Você está na página 1de 26

AMNIOTIC FLUID

(TESTS FOR FETAL DISTRESS)

Ainnah Marielle O. Torres


BSMT 3-2

FETAL DISTRESS
Has been used to describe when
the fetus does not receive
adequate amounts of oxygen
during pregnancy orlabor
It is oftentimes detected through
an abnormal fetal heart rate.

HEMOLYTIC DISEASE OF THE


NEWBORN
Before immunoprophylaxis was
available, HDN affected 1% of all
newborns and was responsible
for the death of one baby in
every 2,200 births.

HEMOLYTIC DISEASE OF THE


NEWBORN
oldest
evaluates the severity of the fetal anemia produced
by HDN
However, antibodies against other red cell antigens
are also capable of producing HDN, and
immunization of Rh-negative mothers may not be
effective or even performed in all cases.
Initial exposure to foreign red cell antigens occurs
during gestation, delivery of the placenta, or a
previous pregnancy when fetal red blood cells enter

By measuring the amount of bilirubin


in the fluid, the extent of hemolysis
taking place may be determined, and the
danger this anemia presents to the fetus
may be assessed.

Amniotic fluid bilirubin is measured by


spectrophotometric analysis using
serial dilutions
The optical density (OD) of the fluid is
measured in intervals between 365 nm
and 550 nm and the readings plotted on
semilogarithmic graph paper.
In normal fluid, the OD is highest at 365
nm and decreases linearly to 550 nm,
illustrated by a straight line.

When bilirubin is present, a rise in OD is seen


at 450 nm because this is the wavelength of
maximum bilirubin absorption. The difference
between the OD of the theoretic baseline and
the OD at 450 nm represents the amniotic
fluid bilirubin concentration.

This difference in OD, referred to as


the absorbance difference at 450 nm
(D A450), is then plotted on a Liley
graph to determine the severity of the
Hemolytic Disease.

zone I indicate no more than a mildly


affected fetus
zone II indicate moderate hemolysis
and require careful monitoring
anticipating an early delivery or
exchange transfusion upon delivery,
zone III indicates severe hemolysis and
suggests
a severely affected fetus

HEMOLYTIC DISEASE OF THE


NEWBORN
specimens must be protected from light at all times
Markedly decreased values will be obtained with as
little as 30 minutes of exposure to light.
Contamination of the fluid by cells, hemoglobin,
meconium, or other debris will interfere with the
spectrophotometric analysis.
Specimens should be immediately centrifuged to
remove particulate interference.
Specimens contaminated with meconium will cause
falsely low D A450 values and are not acceptable for

HEMOLYTIC DISEASE OF THE


NEWBORN
Specimens that are contaminated with blood are
generally unacceptable
This interference can be removed by extraction with
chloroform if necessary. A control may be prepared
by diluting commercial chemistry control sera 1 to
10 with normal saline and treating it in the same
manner as the patient specimen.
Bilirubin and protein levels approximate those in
amniotic fluid and can be varied by using low or high
control sera.

PREVENTION OF HDN
Anti-D immunoglobulin prophylaxis should be
given to all rhesus negative women who have
not already been sensitised. It can be given
soon after delivery and antenatally at 28 and 34
weeks. Treatment is also indicated after other
sensitising events such as abortion,
miscarriage, amniocentesis, ectopic pregnancy,
and abdominal trauma. For further details see
separate articleAnti-D (Rho) Immunoglobulin.

NEURAL TUBE DEFECT

NEURAL TUBE DEFECTS


Neural tube defects arebirth defectsof the brain, spine,
or spinal cord.
They happen in the first month of pregnancy, often before
a woman even knows that she is pregnant.
The two most common neural tube defects arespina
bifidaand anencephaly.
Another type of defect,Chiari malformation, causes the
brain tissue to extend into the spinal canal.

NEURAL TUBE DEFECTS


Are obese
Have poorly controlled diabetes
Take certain antiseizure medicines

Getting enoughfolic acid, a type of B vitamin, before


and during pregnancy prevents most neural tube
defects.

NEURAL TUBE DEFECTS


Neural tube defects are usually diagnosed before the
infant is born, through lab or imaging tests.
There is no cure for neural tube defects. The nerve
damage and loss of function that are present at birth
are usually permanent. However, a variety of
treatments can sometimes prevent further damage and
help with complications.
(NIH: National Institute of Child Health and Human
Development)

NEURAL TUBE DEFECTS


one of the most common birth defects in the United States.
It can be detected by maternal serum alpha-fetoprotein
(MSAFP) blood test, high-resolution ultrasound, and
amniocentesis.
levels of alpha-fetoprotein (AFP) in both the maternal
circulation and the amniotic fluid can be indicative of fetal
neural tube defects, such as anencephaly and spina bifida.
AFP is the major protein produced by the fetal liver during
early gestation (prior to 18 weeks).

NEURAL TUBE DEFECTS


It is found in the maternal serum due to the
combined fetal-maternal circulations and in the
amniotic fluid from diffusion and excretion of fetal
urine.
Increased levels are found in the maternal serum
and amniotic fluid when the skin fails to close over
the neural tissue, as occurs in anencephaly and
spina bifida.
Measurement of amniotic fluid AFP levels is indicated
when maternal serum levels are elevated or a family

NEURAL TUBE DEFECTS


The possibility of a multiple pregnancy also must be
investigated when serum levels are elevated.
Normal values are based on the week of gestational
age, as the fetus produces maximal AFP between 12
and 15 weeks gestation, after which levels in
amniotic fluid begin to decline.
Both serum and amniotic fluid AFP levels are
reported in terms of multiples of the median (MoM).

NEURAL TUBE DEFECTS


The median is the laboratorys reference level for a
given week of gestation.
A value two times the median value is considered
abnormal for both maternal serum and amniotic
fluid.
Elevated amniotic fluid AFP levels are followed by
measurement of amniotic acetylcholinesterase
(AChE).
The test is more specific for neural tube disorders
than AFP, provided it is not performed on a bloody

ABSTINENCE
Lets protect our future
babies!

Você também pode gostar