Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “AMNIOTIC FLUID”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 55 records · Page 3Linked to original sources
PubMed1990

Correlation of absorbance at 650 nm with the presence of phosphatidylglycerol in amniotic fluid.

Amniotic fluid absorbance at 650 nm was correlated with the presence of phosphatidylglycerol (PG) in the isolated surfactant fraction (10,000-g pellet). Shake test results were included. Two hundred ninety-seven samples were analyzed. PG was present in 222 of 226 samples in which the absorbance was greater than or equal to 0.250 and absent from 48 of 71 with an absorbance less than 0.250. PG was present in all 166 samples with a positive shake test and absent in 52 of 131 samples with a negative one. In 65 samples in which the shake test was negative and the absorbance greater than or equal to 0.250, PG was present in all but 4. The false-positive rate for the prediction of respiratory distress syndrome was 0.8% for the Shake test and 0.6% for the absorbance measurement. The results support the usefulness of the absorbance measurement as a simple and reliable procedure for assessing fetal lung maturity.

Amniotic Fluid↗
PubMed1994

Isoforms of cellular fibronectin and tenascin in amniotic fluid.

Amniotic fluid (AF) obtained from second trimester pregnancies presented extradomain (ED) A, B and an oncofetal (onc-f) domain containing isoforms of cellular fibronectin (cFn) in Western blotting of gelatin-bound polypeptides and directly of AF. Western blotting after sequential immunoprecipitation suggested at least three Fn molecules: one containing EDA and the onc-f domain and another minor component distinctly containing all the domains, and a third one only containing EDA. The immunoblotting results for EDA-cFn and onc-f-cFn were closely similar to that for total Fn, whereas in plasma samples of normal and pregnant women only traces of EDA-cFn and onc-f-cFn, but no EDB-cFn, were found. Western blotting of AF also indicated the presence of three isoforms of tenascin (Tn), M(r) 190,000 and 280,000 polypeptides earlier found in many cells, and a M(r) 200,000 polypeptide, novel for AF and not present in plasma. The results suggest a novel extracellular matrix polypeptide composition for AF.

Amniocentesis↗
PubMed2000

Correlation between amniotic fluid glucose concentration and amniotic fluid volume in pregnancy complicated by diabetes.

OBJECTIVE: Pregnancies complicated by diabetes are frequently characterized by an increased volume of amniotic fluid, and the pathophysiologic mechanism of this increase is not known. Our goal was to evaluate the relationship between amniotic fluid glucose concentration and the amniotic fluid index in pregnancies complicated by insulin-treated diabetes and to compare it with that seen in normal pregnancies. STUDY DESIGN: Amniotic fluid index and amniotic fluid glucose levels were measured before elective repeated cesarean delivery in 41 women with insulin-treated diabetes and in 35 women without diabetes. Only singleton gestations without anomalous fetuses were included. Women with diabetes were hospitalized for approximately 4 weeks before delivery, during which time glycemic control was optimized. Amniotic fluid index and amniotic fluid glucose concentration were correlated with each other and were compared between the groups with and without diabetes. RESULTS: The mean amniotic fluid index was significantly increased in the diabetes group (16.6 +/- 5.0 cm in the diabetes group vs 13.4 +/- 3.5 cm in the control group; P =.002). The amniotic fluid glucose concentration was also significantly greater in the diabetes group than in the control group (39 +/- 17 mg/dL in the diabetes group vs 24 +/- 11 mg/dL in the control group; P <.001). Among women with diabetes the amniotic fluid glucose concentration was significantly correlated with the amniotic fluid index (r = 0.32; P =.04), a correlation not found among the control women. The mean fasting blood glucose concentration among the women with diabetes for the week before amniocentesis was 82 +/- 11 mg/dL. CONCLUSION: The amniotic fluid index parallels the amniotic fluid glucose level among women with diabetes. This finding raises the possibility that the hydramnios associated with diabetes is a result of increased amniotic fluid glucose concentration.

