clinical chem - pregnancy and prenatal testing

zygote

once the ovum is fertilized by a sperm cell, it is called a _____

increase

during pregnancy, the plasma volume _____ as extracellular volume _____

renin angiotensin aldosterone system (RAAS)

causes the secretion of aldosterone by the adrenal glands, which allows for the retention of sodium by the distal convoluted tubules and leads to water retention

iron

additional _____ is required for the increased demandof hemoglobin synthesis during pregnancy

iodine

pregnancy is often associated with _____ deficiency, which is important for fetal CNS development

calcium

fetus has a high demand for _____

estradiol and prostaglandins

during pregnancy, there is upregulation of _____

prolactin

plasma concentrations of _____ begin to increase dramatically during the first trimester of pregnancy

GFR

during pregnancy, there is increased _____, which causes a decrease in osmotic pressure in the glomeruli

hyperventilation

during pregnancy, there is increased demand for oxygen consumption and arterial pO2 increases and arterial pCO2 decreases

cholesterols

_____ are used to create steroid hormones for the fetus

neural tube defects (NTDs)

birth defects (congenital conditions) of the brain, spine or spinal cord, one of the most common birth defects seen in the developing fetus that occurs when the neural tube does not close completely

down syndrome (trisomy 21)

extra copy of the long arm region q22.1 to q22.3 of chromosome 21 results in mental deficiency, hypotonia, congenital heart defects, and flat facial profile

trisomy 18 (edward’s syndrome)

occurs when the fetus receives an extra copy of chromosome 18, genetic condition that causes physical growth delays during fetal development, many do not live past 8 weeks gestation

isoimmunization

involves a fetal hemolytic disorder that occurs when maternal antibodies are directed against fetal erythrocytic antigens, most commonly occurs when the mother is Rh-negative and is carrying an Rh-positive fetus

preterm delivery

when a fetus is delivered earlier than the 37th week of gestation, the pregnancy is labeled as _____, biggest concern is respiratory distress syndrome

preeclampsia

persistent high BP and other problems in pregnant women or who have recently given birth; characterized by hypertension, proteinuria, and edema in the second and third trimester

preeclampsia

complications include premature birth, fluid in lungs, bleeding problems, and liver or kidney damage; risk of progression is seizures, stroke, and death

hyperemesis gravidarum (morning sickness)

extreme, persistent nausea and vomiting can occur during the pregnancy; can lead to weight loss, malnutrition, and dehydration

ectopic pregnancy

happens when a fertilized egg implants outside of your uterus, most commonly in the fallopian tube which is not made to hold a growing embryo, this can lead to severe bleeding and is a life threatening condition that requires treatment

calcium

_____ levels are often deficient in the mother during the second and third trimesters of pregnancy

iodine

_____ deficiency can occur as it is actively transported from the mother to the fetus

human chorionic gonadotropin (hCG)

hormone for the early detection of pregnancy, bound by alpha and beta subunits and we can often test for the beta subunit

nonviable

pregnancies where hCG levels plateau before 8 weeks or fail to double every 24 hours are assumed to be _____

down syndrome

in _____, hCG will be 2x higher in the maternal serum

alpha fetoprotein (AFP)

made by the developing baby and passes into the amniotic fluid, passes through the placenta into the blood stream of the mother

mother’s serum AFP test (MS-AFP)

common screening test marker for fetal abnormalities and fetal distress

mother’s serum AFP test (MS-AFP)

tests for genetic disorders such as Down or Turner syndrome, incorrect due dates, twins/triplets, neural tube defects

lower

_____ than normal AFP levels may mean your baby has a genetic disorder such as down syndrome

higher

_____ than normal AFP levels may mean your baby has an increased risk of having a neural tube defect such as spina bifida or anencephaly

amniotic fluid AFP test

used to distinguish between spina bifida and anencephaly

unconjugated estriol (uE3)

present in maternal serum in low concentrations, measured as an indicator of fetal health, screens for down syndrome and trisomy 18

lower

_____ levels of uE3 in second trimester have been associated with a variety of disorders of the fetus

inhibin A

a glycoprotein with a primary function of suppressing FSH, trisomy 21 is associated with an increase in maternal serum levels during the second trimester

oral glucose tolerance test (OGTT)

_____ should be conducted during the 24th to 28th weeks of pregnancy in all patients and screens for gestational diabetes mellitus

fetal fibronectin

appears within 7-14 days of pregnancy, useful for assessing the risk of preterm delivery and will occur in the next 7-14 days in women with signs and symptoms

triple screen

routinely performed between 16-20 weeks gestation, measures AFP, hCG, uE3

quadruple screen test

routinely performed between 16-20 weeks gestation, measures AFP, hCG, uE3, inhibin A