CLS 304 > Chapter 12 Amniotic Fluid > Flashcards

Chapter 12 Amniotic Fluid Flashcards

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1
Q

Liquid product of fetal metabolism

A

Amniotic fluid

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2
Q

Amniotic fluid is present in the

A

Amnion

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3
Q

Membrane that surrounds the fetus

A

Amnion

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4
Q

What is the purpose of the sac (5)

A
  • Provides a protective cushion
  • allows fetal movement
  • stabilizes the temperature to protect fetus from extreme temperature changes
  • permits proper lung development
  • allows for exchange of water and chemicals
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5
Q

What is tested to determine if C-section can be performed

A

Lung development

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6
Q

Label

A
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7
Q

Reasons one might have an amniocentesis performed at 14-18 weeks (5)

A
  • Being 35 or older; risk of birth defects/Down syndrome
  • having a previous child or pregnancy with a birth defect
  • abnormal blood triple or quadruple screening (AFP)
  • family history of genetic disorders (cystic fibrosis, tay-sachs, sickle cell, hemophilia, Huntington chorea, muscular dystrophy)
  • > 3 miscarriages
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8
Q

Reasons one might have an amniocentesis performed past 20 weeks (2)

A
  • Fetal lung maturity

- fetal distress: HDN or infection

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9
Q

How is amniotic fluid formed

A

First produced by amnion and placenta. Then fetus plays active role to balance composition and production

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10
Q

Mechanism involved with balancing amniotic fluid (4)

A
  • Intestinal absorption following fetal swallowing of fluid
  • Capillary exchange in pulmonary system as alveoli of fetal lungs develop
  • water and electrolytes removed and replaced by products of fetal urination
  • maternal exchange remove waste products and adds water, nutrients and electrolytes
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11
Q

Variation of what 3 things indicate fetal distress

A

Fetal urine, lung fluid, and maternal circulation

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12
Q

During first thmester approx. 35mL of amniotic fluid is derived from

A

Maternal circulation

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13
Q

At 37 weeks ammotle fluid peak at 800 to 1200mL. Increased urine is regulated by

A

Fetal swallowing

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14
Q

Lung fluid adds what to amniotic fluid to measure lung maturity

A

Lung surfactants

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15
Q

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

A

Polyhydramnios

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16
Q

Polyhydramnios cause

A

Neural tube disorders, structural/chromosomal abnormalities, cardiac arrhythmias, infections

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17
Q

Decreased amniotic fluid from increased fetal swallowing, membrane leakage <800 mL

A

Oligohydramnios

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18
Q

Oligohydrammos causes

A

Umbilical cord compression

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19
Q

Amniotic fluid composition

A

Similar to maternal plasma with sloughed fetal cells

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20
Q

Amniotic fluid contains biochemical substances produced by fetus such as (9)

A

Bilinibin, lipids, enzymes, electrolytes, urea, creatinine, uric acid, proteins, hormones

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21
Q

Fetal urine increases (3)

A

Creatinine, urea, uric acid

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22
Q

Fetal age can be estimated by

A

Creatinine

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23
Q

Age when creatinine level is 1.5 to 2.0 mg/dL

24
Q

Age when creatinine level is >2.0

25
Needed to determine premature membrane rupture or accidental puncture of maternal bladder from amniocentesis
Maternal urine vs. amniotic fluid
26
<3.5 mg/dL creatinine and <30 mg/dL urea
Amniotic fluid
27
Values as high as 10 mg/dL for creatinine and 300 mg/dL for urea
Urine
28
The presence of glucose, protein, or both is associated more closely with
Amniotic fluid
29
Maternal urine vs. Amniotic fluid measure
Creatinine, glucose, protein, urea
30
Specimen air dries on glass slide; examine microscopically for "fern-like" amniotic fluid crystals
Fern test
31
How is an amniocentesis collected
Needle aspiration into amniotic sac under ultrasound guidance: transabdominal or vaginal
32
When should an amniocentesis be collected and how much
No more than 30 mL after 14th week of gestation
33
How should samples be stored for testing
Keep at room temp and separate cells for genetic testing. Place on ice and refrigerate for fetal/lung FLM tests. Protect from light for bilirubin testing (HDN)
34
Centngage or filter fluid only for what test
Fetal lung maturity (FLM) tests
35
Color for normal appearance
Colorless to very pale yellow
36
Color for traumatic tap, abdominal trauma, intra-amniotic hemorrhage
Blood-streaked
37
Color for bilirubin present, hemolytic disease newborn (HDN)
Yellow to amber
38
Color for meconium (fetal bowel movement)
Dark green
39
Color for fetal death
Dark red-brown
40
Tests for neural tube defects (4)
- Alpha-fetoprotein (AFP) produced by the fetal liver prior to 18 weeks gestation - increased levels in maternal blood or amniotic fluid indicate possible anencephaly or spinal bifida - increased levels are found when skin fails to close over neural tissue - measure maternal blood first, then amniotic fluid
41
What happens to a mom that has 2 babies with Rh+ blood while she has Rh-
First pregnancy= fetal blood enters maternal circulation and Rh antibodies form Second pregnancy= Rh antibodies destroy fetal Rh+ RBCs
42
Most common complication of early delivery
Respiratory distress syndrome (RDS)
43
Lack of lung surfactant keeps
The alveoli open during inhaling and exhaling
44
Decreases the surface tension on the alveoli so the lungs can inflate more easily
Surfactant
45
Amniotic fluid bilirubin measured in spectrophotometric instrument for activity at 450 OD tests for
Hemolytic disease newborn (HDN)
46
Alpha-fetoprotein (AFP) increase tests for
Neural tube defects: anencephaly and spinal bifida. Also possibility of multiple pregnancy
47
``` Surfactant measurements: - lecithin-sphingomyelin ratio (L/S) - phosphatidyl glycerol - foam shake test - microviscosity decrease - lamellar bodies Test for ```
Determination of fetal lung maturity (FLM) for respiratory distress syndrome (RDS). L/S ratio >2.0 is desirable
48
Represent a storage form of surfactants responsible for FLM
Lamellar phospholipids
49
Lamellar phospholipids are produced and secreted by
Type II pneumocytes of the fetal lungs
50
Amniotic fluid lamellar bodies are measured by
Automated cell counters using the platelet methodology
51
A count of greater than 32,000 lamellar bodies represents
Adequate fetal lung maturity
52
Range of lamellar bodies in 3rd trimester
50,000 to 200,000
53
Produced by the placenta and acts as the glue that attaches the placenta to the uterine wall. Also acts as a lubricant aiding in the passage of the newborn through the vaginal canal
Fetal fibronectin
54
What kind of collection detects fetal fibronectin
Cervicovaginal
55
Fetal fibronectin can be used to predict
Pre-term delivery
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