Adult↗
PubMed1997

The accuracy of the summated amniotic fluid index in evaluating amniotic fluid volume in twin pregnancies.

OBJECTIVE: Our purpose was to determine the accuracy of the summated amniotic fluid index designed to estimate the total amniotic fluid volume in twin pregnancies. STUDY DESIGN: The summated amniotic fluid index was measured in 62 normal diamniotic twin pregnancies by adding the deepest vertical pockets in the four quadrants. Actual amniotic fluid volume was then determined in all 124 amniotic sacs by amniocentesis and a dye-dilution technique. For data analysis, amniotic fluid volumes were classified by percentile with use of previously reported norms. RESULTS: There were significant differences in the percentile distribution of amniotic fluid volume as estimated by the summated amniotic fluid index and the actual volume as determined by dye dilution (p < 0.001). The summated amniotic fluid index has a sensitivity of only 13% in predicting amniotic sac volume. CONCLUSION: The summated amniotic fluid index is a poor predictor of intertwin differences in amniotic fluid volume and cannot identify twin pairs at risk for oligohydramnios and hydramnios.

Adult↗
PubMed1998

Evaluating rapid diagnostic tests of intra-amniotic infection: Gram stain, amniotic fluid glucose level, and amniotic fluid to serum glucose level ratio.

OBJECTIVE: The aim of the study was to compare the diagnostic utility of the Gram stain, the amniotic fluid glucose level, and the ratio of amniotic fluid glucose level to serum glucose level in detecting intra-amniotic infection. STUDY DESIGN: We conducted a prospective study of 127 patients with preterm labor and 26 patients with preterm premature rupture of the membranes (153 total). All patients underwent amniocentesis to diagnose intra-amniotic infection. The diagnostic criterion for intra-amniotic infection was a positive amniotic fluid culture result. RESULTS: The Gram stain is 80% sensitive and 91% specific when a positive is considered the presence of white blood cells or bacteria. Amniotic fluid glucose level and the ratio of amniotic fluid glucose level to serum glucose level are significantly lower when amniotic fluid culture results are positive, but as diagnostic tests they are inferior to the Gram stain. Logistic regression models that combine predictors yield superior accuracy with respect to individual tests. The most accurate combination was amniotic fluid glucose level and Gram stain with white blood cells or bacteria. Although the number of patients with preterm premature rupture of the membranes was small in this study (n = 26), analysis of our data suggests that the diagnostic performance levels of these tests were similar when used in patients with preterm labor and intact membranes and in patients with premature rupture of the membranes. CONCLUSIONS: The amniotic fluid glucose level and the ratio of amniotic fluid to serum glucose level have equivalent diagnostic utility and are inferior to the Gram stain. The combination of Gram stain with amniotic fluid glucose level is superior to any individual test.

Adult↗
PubMedDate not supplied

Activin A and inhibin B in extra-embryonic coelomic and amniotic fluids, and maternal serum in early pregnancy.

Activin A and inhibin B levels were measured, using a two-site enzyme immunoassay, in extra-embryonic coelomic fluid, amniotic fluid and maternal serum samples retrieved from 23 healthy pregnant women, at 8 (n=8), 9 (n=8), and 10 (n=7) weeks of gestation. Dimeric activin A and inhibin B were measurable in all samples. Median (+/-SEM) activin A concentrations in coelomic fluid (0.98+/-0.34 ng/ml) were significantly higher than in maternal serum (0.68+/-0.05 ng/ml) and in amniotic fluid (0.09+/-0.04 ng/ml) (P<0.05). Maternal serum activin A levels were significantly higher than amniotic fluid concentrations. Median (+/-SEM) inhibin B concentrations in coelomic fluid (24.32+/-6.02 pg/ml) were significantly higher than in maternal serum (5.94+/-0.97 pg/ml) and in amniotic fluid (6.31+/-1.53 pg/ml) (P<0.05), while no significant difference between maternal serum levels and amniotic fluid concentrations was found. No significant difference in activin A and inhibin B levels in extra-coelomic fluid, amniotic fluid, and maternal serum throughout the 3 weeks of pregnancy was found. The present study showed that coelomic fluid is an important reservoir of activin A and inhibin B, supporting the hypothesis that the extra-embryonic coelom may have a secretory role during the first 11 weeks of gestation.

