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PubMed1977

Correlation between thromboplastic activity and lecithin/sphingomyelin ratio in amniotic fluid preliminary report.

THe thromboplastic activity of amniotic fluid was correlated with the lecithin sphingomyelin (L/S) ratio in 59 pregnancies. It was shown that the thromboplastic activity and the L/S ratio in amniotic fluid had a coefficient of correlation of r = --0-73 (P less than 0-004). The thromboplastic activity was estimated by a modified method for prothrombin time, and a time of 113 seconds appeared to correspond to an L/S ratio of 2, in that it was the border line between maturity and immaturity of the fetal lungs. Thirty women were delivered within 24 hours of a sample of amniotic fluid being obtained. In the three patients whose babies developed the respiratory distress syndrome, the thromboplastic activity was estimated as being slower than 113 seconds.

Amniotic Fluid↗

PubMed2000

The amniotic fluid index in normal twin pregnancies.

OBJECTIVE: We sought to investigate the amniotic fluid index for individual gestational sacs of twin pregnancies. STUDY DESIGN: Four hundred eighty-eight patients with normal diamniotic twins were examined between 14 and 40 weeks' gestation. The dividing membrane between twin fetuses was identified. An amniotic fluid index was then obtained for each gestational sac. RESULTS: The median amniotic fluid index in individual twin gestational sacs rises slowly from 14 to 16 weeks' gestation to 23 to 28 weeks' gestation and then gradually declines. The median amniotic fluid index values by gestational age for twin A and twin B are not statistically different. Although twin pregnancies have a slightly lower median amniotic fluid index value than singleton pregnancies, the difference is also not statistically significant. CONCLUSION: Individual amniotic fluid indices can be obtained in twin pregnancies, and the values are comparable with those of singleton gestations.

Amniotic Fluid↗

PubMed2000

Amniotic fluid index and single deepest pocket: weak indicators of abnormal amniotic volumes.

OBJECTIVE: To compare amniotic fluid index (AFI) with the single deepest pocket in the identification of actual abnormal amniotic fluid (AF) volumes. METHODS: One hundred seventy-nine women with singleton pregnancies at the University of Mississippi between March 1994 and June 1999 had ultrasound estimations of AF volume sequentially using the AFI and single deepest pocket techniques. Each woman subsequently had ultrasound-directed amniocentesis with dye-dilution and spectrophotometric calculation of actual AF volume. RESULTS: Actual AF volumes were low (under 5% by volume for gestational age) in 62 women, normal (5-95%) in 100 women, and high (more than 95%) in 17 women. An AFI up to 5 cm (sensitivity 10%, specificity 96%) and a single deepest pocket up to 2 cm (sensitivity 5%, specificity 98%) were similarly inadequate in identifying dye-determined low AF volumes. Likewise, AFI above 20 (sensitivity 29%, specificity 97%) and a single-deepest pocket above 8 cm (sensitivity 29%, specificity 94%) were poor in identifying dye-determined abnormally high volumes. CONCLUSION: There was no difference between AFI and single deepest pocket techniques for identifying truly abnormal AF volumes. Both techniques were unreliable for identifying true AF volumes.

Adult↗

PubMed1983

[Quantitative behavior of pregnancy-specific beta glycoproteins (Sp1) in the amniotic fluid in normal and pathologic pregnancies].

SP1 levels of 150 amniotic fluid samples from 70 healthy gravidae and 63 gravidae suffering from different disturbances of pregnancy obtained between gestational weeks 16 and 42 have been estimated by means of the simple radial immunodiffusion method. For this end amniotic fluid has been tenfold concentrated by lyophilisation. SP1 concentrations increase gradually during pregnancy, but individual differences are wide especially at the end of pregnancy. The regression line ascends. In the average, the SP1 concentration of amniotic fluid is 1 per cent of the serum values. Cases of rhesus isoimmunization and EPH-gestosis are often correlated with high amniotic fluid levels of SP1. However, the diagnostic importance is restricted by a considerable overlap of the confidence intervals. The significance of amniotic fluid SP1 as an additional parameter for risk pregnancies is, nevertheless, to be discussed.

Amniotic Fluid↗

PubMed2000

Effect of esophageal ligation on amniotic fluid volume and urinary flow rate in fetal sheep.

