Test ID: AFBIL
Bilirubin, Amniotic Fluid
NY State Approved 
Indicates the status of NY State approval and if the test is orderable for NY State clients.
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
Special Instructions and Forms Describes specimen collection and preparation information, test algorithms, and other information pertinent to test. Also includes pertinent information and consent forms to be used when requesting a particular test
Method Name A short description of the method used to perform the test
Spectrophotometric Scan
Reporting Name A shorter/abbreviated version of the Published Name for a test; an abbreviated test name
Aliases Lists additional common names for a test, as an aid in searching
AMNIOTIC FLUID OPTICAL DENSITY
D-Isoimmune
Delta OD
Isoimmune Disease
OD 450
Optical Density, Amniotic Fluid
Hemolytic disease of the newborn
HDN
Specimen Type Describes the specimen type needed for testing
Specimen Required Defines the optimal specimen. This field describes the type of specimen required to perform the test and the preferred volume to complete testing. The volume allows automated processing, fastest throughput and, when indicated, repeat or reflex testing.
Collection Container/Tube: Amniotic fluid container
Submission Container/Tube: Opaque, amber vial (Supply T192)
Specimen Volume: 3.5 mL
Collection Instructions:
1. Centrifuge, separate supernatant, and send both supernatant and sediment in separate opaque, amber vials to protect from light.
2. Label specimens as sediment and supernatant.
Additional Information: Gestational age at time of amniocentesis is required.
Specimen Minimum Volume Defines the amount of specimen required to perform an assay once, including instrument and container dead space. Submitting the minimum specimen volume makes it impossible to repeat the test or perform confirmatory or perform reflex testing. In some situations, a minimum specimen volume may result in a QNS (quantity not sufficient) result, requiring a second specimen to be collected.
Reject Due To Identifies specimen types and conditions that may cause the specimen to be rejected
| Hemolysis | NA |
| Lipemia | NA |
| Icterus | Mild OK; Gross OK |
| Other | NA |
Specimen Stability Information Provides a description of the temperatures required to transport a specimen to the laboratory. Alternate acceptable temperature(s) are also included.
| Specimen Type | Temperature | Time |
|---|---|---|
| Amniotic Fld | Frozen | 70 days |
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.
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.
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.
Clinical Reference 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
Method Description Describes how the test is performed and provides a method-specific reference
Scanning spectrophotometry (SP).(Ashwood ER: Clinical chemistry of pregnancy. In Tietz Textbook of Clinical Chemistry. Fourth edition. Edited by CA Burtis, ER Ashwood. Philadelphia, WB Saunders Company, 2006, pp 2187-2188; Bailey DN, Briggs JR: Studies of the extraction of bilirubin from human amniotic fluid. Am J Clin Pathol 2006;125:771-773; Halldorsdottir AM, Grenache DG, Snyder J et al: Comparison of various methods for amniotic fluid deltaOD450 bilirubin measurement. Clin Chim Acta 2008;389:160-163)
Day(s) and Time(s) Test Performed Outlines the days and times the test is performed. This field reflects the day and time the sample must be in the testing laboratory to begin the testing process and includes any specimen preparation and processing time required before the test is performed. Some tests are listed as continuously performed, which means assays are performed several times during the day.
Monday through Saturday; Continuously
Analytic Time Defines the amount of time it takes the laboratory to setup and perform the test. This is defined in number of days. The shortest interval of time expressed is "same day/1 day," which means the results may be available the same day that the sample is received in the testing laboratory. One day means results are available 1 day after the sample is received in the laboratory.
Maximum Laboratory Time Defines the maximum time from specimen receipt at Mayo Medical Laboratories until the release of the test result
Specimen Retention Time Outlines the length of time after testing that a specimen is kept in the laboratory before it is discarded
Performing Laboratory Location The location of the laboratory that performs the test
Test Classification Provides information regarding the medical device classification for laboratory test kits and reagents. Tests may be classified as cleared or approved by the US Food and Drug Administration (FDA) and used per manufacturer's instructions, or as products that do not undergo full FDA review and approval, and are then labeled as an Analyte Specific Reagent (ASR), Investigation Use Only (IUO) product, or a Research Use Only (RUO) product.
CPT Code Information Provides guidance in determining the appropriate Current Procedural Terminology (CPT) code(s) information for each test or profile. The listed CPT codes reflect Mayo Medical Laboratories interpretation of CPT coding requirements. It is the responsibility of each laboratory to determine correct CPT codes to use for billing.
82247
LOINC® Code Information Provides guidance in determining the Logical Observation Identifiers Names and Codes (LOINC) values for the result codes returned for this test or profile.
| Result ID | Reporting Name | LOINC Code |
|---|---|---|
| AMBL | Amniotic Fluid | 12476-8 |
| AFCMT | Other Information | In Process |
| GSTN | Gestation | 18185-9 |
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