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An in-depth analysis of serous fluids, their normal formation, and the causes of their effusion. It discusses the differentiation between transudate and exudate, hemothorax, hemorrhagic exudate, chylous, and pseudochylous effusion. The document also covers the methods of collection and chemical tests on ascitic fluid, as well as the analysis of amniotic fluid and its functions, volume, macroscopic analysis, and specimen collection.
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kate aubrey liu / BSMT III-2^1
Fluid present in the amnion , a membranous sac which surrounds the fetus This membranous sac is metabolically active, resulting to constant exchanges of water and chemicals in the amniotic fluid, fetus, and maternal circulation The placenta is the ultimate source of amniotic fluid water and solutes FUNCTIONS Cushion for the fetus Stabilizes temperature Allows fetal movement Proper lung development VOLUME The volume of amniotic fluid is significantly contributed by fetal urine and lung fluid Normal Volume: 800-1200 mL ( 3rd trimester) During 1st trimester, 35 mL of amniotic fluid is derived primarily from the maternal circulation fetal urine is the major contributor of amniotic fluid volume after the 1 st^ trimester of pregnancy MACROSCOPIC ANALYSIS POLYHYDRAMNIOS Increased amniotic fluid volume (>1200 mL) Causes: Decreased fetal swallowing of urine Neural tube disorders/defects Fetal structural anomalies Cardiac arrhythmias Congenital infections, Chromosomal abnormalities OLIGOHYDRAMNIOS Decreased amniotic fluid volume (<800 mL) Causes: Increased fetal swallowing of urine Membrane leakage Urinary tract deformities Congenital malformations Premature rupture of amniotic membranes Umbilical cord compression resulting in decelerated heart rate and fetal death SPECIMEN COLLECTION Method of collection: amniocentesis (paired with ultrasound para di lumagpas sa bata yung needle) Up to 30 mL collected in sterile syringe 2 nd^ trimester amniocentesis is used for: assessing genetic defects (e.g. T21, T15, T18) 3 rd^ trimester amniocentesis is used for: assessing fetal lung maturity (FLM), and Fetal Hemolytic Disease (HDFN) Quadruple screening tests prior to performing amniocentesis: Alpha fetoprotein Human chorionic gonadotrophin Unconjugated estriol (UE4) Inhibin A SPECIMEN HANDLING Test for FLM : Ice on delivery, kept frozen/iced or refrigerated. Filtration prevents loss of phospholipids Test for Cytogenetic Studies : Kept at room temperature or at 37 degrees Celsius to preserve the viability of analytes Test for HDN : Protected from light because bilirubin, which is prone to photooxidation, is used to determine HDN OTHER TEST TO IDENTIFY A FLUID AS AN AMNIOTIC FLUID: FERN TEST Detects ruptured membranes Also used to diagnose pregnancy There is a fern crystal formation due to increased sodium chloride + protein + exposure to air = fern crystal formation Procedure: Specimen (vaginal fluid)→ Slide→ Air dry (+) Fern line crystals [Amniotic fluid with (+) Protein and (+)NaCl]