OBJECTIVE: Although the fetus normally swallows large volumes of amniotic fluid each day, it is unclear whether amniotic fluid volume increases after fetal esophageal obstruction or whether fetal urine production changes. Our objective was to determine the effects of fetal esophageal ligation on amniotic fluid volume and urinary flow rate over time. STUDY DESIGN: Seven late-gestation fetal sheep underwent esophageal ligation, and 7 served as time control animals. The urachus was ligated to eliminate urine flow to the allantoic cavity. On days 1, 3, 5, 7, and 9 after surgery, we measured the composition of amniotic fluid, fetal urine, and fetal and maternal blood, as well as amniotic fluid volume and fetal urinary flow rate. A 3-factor analysis of variance was used for statistical analysis. RESULTS: Amniotic fluid volume did not change with time in the control group, averaging 876 +/- 142 mL (mean +/- SEM), and it decreased in the esophageal ligation group (P =.020), averaging 309 +/- 75 mL on day 9. Fetal urinary flow rate was lower (P =.0063) in the esophageal ligation group (431 +/- 27 mL/d) than in the control group (631 +/- 54 mL/d). There were no differences in fetal or maternal blood compositions between the two groups. Amniotic fluid sodium and chloride increased in the ligated animals. CONCLUSION: Polyhydramnios did not occur after esophageal ligation, even though the fetuses excreted approximately 4000 mL of urine over the 9-day study period. This suggests that intramembranous absorption is substantially increased. With only small changes in amniotic solute concentrations, intramembranous solute absorption must occur simultaneously with water, suggesting a near-zero reflection coefficient for solutes. We speculate that fetal urine, lung secretions, or both contain a factor that increases intramembranous permeability.

Amniotic Fluid↗

PubMed1990

Does reduction of amniotic fluid affect fetal movements?

The effect of the amount of amniotic fluid on the form of fetal general movements was studied longitudinally in 19 pregnancies complicated by premature rupture of the amniotic membranes (PROM). Before birth, general movements were studied weekly by means of 1-h ultrasound observations, performed under standardized conditions. In the early postnatal period, 11 of these infants were followed with video recordings of their spontaneous movements. In the fetus, speed and amplitude of general movements were directly related to the reduction in amniotic fluid. A moderate reduction of amniotic fluid was associated with a decrease in amplitude, while a more severe reduction of amniotic fluid caused a decrease in speed as well. Postnatally, the small amplitude and low speed showed a marked tendency to normalize between 1 and 5 weeks. These results are important for the qualitative assessment of motor behaviour in pregnancies with obstetrical complications that are associated with oligohydramnios (such as PROM or intra-uterine growth retardation).

Amniotic Fluid↗

PubMed1993

Fibrinolytic components in fetal membranes and amniotic fluid.

OBJECTIVE: We evaluated fibrinolytic components in plasma and amniotic fluid of pregnant women and in postpartum fetal membranes. STUDY DESIGN: Fibrinolytic parameters in amniotic fluid and plasma were measured by means of enzyme-linked immunosorbent assays. Fetal membranes collected after spontaneous labor at term were analyzed by immunohistochemical methods with immunospecific antibodies against fibrinolytic components. RESULTS: Amniotic fluid contained high plasminogen activator inhibitor-1 concentrations but had low activity. Strong staining for plasminogen activator inhibitor-1 and vitronectin was observed in chorionic trophoblasts and moderate staining in decidual connective tissue. Strong staining for plasminogen activator inhibitor-2 was seen in decidual cells. Although prominent staining of plasminogen activators and plasminogen were observed in the amniotic epithelium, virtually no plasminogen activator inhibitor-1, plasminogen activator inhibitor-2, or alpha 2-plasmin inhibitor staining was detected. CONCLUSION: The delicate balance of fibrinolytic activators and inhibitors in fetal membranes and amniotic fluid may contribute to the triggering of membrane rupture at term.

Amniotic Fluid↗

PubMed1991

[The concentration of glucose in the amniotic fluid in a high risk pregnancy group].

Amniotic fluid glucose levels were measured in 125 pregnant women included in high-risk group in respect of perinatal pathology. In the reference group the measurements have demonstrated an agreement between glucose concentrations in the amniotic fluid and gestation term and an inverse relationship between pregnancy progress and glucose level, whereas in diabetics this relationship was direct. Fetal developmental defects were associated with elevated glucose content in the amniotic fluid, concomitant placental abnormalities were conducive to reduction of these levels, and no correlations between this parameter and pregnancy terms were observed.

Adolescent↗

PubMed1998

Hepatocyte growth factor in human amniotic fluid promotes the migration of fetal small intestinal epithelial cells.

OBJECTIVE: Previously we reported on the abundant existence of hepatocyte growth factor in amniotic fluid. This study was conducted to clarify the effects of hepatocyte growth factor in amniotic fluid on fetal intestinal epithelial cells. STUDY DESIGN: Amniotic fluid samples were obtained from 22 cases at various gestational ages. The effects of amniotic fluid and recombinant human hepatocyte growth factor on proliferation, migration, and morphogenesis of intestine 407 cells (a cell line derived from fetal intestinal epithelial cells) were investigated. RESULTS: The mobility of intestine 407 cells was stimulated by amniotic fluid in proportion to the concentration of hepatocyte growth factor in amniotic fluid with the same effect observed with recombinant human hepatocyte growth factor. This activity was neutralized by addition of antihuman hepatocyte growth factor antibody. Neither increased deoxyribonucleic acid synthesis nor morphogenesis in response to amniotic fluid was identified under the conditions used. CONCLUSION: Amniotic fluid stimulates intestinal epithelial cell migration by way of hepatocyte growth factor in amniotic fluid during development of the fetal intestine.