Activins↗
PubMed2002

Quantification of 3-hydroxyglutaric acid in urine, plasma, cerebrospinal fluid and amniotic fluid by stable-isotope dilution negative chemical ionization gas chromatography-mass spectrometry.

This paper describes a stable isotope dilution method for quantification of 3-hydroxyglutaric acid (3-HGA) in body fluids. The method comprises a solid-phase extraction procedure, followed by gas chromatographic separation and negative chemical ionization mass spectrometric detection. This method is selective and sensitive, and enables measurement of 3-HGA concentrations in urine-, plasma-, and CSF- samples of controls. The control ranges for 3-HGA were: urine 0.88-4.5 mmol/mol creatinine (n=12); plasma 0.018-0.10 micro mol/l (n=10), CSF 0.022-0.067 micro mol/l (n=10). We applied this method to measure 3-HGA in body fluids of three patients with glutaric aciduria type I. We also quantified 3-HGA in amniotic fluid of controls (range 0.056-0.11 micro mol/l; n=12) and in two samples from fetuses affected with glutaric aciduria type I.

Amniotic Fluid↗
PubMed1997

Ultrasonographic assessment of amniotic fluid does not reflect actual amniotic fluid volume.

OBJECTIVE: Our objective was to compare the ability of two methods of amniotic fluid assessment (two-diameter amniotic fluid pocket versus the amniotic fluid index) to predict oligohydramnios (actual amniotic fluid volume < 500 ml) or polyhydramnios (actual amniotic fluid volume > 1500 ml). STUDY DESIGN: The amniotic fluid index and the two-diameter amniotic fluid pocket were assessed before amniocentesis and determination of amniotic fluid volume with the dye (aminohippurate sodium)-dilution technique. To assess the detection of either oligohydramnios or polyhydramnios, the areas under the receiver-operator characteristic curves (+/-SE) were estimated by the point-to-point trapezoidal method of integration. Prediction limits were calculated by regression analysis of amniotic fluid index or two-diameter amniotic fluid pocket versus actual amniotic fluid volume and determination of 95th percentile ranges for amniotic fluid volume. RESULTS: We studied 144 patients with a mean (+/-SD) gestational age of 31.7 +/- 5.5 weeks; mean (+/-SD) amniotic fluid index and two-diameter amniotic fluid pocket were 12.6 +/- 6.1 cm and 21.2 +/- 18.4 cm2, respectively. Mean (+/-SD) actual amniotic fluid volume was 722 +/- 735 ml (range 101 to 4318 ml). The areas under the four receiver-operator characteristic curves were not significantly different from the nondiagnostic line (p < 0.05). Regression slopes (r values) for amniotic fluid index and two-diameter amniotic fluid pocket versus actual amniotic fluid volume were 0.34 and 0.23, respectively. Calculation of the prediction limit for 95% confidence that oligohydramnios is absent requires that the amniotic fluid index be 30 cm and the two-dimension amniotic fluid pocket be 90 cm2, both thresholds of which are currently considered to represent clinical polyhdramnios. CONCLUSIONS: Both amniotic fluid index and two-dimension amniotic fluid pocket appear to be inaccurate predictors of actual oligohydramnios or polyhydramnios when compared with dye-dilution calculations of actual amniotic fluid volume.

Adult↗
PubMedDate not supplied

Amniotic fluid index: correlation with amniotic fluid volume.

