Question

A pregnant diabetic female, age 28 years, is expecting for the second time. She has a history of miscarriage, at the time of her miscarriage, she was a volunteer in Haiti and didn't seek out medical assistance. Her OBGYN is concerned that this current pregnancy may result in a similar outcome due to a hemolytic disease due to a Rh incompatibility. Her physician ordered an amniocentesis at 34 weeks gestation as she is considering inducing labor, and results are as follows:

Optical density at 450 nm = increased

Liley graph reading = 0.6

L/S ratio = 2.1

FLM II = 55 mg surfactant/g of albumin

Questions:

1. What do these tests reveal? Why is the FLM II reading important in this case? Explain your answer.

2. Why is the physician considering inducing labor? Explain your answer.

Answer 1

1) AMNIOCENTESIS REVEALS TO IDENTIFYING NEURAL TUBE DRFFECT LIKE SPINA BIFIDA, GENETIC DISORDERS LIKE DOWN SYNDROME, CYSTIC FIBROSIS etc and it helps to EVALUATE Rh INCOMPATIBILITY, and FETAL LUNG MATURITY. * FLM II READING IS IMPORTANT IN THIS CASE BECAUSE OF " TO RULE OUT RESPIRATORY DISTRESS SYNDROME OF NEWBORN FROM INSUFFICIENT PULMONARY SURFACTANT. THIS MAY OCCUR SUDDENLY AFTER DELIVERY ESPECIALLY WHEN THE MOTHER IS DIABETIC. 2) THE PATIENT IS WITH HEAMOLYTIC DISEASE WITH Rh INCOMPATIBILITY. THE PHYSICIAN CONSIDERING INDUCING LABOUR FOR THE PREVENTION OF STILL BIRTH. MOTHER IS Rh NEGATIVE, HER IMMUNE SYSTEM TREAT THE BABY LIKE A FOREIGN BODY IF BABY IS POSITIVE. BODY PRODUCE ANTIBODIES AGAINST FETAL RBC. IT MAY LEADS TO DESTRUCTION OF RBC MAY LEADS TO HIGH LEVEL OF BILIRUBIN IN BABY. IT MAY CAUSE STILL BIRTH. * BABY IS MORE LARGER THAN OTHER BABIES IN A DIABETIC MOTHER. IT WILL LEADS TO DIFFICULT VAGINAL DELIVERY AND MAY CAUSE NERVE INJURIES TO THE BABY. SO INDUCING LABOUR HELPS TO PREVENT EXCESSIVE FETAL GROWTH AND ASSOCIATED COMPLICATIONS LIKE STILL BIRTH.