Amniotic Fluid↗

PubMedDate not supplied

[The effect of amniotic fluid on bacteria].

Antibacterial activity of the amniotic fluid (performed by transabdominal amniocentesis) was analysed in 61 pregnant women between the 15th and the 42nd week of gestational age by using laboratory stocks of Escherichia coli, Pseudomonas aeruginosa and Klebsiella of human origin. It is stated that up to the 30th week of pregnancy the amniotic fluid does not exert any inhibition effect on the growth of Escherichia coli, Pseudomonas aeruginosa, or Klebsiella. After the 31st week the inhibition activity of the amniotic fluid in thee bacteria progressively (with the gestational age) intensifies.

Amniotic Fluid↗

PubMed2005

Ancillary studies in amniotic fluid embolism: a case report and review of the literature.

The incidence of amniotic fluid embolism during pregnancy is approximately 1/50,000 and has a mortality rate in excess of 80%. The postmortem diagnosis of amniotic fluid embolism can be challenging for forensic investigators and pathologists. At autopsy, usually signs of disseminated intravascular coagulation suggest an amniotic fluid embolism. A definitive diagnosis of amniotic fluid embolism cannot be made until ancillary studies are performed on the decedent's tissues. We report a case of a 37-year-old G3P2 white female who was 36 weeks gestation when her membranes spontaneously ruptured. She suddenly became breathless, went into cardiogenic shock, and died. The autopsy revealed gross and microscopic findings of amniotic fluid embolism, which was confirmed with ancillary studies consisting of special stains, immunohistochemistry, and a serum tryptase level. The authors hope this case report, including gross and microscopic autopsy findings with procedural and ancillary studies, and review of the literature will help investigators and pathologists in the diagnosis of amniotic fluid embolism.

Adult↗

PubMed1976

[Effects of amniotic fluid on the development of neoplastic tissue in organotypic culture].

In previous researches, it has been observed that the human amniotic fluid presents in vitro an antineoplasic action. 75% of the examined amniotic fluids contain an anti HCG principle. In order to evaluate if the effect of amniotic fluid is due to this principle, cultures of tumoral tissue have been performed, with the Wolff and Wolff's method, using media containing either positive amniotic fluid or negative amniotic fluid. Results obtained with positive amniotic fluid have confirmed the previous observations. A complete degeneration of both tumoral tissue and mesonephros was observed when the culture medium was enriched with negative amniotic fluid.

Adenocarcinoma↗

PubMed1987

Amniotic fluid protease activity, protease inhibitory activity, and fetal lung maturity.

Amniotic fluid acid protease and acid protease inhibitory activities were examined in normal pregnancies as a function of gestational age. The acid proteolytic activity of the amniotic fluid is almost constant during gestational weeks 16-29 (26 +/- 13 micrograms globin/ml/2 hrs, mean +/- SD, n = 64). The activity sharply increases after 29 weeks in a time-dependent fashion and reaches a value of 302 +/- 89 (mean +/- SD, n = 13) at 39-40 weeks gestation. Under standard conditions, the ability of amniotic fluid to inhibit bovine pepsin declined during gestation in a linear fashion from 44 +/- 13% (mean +/- SD, n = 36) at 16-18 weeks to 9 +/- 10% (mean +/- SD, n = 41) at 36-40 weeks. A correlation coefficient of r = 0.72 was found between pepsin inhibitory activity and gestational age. No consistent change was noted in the extent of inhibition of the endogenous acid protease throughout pregnancy. In 61 amniotic fluid samples, a correlation coefficient of r = 0.70 was found between acid protease activity and the lecithin/sphingomyelin (L/S) ratio. During the course of this study, five cases of respiratory distress syndrome (RDS) were diagnosed clinically. All five infants had a low protease activity (55 +/- 22 micrograms globin/ml/2 hr, mean +/- SD) as well as a low L/S ratio (0.68 +/- 0.20, mean +/- SD). In contrast, no case of RDS of the newborn was observed among 29 pregnancies with high protease activity and a high L/S ratio. The present observations may suggest a predictive value of amniotic fluid acid protease activity in assessment of fetal lung maturity.

Amniotic Fluid↗

PubMed1992

Use of esterase inhibitors and zone electrophoresis to define bacterial esterases in amniotic fluid.

