amniotic fluid and vaginal secretions

fetal fibronectin (fFN)

-glycoprotein in cells that join placenta to uterine wall

-undetectable in vag secretions 24-35 wks

-released during labor

-elevated levels inc risk of premature labor

-meas by: lateral flow, solid-phase immunochromatographic assay

placental a-microglobulin-1 (PAMG-1)

-glycoprotein

-high concen in amniotic fluid

-presence in cervicovag secretions assoc with premature delivery risk and PROM

-meas by: lateral flow, solid-phase immunochromatographic assay

aminocentesis

needle aspiration of amniotic fluid

oligohydramnios

-low level of amniotic fluid (<800 mL)

-congenital malformation

-intrauterine infection

polyhydramnios

-high level of amniotic fluid (>1200 mL)

-congenital malformation

-dec fetal swallowing

pink/red

color of fluid in

-traumatic tap

-abdominal trauma

-intra-amniotic hemorrhage

normal

normal/abnormal amniotic fluid is colorless/pale yellow with some turbidity

green

color of amniotic fluid in 

-fetal distress

-meconium

bilirubin, HDN

indicated by dark yellow/amber colored amniotic fluid

fetal death

indicated by dark red-brown colored amniotic fluid

dec

fluid clarity inc/dec with gestation progression 

RT

temperature of amniotic fluid for cytogenic analysis

hemolytic disease of the newborn

-fetus has RBC antigen (RH pos) that mother does not (neg)

-mother produces Ab that crosses placenta and causes damage to baby’s red cells

-bilirubin in amniotic fluid

height

amount of bilirubin present determined by this graphical feature when plotting abs vs wavelength

Liley

-chart type to plot optical density for bilirubin measurement

-three zones (mild, moderate, severe)

410

nm where oxyhemoglobin optical density peaks

450

nm where bilirubin optical density peaks

365

normal optical density peak (nm)

Queenan

-chart type to plot optical density for bilirubin measurement

-four zones (Rh neg, intermediate, Rh pos, intrauterine death risk)

infection

-can cause fetal distress

-WBC presence (dipstick, leukocyte esterase)

-gram stain and culture

alpha fetoprotein (AFP)

-made in liver

-inc in neural tube disorders

-dec in Down’s

-fetus: peak at 10-13 wks, dec until term

-maternal: peak 3rd tri

-detected in mother or amniotic fluid

acetylcholinesterase

-nerve tissue

-inc with neural tube disorders

inc, n, n

AFP, hCG, uE3 in neural tube defect

dec, inc, dec, inc

AFP, hCG, uE3, inhibin A 

-Down’s syndrome profile

n, dec, dec

AFP, hCG, uE3

-trisomy 18 profile

respiratory distress

most frequent complication of preterm delivery

alveolar phospholipids

-fetal lung maturity

-lecithin

-sphingomyelin

-phosphatidyl inositol

-phosphatidyl glycerol

lecithin

-alveolar phospholipid component

-stability

-inc at 35 wks

sphingomyelin

-alveolar phospholipid

-constant through gestation

-serves as control for L/S assessment of FLM

lecithin/sphingomyelin ratio (L/S)

-increases with lecithin production at 35 wks

-indicative of FLM

phosphatidylglycerol, phosphatidylinositol

-lung surface lipids (alveolar phospholipids)

-inc at 35 wks (like lecithin)

-tested for FLM

aninostat-FLM

instrument measures alveolar phospholipids

creatinine

-indicates fetal age

-36 wks in amniotic fluid (urine from fetal kidney) 

lamellar bodies

-type II cells in alveoli

-storage form of surfactant

-released into amniotic fluid from lungs

-indicates lung maturity

-sim size to PLTs (hematology analyzer to count)

infection

indicated by:

-maternal and fetal tachy

-maternal temp >38

-uterine tenderness, irritability

-foul-smelling vag discharge

caused by:

-premature delivery

-prolonged labor

-prom

cervix

where infection-causing bacteria typically found