We calculated the amniotic fluid indexes (AFIs) of 310 women on 459 occasions. Normative data were analyzed and compared with data in several high-risk groups. In the normal gestations there was a progressive increase in AFI with advancing gestation until 32 weeks, after which there was a decline. The mean AFIs in abnormal gestations varied with the clinical diagnoses. These values were compared to those obtained by assessing amniotic fluid volume (AFV), that is a pocket more than 2 cm. There were 51 patients with abnormal AFVs. Forty-two had decreased fluid, six also had decreased AFIs; nine had increased AFVs and five (all with diabetes) also had increased AFIs. Thus, AFIs in normal pregnancies showed an orderly pattern of change with gestational age, and there was no accurate correlation between AFI and AFV. Thus, using AFV alone may lead to false interpretations of amniotic fluid status.

Amniotic Fluid↗
PubMed2003

Interleukin-18 in cervical mucus and amniotic fluid: relationship to microbial invasion of the amniotic fluid, intra-amniotic inflammation and preterm delivery.

OBJECTIVE: To evaluate the relationship between interleukin (IL)-18 in cervical mucus and amniotic fluid and microbial invasion of amniotic fluid, preterm delivery and intra-amniotic inflammation in women in preterm labour, with preterm prelabour rupture of membranes and at term. DESIGN: A prospective follow up study. SETTING: Sahlgrenska University Hospital, Göteborg, Sweden. SAMPLE: Women with singleton pregnancies (<34 weeks) presenting with preterm labour (n = 87) or preterm prelabour rupture of membranes (n = 47) and women, not in labour, at term (n = 28). METHODS: Amniotic fluid was retrieved transabdominally. Cervical mucus was taken from the uterine cervix of women in preterm labour and at term. IL-18 was analysed with enzyme-linked immunosorbent assay. MAIN OUTCOME MEASURES: IL-18 in relation to microbial invasion of the amniotic fluid, delivery within seven days or <34 weeks of gestation and intra-amniotic inflammation. RESULTS: The levels of IL-18 in cervical mucus and amniotic fluid were higher in women with preterm labour than in those not in labour at term. In the preterm labour group, significant associations were found between elevated IL-18 in amniotic fluid and microbial invasion of the amniotic fluid, as well as between delivery within seven days or <34 weeks of gestation and intra-amniotic inflammation. Delivery was delayed longer in the preterm prelabour rupture of membranes subgroup with IL-18 >or=1.0 ng/mL than in that with IL-18 <1.0 ng/mL. CONCLUSIONS: In the preterm labour group, high IL-18 in amniotic fluid (but not in the cervix) was associated with microbial invasion of the amniotic fluid, intra-amniotic inflammation and prompt delivery. On the other hand, elevated IL-18 in preterm prelabour rupture of the membranes group correlated with a longer interval to delivery.

Adult↗
PubMed2003

Predictability of intrapartum and neonatal outcomes with the amniotic fluid volume distribution: a reassessment using the amniotic fluid index, single deepest pocket, and a dye-determined amniotic fluid volume.

OBJECTIVE: The purpose of this study was to establish whether ultrasound-estimated or dye-determined amniotic fluid distribution (upper compared with lower quadrant) is predictive of perinatal outcome. STUDY DESIGN: Amniotic fluid distribution as measured by the amniotic fluid index, single deepest pocket, and dye-determined volumes was ascertained and correlated with intrapartum and neonatal outcomes. RESULTS: Between January 1997 and January 2001, 135 women (70 upper-greater and 65 lower-greater) participated in this prospective observational study. The sum of the amniotic fluid index (P =.309), single deepest pocket (P =.168), and dye-determined amniotic fluid volume (P =.368) for the upper-greater compared with the lower-greater groups were similar. Decelerations in labor (P =.597), late decelerations (P =.999), cesarean deliveries for fetal distress (P =.413), and umbilical cord pH < 7.2 were similar (P =.647) CONCLUSION: Ultrasound-estimated and dye-determined amniotic fluid volumes are similar between upper-greater and lower-greater groups, and intrapartum/neonatal outcomes are not affected by the amniotic fluid distribution.

