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Interpretive Handbook

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Test 8390:
Bilirubin, Amniotic Fluid

Clinical Information Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test

The presence of bilirubin in amniotic fluid, which results in a yellow color, is an indicator of fetal erythroblastosis. Visual inspection of amniotic fluid is unreliable because bilirubin is not the only cause of an excessive yellow color; therefore, the presence of bilirubin must be confirmed with spectrophotometric methods. Meconium may contribute a green color (biliverdin) that can obscure the color of bilirubin and hemoglobin.

Useful For Suggests clinical disorders or settings where the test may be helpful

Evaluation of Rh disease, ie, hemolytic disease of the fetus

 

Monitoring disease progression to assess need for fetal transfusion

Interpretation Provides information to assist in interpretation of the test results

The reference range for bilirubin in amniotic fluid is related to the gestational age of the fetus. Refer to either the Queenan Curve (gestational age <27 weeks) or the Liley Chart (gestational age >27 weeks) listed under Delta OD of Bilirubin in Amniotic Fluid in Special Instructions.

Cautions Discusses conditions that may cause diagnostic confusion, including improper specimen collection and handling, inappropriate test selection, and interfering substances

Bilirubin is photosensitive. Collect the specimen in an opaque amber container and/or wrap in aluminum foil.

Reference Values Describes reference intervals and additional information for interpretation of test results. May include intervals based on age and sex when appropriate. Intervals are Mayo-derived, unless otherwise designated. If an interpretive report is provided, the reference value field will state this.

Interpretation of fetal risk is dependent upon gestational age.

Refer to either the Queenan Curve (gestational age <27 weeks) or the Liley Chart (gestational age >27 weeks) listed under Delta OD of Bilirubin in Amniotic Fluid in Special Instructions.

Clinical References Provides recommendations for further in-depth reading of a clinical nature

1. Scott F, Chan FY: Assessment of the clinical usefulness of the 'Queenan' chart versus the 'Liley' chart in predicting severity of rhesus iso-immunization. Prenat Diagn 1998;18:1143-1148

2. Liley AW: Liquor amnii analysis in the management of the pregnancy complicated by rhesus sensitization. Am J Obstet Gynecol 1961;82:1359-1370