Question

Case #5 Amniocentesis is performed on a woman believed to be in 35th week of gestation. This is the second pregnancy for this Rh-negative, diabetic woman. Spectrophotometer analysis of the AF for bilirubin shows a high peak at 450 mu. The physician is considering inducing labor.

Answer 1

1. Doctor may consider for early indiction of labour as peak value indicates severe anemia in fetus

2. Reason for false positive test is if there is meconium inside the womb, in case of fetal acidosis

reason for false negative result if sample is exposed to light or volume of amniotic fluid is excessive.

3. Other consideration in inducing labor may be to check lung maturity of fetus.

4. lecithin sphingomyelin ratio is normal showing lung maturity so physician may go with induction of labor

5. dopler ultrasound may be done to check blood flow to baby ‘s brain and this can tell about anaemia and how severe is that

6. tests other than L S test:

• AmnioStat-FLM
  • This test looks for the presence of a lung surfactant called phosphatidylglycerol (usually just called PG).
  • This is an agglutination test that uses antibodies to detect PG in amniotic fluid. If PG is present then visible agglutinates (clumps of particles) can be seen and the fetal lungs are considered mature.
• Lamellar Body Count
  • In certain cells of the lungs, surfactants are packaged into granules called lamellar bodies and secreted from the cells into the alveoli. This test actually counts the number of lamellar bodies in amniotic fluid.
  • The higher the lamellar body count, the more likely it is that the fetal lungs are mature.