Adult↗
PubMedDate not supplied

Subjective ultrasonographic assessment of amniotic fluid depth: comparison with the amniotic fluid index.

The purpose of this study was to evaluate the ability to identify abnormalities in amniotic fluid volume by subjective ultrasonographic assessment compared to a semiobjective method. In 886 consecutive ultrasound examinations subjective assessment of the amniotic fluid volume was performed and graded into 3 categories: normal, decreased, and increased. Following that, a four-quadrant sum (amniotic fluid index) was performed by the same experienced ultrasonographer and divided into 3 categories using the 5th and 95th percentiles. The sensitivity of the subjective analysis to diagnose a decreased amniotic fluid volume when compared with the amniotic fluid index was 58% (95% confidence interval, CI: 40-70%), with a false-positive rate of 17% (CI 8-32%). The sensitivity of the subjective analysis to diagnose an increased amniotic fluid volume when compared with the amniotic fluid index was 100% (CI 70-100%). However, the false-positive rate was 74% (CI 55-85%). Diagnosis of a normal amount of amniotic fluid by the subjective technique had a sensitivity of 96% (CI 95-97%) and a false-positive rate of 3% (CI 2-4%). Subjective ultrasonographic assessment of the amniotic fluid volume may serve as a screening test for the experienced ultrasonographer. However, when a decreased or increased amount of amniotic fluid volume is suspected, one may elect to use the amniotic fluid index for confirmation of the subjective impression.

Amniotic Fluid↗
PubMed1993

Intraobserver reliability of amniotic fluid volume estimation by two techniques: amniotic fluid index vs. maximum vertical pocket.

We evaluated the intraobserver agreement of two techniques of amniotic fluid assessment: amniotic fluid index and maximum vertical pocket. The intraobserver variation of the two forms of amniotic fluid assessment was obtained by evaluating amniotic fluid prior to fetal biometry (post-biometry value) and after fetal biometry (pre-biometry value). Between January and June 1990, this amniotic fluid assessment was by the maximum vertical pocket technique, and between July and December 1990, by the amniotic fluid index technique. In the Grace Maternity Hospital, Vancouver, 352 subjects were evaluated by the maximum vertical pocket technique, and 184 subjects by the amniotic fluid index technique.Amniotic fluid volumes were categorized into normal, oligohydramnios, and polyhydramnios, and the pre-biometry and post-biometry categories of amniotic fluid index and maximum vertical pocket techniques were compared by kappa statistics. The maximum vertical pocket technique showed poor intraobserver agreement (kappa = 0.33), but the amniotic fluid index technique showed good agreement (kappa = 0.72). With the poor reproducibility of the maximum vertical pocket technique in assessing extremes of amniotic fluid volume, it is difficult to support its use as a component of fetal assessment.

Journal Article↗
PubMed1994

Does measurement of amniotic fluid index detect changes in amniotic fluid volume after second-trimester amniocentesis?

The objective of this study was to establish whether variations of amniotic fluid volume induced by second-trimester amniocentesis could be detected by serial measurements of amniotic fluid index. A total of 130 singleton pregnancies undergoing second-trimester amniocentesis for genetic indications were considered. Amniotic fluid index was measured at three different time intervals: 30-60 min before amniocentesis, immediately after the procedure, and 60 min after the procedure. Serial measurements were obtained either by a single operator (n = 55) or by the three independent operators (n = 75). Significantly lower amniotic fluid index values were demonstrated immediately after amniocentesis when compared with the pre-amniocentesis and subsequent measurements in the study design with both the single and multiple operators. No statistically significant changes were found between the first amniotic fluid index measurements and those obtained 1 h after amniocentesis. These results suggest that second-trimester amniocentesis induces a temporary decrease of amniotic fluid volume detectable by serial amniotic fluid index measurements, no longer evident 1 h after the procedure.

