement of FLM.

Phosphatidyl glycerol

A

thin-layer chromatography lung profile

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23
Q

(5) parameters measured/detected for fetal maturity

has provided a more rapid and easy to perform method for assessment of fetal maturity

Phosphatidyl glycerol

A

immunologic agglutination test for PG

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24
Q

(5) parameters measured/detected for fetal maturity

uses antisera containing polyclonal anti-PG antibodies that are specific for PG- containing lamellar bodies in the amniotic fluid

Phosphatidyl glycerol

Study These Flashcards
A

Amniostat-FLM

25
# (5) parameters measured/detected for fetal maturity sizes of agglutinates inAmniostat-FLm is read macroscopically and the results are reported as either? | Phosphatidyl glycerol
Negative, Low or high positive
26
# (5) parameters measured/detected for fetal maturity Amniostat-FLM result pulmonary immaturity | Phosphatidyl glycerol
Negative
27
# (5) parameters measured/detected for fetal maturity Amniostat-FLM result pulmonary maturity | Phosphatidyl glycerol
Low or high positive
28
# (5) parameters measured/detected for fetal maturity T or F Amniostat-FLM is affected by specimen contamination with blood and meconium | Phosphatidyl glycerol
f (Amniostat-FLM is **NOT affected** by specimen contamination with blood and meconium)
29
# (5) parameters measured/detected for fetal maturity * called the “foam” or “shake” test * used to determine the presence of individual lung- surface lipid concentrations * can be performed at the bedside or in the laboratory
Foam stability index
30
# (5) parameters measured/detected for fetal maturity (1) In foam stability index amniotic fluid is mixed with? | Foam stability index
95% ethanol
31
# (5) parameters measured/detected for fetal maturity (2) After mixing, fluid is shaken for how many seconds? | Foam stability index
15 seconds
32
# (5) parameters measured/detected for fetal maturity (3) After shaking, it should be allowed to? | Foam stability index
sit undisturbed for 15 minutes
33
# (5) parameters measured/detected for fetal maturity At the end of this time, the surface of the fluid is observed for the presence of? | Foam stability index
continuous line of bubbles around the outside edge
34
# (5) parameters measured/detected for fetal maturity indicates that a sufficient amount of phospholipid is available to reduce the surface tension of the fluid even in the presence of alcohol, an antifoaming agent | Foam stability index
Presence of bubbles
35
# (5) parameters measured/detected for fetal maturity Which is correct modified foam test a. 0.5 ul of amniotic fluid b. 95% ethanol c. 0.60 mL in 0.01 mL increments of ethanol d. ALL e. None | Foam stability index
b. 95% ethanol ## Footnote a. 0.5 ul of amniotic fluid (should be mL) c. 0.60 mL in 0.01 mL (should be 0.42-0.55 mL range)
36
# (5) parameters measured/detected for fetal maturity Reference value for foam stability index which indicates FLM? | Foam stability index
value of 47 or higher >47
37
# (5) parameters measured/detected for fetal maturity T or F The Foam Stability Index has shown good correlation with the L/S ratio and tests for phosphatidyl glycerol | Foam stability index
T
38
# (5) parameters measured/detected for fetal maturity T or F Foam stability index can be used with contaminated amniotic fluid because blood and meconium also reduce surface tension, yielding a falsely mature index result | Foam stability index
F (**cannot be used** with contaminated amniotic fluid because blood and meconium also reduce surface tension, yielding a falsely mature index result)
39
# (5) parameters measured/detected for fetal maturity * These are densely packed layers of phospholipids that represent a storage form of pulmonary surfactant * Similar to that of small platelets, ranging in size from 1.7 to 7.3 fL, or 1 to 5μm
Lamellar bodies
40
# (5) parameters measured/detected for fetal maturity Surfactant is composed of (blank) phospholipid and (blank) protein | Lamellar bodies ## Footnote percentage
90% phospholipid, 10% protein
41
# (5) parameters measured/detected for fetal maturity Surfactant is packaged into layered storage granules called ?
lamellar bodies
42
# (5) parameters measured/detected for fetal maturity Lamellar bodies are secreted by?
type II pneumocytes of the fetal lung at about 24 weeks of gestation ## Footnote absorbed into the alveolar spaces to provide surfactant
43
# (5) parameters measured/detected for fetal maturity T or F about 26 weeks of gestation and increase in concentration from 50,000 to 200,000 per microliter by the end of the third trimester | Lamellar bodies
T
44
# (5) parameters measured/detected for fetal maturity T or F As the fetal lung matures, increased lamellar body production is reflected by an increase in amniotic fluid phospholipids and the L/S ratio | Lamellar bodies
T
45
# (5) parameters measured/detected for fetal maturity Directly proportional or inversely proportional? No. of lamellar bodies = ? | Lamellar bodies ## Footnote correlation with amount of phospholipid and L/S ratio
Directly proportional with phospholipids and L/S ratio ## Footnote lamellar bodies present in the amniotic fluid correlates with the amount of phospholipid present in the fetal lungs
46
# (5) parameters measured/detected for fetal maturity T or F The presence of lamellar bodies decreases the OD of the amniotic fluid.
F (The presence of lamellar bodies **increases** the OD of the amniotic fluid)
47
# (5) parameters measured/detected for fetal maturity Specimens are centrifuged at? | Lamellar bodies
2000 g for 10 minutes
48
# (5) parameters measured/detected for fetal maturity Specimens are examined using wavelength of? | Lamellar bodies
650 nm
49
# (5) parameters measured/detected for fetal maturity Reference value for lamellar body count which indicates FLM | Lamellar bodies
>50,000/uL
50
# (5) parameters measured/detected for fetal maturity LBC value below 15,000/μL is considered? | Lamellar bodies
immature ## Footnote Results in between these two values are considered indeterminate and further testing using alternate methods is recommended
51
# (5) parameters measured/detected for fetal maturity T or F Lamellar body count procedure rules out interference and other contaminants such as meconium
F (does rule out pther interference but **NOT other contaminants such as meconium**)
52
# SUMMARY Determine test based on refrence value and significance: Ref. value: A450 >.025 Significance: Hemolytic disease of the newborn
Bilirubin scan
53
Determine test based on refrence value and significance: Ref. value: <2.0 MoM Significance: Neural tube disorders
Alpha-fetoprotein
54
Determine test based on refrence value and significance: Ref. value: ≥2.0 Significance: FLM
Lecithin-sphingomyelin ratio
55
Determine test based on refrence value and significance: Ref. value: Positive Significance: FLM/PG | Fetal lung maturity/phosphatidyl glycerol
Amniostat fetal lung maturity
56
Determine test based on refrence value and significance: Ref. value: ≥47 Significance: FLM
Foam Stability Index
57
Determine test based on refrence value and significance: Ref. value: ≥0.150 Significance: FLM
Optical density 650 nm
58
Determine test based on refrence value and significance: Ref. value: ≥32,000/mL Significance: FLM
Lamellar body count

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