Article

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

Immuno-analyse & Biologie Spécialisée (Impact Factor: 0.05). 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.