Journal Article↗
PubMed1992

Comparison of gram stain, leukocyte esterase activity, and amniotic fluid glucose concentration in predicting amniotic fluid culture results in preterm premature rupture of membranes.

OBJECTIVE: The purpose of this study was to prospectively compare three rapid and inexpensive tests that have been proposed as predictors of amniotic fluid culture results in preterm premature rupture of membranes. STUDY DESIGN: Amniocentesis was performed on 117 patients < or = 34 weeks' gestational age with premature rupture of membranes and no clinical evidence of infection. Amniotic fluid was sent for Gram stain and aerobic, anaerobic, and Mycoplasma cultures. Leukocyte esterase activity and glucose concentration were also determined on the amniotic fluid. RESULTS: Amniotic fluid cultures were positive in 56 patients (47.8%). Leukocyte esterase activity of 1+ or 2+ and an amniotic fluid glucose concentration < or = 16 mg/dl were significantly more sensitive (p < 0.005) than Gram stain in detecting positive amniotic fluid cultures (73%, 68%, and 41%, respectively). CONCLUSIONS: Although each of these rapid tests is useful in assessing for subclinical intraamniotic infection, none of them have sufficient accuracy to make clinical decisions solely on the basis of their results.

Amniotic Fluid↗
PubMed1993

Acute amniotic fluid loss and changes in the amniotic fluid index. Correlation and effect on umbilical artery velocimetry.

This study was undertaken to determine whether changes in the amniotic fluid index accurately reflected measured amniotic fluid loss after artificial rupture of membranes and whether this acute loss of fluid volume affected umbilical artery resistance as measured by Doppler velocimetry. Twenty-five uncomplicated term pregnancies underwent umbilical artery velocimetry and amniotic fluid index determination in the active phase of labor before and after amniotomy. Amniotic fluid loss was measured by direct collection of fluid during and immediately following rupture of the membranes. The preamniotomy and postamniotomy data were compared using the paired t test, and the relationship between amniotic fluid index change and actual fluid loss was tested by linear regression. The change in the amniotic fluid index after amniotomy was significant (paired t test, P < .0001), and a significant relationship was found by linear regression between the actual amniotic fluid loss and the change in the amniotic fluid index (P < .01, r2 = .28). Despite significant changes in the amniotic fluid index, however, no significant change in the umbilical artery systolic/diastolic ratio could be demonstrated. Our data suggest that amniotomy in the active phase of labor in uncomplicated pregnancies does not affect umbilical artery resistance and that the amniotic fluid index is a limited, semiquantitative method of assessing acute changes in amniotic fluid volume.

Adolescent↗
PubMed1984

Amniotic fluid activates complement. A role in amniotic fluid embolism syndrome?

A 30-year-old woman died with massive pulmonary microvascular leukostasis immediately after cesarean hysterectomy. We postulated that this might have resulted from amniotic fluid embolization and, therefore, tested amniotic fluids as activators of granulocytes and the plasma complement system. Normal human amniotic fluid failed to aggregate granulocytes, provoke a respiratory burst, or attract the cells chemotactically. However, amniotic fluid activated complement when incubated with normal plasma. The ability to activate complement resided in lipid-rich particulate material in the fluid, and activation proceeded mainly (but probably not exclusively) via the alternative complement pathway. Amniotic fluids varied widely in their ability to activate complement, with the most potent samples derived from women with distressed pregnancies. Plasma samples from donors also varied widely in their ability to be activated by amniotic fluid, and many of the most activatable plasma samples derived from gravid women. We propose that amniotic fluid embolization can, like "shock lung" syndrome, have a leukostatic early phase, and that complement and granulocyte activation on embolization of amniotic fluid can contribute to the pulmonary collapse characteristic of that syndrome, especially when a potently activating fluid is combined with a potently activatable plasma.

Adult↗