Article

Bilirubin in amniotic-fluid and Liley's chart during the second quarter of pregnancy

Immuno-analyse & Biologie Spécialisée (Impact Factor: 0.13). 03/2008; 23:35-44.

ABSTRACT At the moment, the management of the pregnancy complicated by Rhesus sensitization is less invasive: genotype RHD of the fetus is determined by PCR on fetal DNA from maternal plasma and the severe fetal anemia is detected by Doppler ultrasonography. Nevertheless, the amniocentesis is still realized for RHD determination by PCR on amniotic cells and for amniotic-fluid DO450 measurement. This parameter interpreted with the Liley or the Queenan chart predicts the gravity of the haemolytic disease of the fetus and new-born . Blood or meconium contaminations decrease the reliability of the test. In addition of the DO450, we determine bilirubine concentration by spectrophotometric using the formula of Fleming and Woolf. We established references limits of the two tests according gestational age on the basis of percentile 95 of our population (n=1200). Limits for DO405 in our laboratory were in agreement with the limit between the « indeterminate » and « Rh positive affected » zone of Queenan chart. The two tests interpreted according to our standards are in agreement in 96.5% of the cases.

At the moment, the management of the pregnancy complicated by Rhesus sensitization is less invasive: genotype RHD of the fetus is determined by PCR on fetal DNA from maternal plasma and the severe fetal anemia is detected by Doppler ultrasonography. Nevertheless, the amniocentesis is still realized for RHD determination by PCR on amniotic cells and for amniotic-fluid DO450 measurement. This parameter interpreted with the Liley or the Queenan chart predicts the gravity of the haemolytic disease of the fetus and new-born . Blood or meconium contaminations decrease the reliability of the test. In addition of the DO450, we determine bilirubine concentration by spectrophotometric using the formula of Fleming and Woolf. We established references limits of the two tests according gestational age on the basis of percentile 95 of our population (n=1200). Limits for DO405 in our laboratory were in agreement with the limit between the « indeterminate » and « Rh positive affected » zone of Queenan chart. The two tests interpreted according to our standards are in agreement in 96.5% of the cases.

At the moment, the management of the pregnancy complicated by Rhesus sensitization is less invasive: genotype RHD of the fetus is determined by PCR on fetal DNA from maternal plasma and the severe fetal anemia is detected by Doppler ultrasonography. Nevertheless, the amniocentesis is still realized for RHD determination by PCR on amniotic cells and for amniotic-fluid DO450 measurement. This parameter interpreted with the Liley or the Queenan chart predicts the gravity of the haemolytic disease of the fetus and new-born . Blood or meconium contaminations decrease the reliability of the test. In addition of the DO450, we determine bilirubine concentration by spectrophotometric using the formula of Fleming and Woolf. We established references limits of the two tests according gestational age on the basis of percentile 95 of our population (n=1200). Limits for DO405 in our laboratory were in agreement with the limit between the « indeterminate » and « Rh positive affected » zone of Queenan chart. The two tests interpreted according to our standards are in agreement in 96.5% of the cases.

1 Bookmark
 · 
194 Views
  • Obstetrical & Gynecological Survey - OBSTET GYNECOL SURV. 01/1962; 17(2):188-192.
  • American Journal of Obstetrics and Gynecology 07/1963; 86:485-94. · 3.88 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Six different methods for assessing amniotic fluid bilirubin were compared in 111 samples from 37 patients. When the Liley methods were compared, the chloroform extraction and 5% correction methods resulted in 20% and 4% reductions, respectively, in the mean change in optical density at 450 nm when compared with the uncorrected mean (0.086 +/- 0.06 [p less than 0.05] and 0.104 +/- 0.07 [p, not significant] vs 0.108 +/- 0.08). This reduction was observed in spite of significant visual blood contamination being rarely noted. The predictions based on amniotic fluid analysis were compared with the first fetal or neonatal hematocrit. The chloroform-extracted change in optical density at 450 nm accurately predicted fetal status in all patients, whereas lesser degrees of accuracy were observed with other methods. Hydrops fetalis did not occur during the observation period, and fetuses needing transfusion (n = 5) or early delivery (n = 10) were indicated correctly. The chloroform extraction change in optical density at 450 nm accurately predicts fetal status, and its use should continue.
    American Journal of Obstetrics and Gynecology 11/1991; 165(4 Pt 1):1030-5. · 3.88 Impact Factor

Full-text

Download
164 Downloads
Available from
May 31, 2014