Prenatal Testing

Front 1

An extra copy of chromosome 18, results in open neural defects, and death of the infant withing a few months.

Back 1

Trisomy 18

Front 2

The triple screen of maternal serum provides the same type of abnormal results as does Down's syndrome while fetal karyotyping is the definitive test and will differentiate trisomy 21 from _

Back 2

Trisomy 18

Front 3

Multiple pregnancies (twins) can result in nearly double the amount of ____ ____ found in maternal circulation.

Back 3

alpha fetoprotein

Front 4

___________ is a statistical application of the biochemical marker used to normalize values for reference ranges that change readily with age or other factors.

Back 4

Multiples of median (MoM)

Front 5

is formed between the amnionic sac and the uterine wall.

Back 5

fibronectin

Front 6

not all premature labor results in delivery; detect ____ in mom's cervix. negative ___ = delivery is very unlikely for the next two weeks. positive ___= deliveries are imminent

Back 6

fibronectin

Front 7

performed by an obstetrician with the aid of an ultra sound. usually performed between 14 and 38 weeks o gestation. the procedure is fast and rapid.

Back 7

Amniocentesis

Front 8

is an ultrafiltrate of mom's plasma and has plasma-type values for the electrolytes, urea, creatinine, etc.

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Initial aminiotic fluid

Front 9

Final volume of amniotic fluid at term:

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300-1500mLs

Front 10

low volume of amniotic fluid

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Oligohydramnios

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excessive volume

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polyhydraminos

Front 12

intrauterine hemolysis is monitored by

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AF A450

Front 13

Causes of intrauterine hemolysis

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erythroblastosis fetalis or hemolytic disease of the newborn (HDN)

Front 14

ABO incompatability of (usually) Rh negative mother and Rh positive fetus, leading to antibody response and RBC hemolysis =

Back 14

bilirubin in amniotic fluid

Front 15

fetal anemia stimulates _____ leading to elevated unconjugated bilirubin due to decreased conjugated bilirubin due to decreased conjugation by liver.
At birth both anemia and kernicterus may be seen.
>unconjugated bili (fat soluble) is toxic to CNS and causes kernicterus.

Back 15

erythropoisis

Front 16

Treatment options for Hemolytic Disease of Newborn

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immediate delivery
intrauterine transfusion
observation

Front 17

At birth, lungs must shift from being fluid-filled to becoming a gas exchange system. Lungs must have developed _______ and ______.

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-adequate alveoli
-surfactant

Front 18

is a type of phospholipid, full of saturated fatty acids (phosphotidylcholine=lecithin, sphyngomyelin, phosphotidylinositol. It is formed by type II pneumocytes and lines the alveolar epithelium. Type I pneumocytes are equipped for gas exchange.

Back 18

surfactant

Front 19

maintains lung function by maintaining alveolar stability and reducing pressure needed to distend lungs (surface tension of alveolar wall)

Back 19

surfactant

Front 20

results in delivery before 34 weeks and is also knows as hyaline membrane disease.

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respiratory distress syndrome (RDS)

Front 21

-very small amount of lecithin and sphingomyelin
-alveoli collapse upon exhaling due to lack of surfactant.
>>>collapse restricts gas exchange >respiratory acidosis and hypoxia>______

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RDS

Front 22

can be given to delay birth when preterm labor is indicated.

Back 22

cotisol

Front 23

is a condition of pregnant women marked by water retention (with swelling particularly in the feet, legs and hands) high blood pressure and protein in the urine.

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pre-eclampsia

Front 24

is when pre-eclampsia progresses to a grand mal seizure.

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eclampsia

Front 25

has no surfactant activity and is used to correct for dilutional effect of the volume of amniotic fluid.

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sphingomyelin

Front 26

comparing the amount of lecithin to the amount of sphinogomyelin in the amniotic fluid in order to determine whether the type II pneumocytes

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L/S ratio

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if L/S> 2.0 and PG+=

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low risk for RDS

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if L/S>2.0 or PG+ (not both)=

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medium risk for RDS

Front 29

if L/S <2.0 and PG-=

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high risk for RDS(delivery should be delayed if possible) Note: diabetic mothers are low risk if L/S> 2.5 and PG+

Front 30

-qualitative immunoassay
->2 mg/L> low risk for RDS
-not a ratio, therefore does not correct for large or small volume of AF

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PG

Front 31

-the assay is performed on a special fluorescence polarization instrument.
-"mature fetal lungs" are indicated by values greater than 50mg surfactant per gram of albumin

Back 31

amniotic surfactant to albumin ratio

Front 32

are the storage form of surfactant and are similar in size to normal platelets

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lamellar bodies

Front 33

-they can be counted on a automated cell counter
-a count of these bodies estimates the amount of surfactant present
->30,000ul is highly predictive of pulmonary maturity, while a count <10,000uL suggest a risk for RDS

Back 33

lamellar bodies

Front 34

methods are faster and less technique dependent than traditional phospholipids analysis

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lamellar body count

Front 35

if neural tube does not close (tissue does not cover spinal cord)=_______>baby's spinal fluid seeps into AF and AF gets absorbed into mom's plasma

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spina bifida

Front 36

is a protrusion of brain through an abnormal opening

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encephalocele

Front 37

is a condition in which the fetus does not develop a cerebrum

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anencepha

Front 38

is measured in mom's plasma (immunoassay). increase result is preliminary of open neural defect, must be followed by ultrasound and AFAFP

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AFP

Front 39

is the most significant protein found in the second trimester fetus.

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Alpha fetoprotein (AFP)

Front 40

a transport protein produced by the fetal liver with a function similar to that of albumin.

Back 40

AFP

Front 41

binds and transports substances that are not very water soluble such as steroid hormones, vitamins, lipids and bilirubin.

Back 41

AFP

Front 42

found in amniotic fluid and maternal circulation only in small amounts under normal circumstances due to its large molecular weight and inability to diffuse readily to maternal circulation from feto-placental circulation

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AFP

Front 43

AFP levels in maternal serum (MSAFP) correlate with some birth defects in the fetus.

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AFP

Front 44

is a congenital disorder of the autosomal chromosome 21 with either a trisomy or three copies of the long arm, or translocations of the long arm.

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down syndrome

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may have physical and development problems including congenital heart failure, growth and mental retardation, muscular weakness, flat facial profile and with slanting eyes, broad short skull, broad hands with short fingers and possible anatomical defects in the esophagus.

Back 45

down's syndrome children

Front 46

-decreased MSAFP
-decreased unconjugated estriol
-increased chorionic gonadotropin levels. these three test of maternal serum are termed a triple screen.

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Laboratory markers for down syndrome.

Front 47

the definitive test for down syndrome.

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karyotyping