SPECIAL HANDLING PROCEDURE

AMNIOTIC FLUID
CEREBROSPINAL FLUID
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AMNIOTIC FLUID
• Amniotic fluid is a clear, slightly yellowish liquid that surrounds
the fetus during pregnancy, it is contained in the amniotic sac.
• The amniotic fluid constantly circulates as the baby swallows and
inhales the fluid, and then releases it.
Collection of Amniotic Fluid
• The procedure in collecting and obtaining amniotic fluid is
called transabdominal amniocentesis.
• It is preferably collected after 15 weeks of gestation
(pregnancy) and is obtained by a physician.
• The procedure is performed with ultrasound guidance,
involves inserting a needle through the mother’s abdominal
wall into the uterus and aspirating approximately 10 mL of
fluid from the amniotic sac.
Procedure
 A small area of the abdomen is  Specimens for chromosome analysis
cleansed with an antiseptic. must be kept at room temperature.
 Under ultrasound guidance, a thin,  Specimens for some chemistry tests
hollow needle through abdomen and must be kept on ice. Follow
uterus, and into the amniotic sac, is laboratory protocol.
inserted.
 A small amount of fluid is removed
through the needle and sent for
laboratory analysis ASAP.
 It is important that the gestational age
of the fetus be included on the
specimen label.
 Amniotic fluid is normally sterile and
must be collected in a sterile container.
 The specimen should be protected
from light to prevent breakdown of
bilirubin.
Why It Should Be Done
Amniocentesis should be done if:
• A pregnant woman has an abnormality on an initial prenatal
screening test
• Maternal age over 35 years by the pregnancy due date
• There is a family history or previous child with a chromosomal
and genetic disorder (Down’s Syndrome)
- it can be detected by chromosome studies done on fetal
cells removed from the fluid
• Risk of Hemolytic disease/ Rh disease
- it can be detected by measuring bilirubin levels.
• To estimate gestational age
- amniotic fluid creatinine levels have also been used to
estimate gestational age because these levels are related to
fetal muscle mass
• To assess fetal lung maturity
- phospholipids level determine fetal lung maturity, it act as
surfactants to keep the alveoli of the lungs inflated. Results
are reported as a lecithin-to-sphingomyelin (L/S) ratio. It is
more likely to be immature if L/S ratio is less than 2.
• To detect Open Neural Defect Tube (Spina bafida)
- an increased level of alpha fetoprotein (AFP) suggests an
abnormality, AFP level are different in each gestation week
 CEREBROSPINAL FLUID (CSF)

• Cerebrospinal fluid (CSF) is a clear,

colorless liquid that surrounds the brain
and spinal cord.
• CSF helps protect this system by acting like
a cushion against sudden impact or injury
to the brain or spinal cord
• CSF has many of the same constituents as
blood plasma.
Collection of Cerebrospinal Fluid
• A sample of cerebrospinal fluid (CSF)
collected by a health practitioner from the
lower back using a procedure called a lumbar
puncture or spinal tap.
• The procedure is done with special x-ray
guidance that aids the needle position. Once
the needle is in position, the CSF pressure is
measured and a sample of 1 to 10 milliliters
(mL) of CSF is collected in 3 vials.
Why It Should Be Done
Cerebrospinal Fluid Analysis is done to:
• diagnose meningitis
- the layers of tissue that surround the spinal cord and
brain, can disrupt the blood-brain barrier and allow white
blood cells (WBCs) and red blood cells (RBCs) and
increased amounts of protein into the CSF
• diagnose other disorders such as brain abscess, CNS cancer,
and multiple sclerosis
-these can also produce antibodies that can be found in
the CSF
• Conduct Routine tests on spinal fluid such as cell counts,
chloride, glucose, and total protein
Procedure
 The patient will lie on your side with  The second for microbiology
knees pulled up toward the chest, studies, and the third for cell
and chin tucked downward. counts. CSF should be kept at
 After the back is cleaned, the health room temperature, delivered to
care provider will inject a local the lab STAT , and analyzed
numbing medicine (anesthetic) into immediately.
the lower spine.
 A spinal needle will be inserted. A
sample of 1 to 10 milliliters (mL) of
CSF is collected in 3 vials.
 The needle is removed, the area is
cleaned, and a bandage is placed
over the needle site.
 The first tube is used for chemistry
and immunology tests.
References

McCall, R. E., & Tankersley, C. M.

(1993). Phlebotomy essentials. Philadelphia: J.B.
Lippincott.

https://labtestsonline.org

https://medlineplus.gov

http://www.leehealth.org
Thank you