OBJECTIVE: The purpose of our study was to define further the role of bacterial esterases in amniotic fluid obtained from women with chorioamnionitis. STUDY DESIGN: Amniotic fluid samples from 39 patients with chorioamnionitis were submitted for bacterial cultures and in vitro assay. Esterase inhibitors diisopropyl fluorophosphate and iodoacetic acid were added and the degree of inhibition calculated. These results were compared with the amniotic fluid culture results. Chi square analysis was performed to compare the results of the esterase assay and the inhibition assay between the uninfected and infected amniotic fluid samples. RESULTS: Thirty-one patients had positive bacterial cultures, with 21 being infected with gram-negative organisms. All samples showed significant inhibition (range 55% to 82%) with diisopropyl fluorophosphate. There was partial inhibition with iodoacetic acid (range 10% to 30%) in the gram-negative samples but no inhibition in the gram-positive and uninfected samples. Six infected and two uninfected samples were analyzed by using zone electrophoresis with human plasma as a control. Minimal esterase motility was noted in the amniotic fluid samples as compared with that in plasma. CONCLUSION: The esterases in amniotic fluid appeared to be of bacterial, not human, origin. Furthermore, different groups of bacteria appeared to produce different esterases in infected amniotic fluid.

Amniotic Fluid↗

PubMed1995

Endothelin has a role in early pathogenesis of amniotic fluid embolism.

The early pathogenesis of amniotic fluid embolism is not completely understood. The entrance of amniotic fluid (AF) into the systemic circulation leads to an initial phase of pulmonary vasospasm, pulmonary hypertension and cor pulmonale. We studied the effect of AF on endothelin (ET) production in vivo and in vitro. Injection of rabbits (pregnant and nonpregnant) with meconium-stained AF, raw AF and supernatant AF led to a significant increase in serum ET. This result was confirmed by using human umbilical vein endothelial cell cultures incubated with the same types of AFs. After infusion of rabbits with AFs, we observed that the lung, heart and kidney were positively stained for ET and von Willebrand factor. AF was found to have an injurious effect on endothelial cells measured by using fura-2. The maximal injurious effect of AFs was observed for the meconium-stained AF. We hypothesized that the early pathological changes in AF embolism may be mediated by ET.

Animals↗

PubMed1989

Amniotic fluid erythropoietin predicts fetal distress in Rh-immunized pregnancies.

Repeated amniotic fluid erythropoietin measurements in 23 Rh-immunized pregnancies were done to evaluate erythropoietin levels of amniotic fluid as an indicator of fetal distress (umbilical artery, pH 7.14 or less, or 1-minute Apgar score of 4 or less). Amniotic fluid erythropoietin levels did not vary significantly between 168 and 273 gestational days in the pregnancies without fetal distress. Increasing levels of amniotic fluid erythropoietin predicted highly reliably severe fetal distress at birth. Whether erythropoietin levels of amniotic fluid can also predict fetal distress in other pathologic pregnancies needs further study.

Amniotic Fluid↗

PubMed1984

Antimicrobial activity of amniotic fluid in South Indian women.

Samples of amniotic fluid obtained from 48 South Indian women in the third trimester of pregnancy were studied for antimicrobial activity. The growth of Staphylococcus albus, Candida albicans and Clostridium perfringens was inhibited by nearly all samples studied while the growth of Staphylococcus aureus, Escherichia coli and Bacteroides fragilis was inhibited by 50%, 42% and 18% of samples respectively. The growth of Streptococcus faecalis was not inhibited. Using radial immunodiffusion, IgG was measurable in all 10 samples studied (mean 23 mg/dl), whereas IgA was measurable in only three of these samples (mean 1.32 mg/dl). However, while specific IgA against C. albicans was detected by indirect immunofluorescence in 93% of samples, specific IgG against C. albicans was detected in only 26% of samples (P less than 0.001). Amniotic fluid obtained from parous women had greater inhibitory activity against E. coli (P less than 0.05) than did the amniotic fluid obtained from nulliparae.

Amniotic Fluid↗

PubMed2003

Fetal tissue engineering from amniotic fluid.

BACKGROUND: We have recently shown, in an animal model, that amniotic fluid can be a source of cells for fetal tissue engineering. This study was aimed at determining whether fetal tissue constructs could also be engineered from cells normally found in human amniotic fluid. STUDY DESIGN: Cells obtained from the amniotic fluid of pregnant women at 15 to 19 weeks of gestation (n=6) were cultured in Dulbecco's Modified Eagle's medium (Sigma Chemical, St Louis, MO) containing 20% fetal bovine serum and 5 ng/mL basic fibroblast growth factor in a 95% humidified, 5% CO(2) chamber at 37 degrees C. A subpopulation of morphologically distinct cells was then mechanically isolated from the rest and selectively expanded. The lineage of this subpopulation of amniocytes was determined by immunofluorescent staining with antibodies against standard intermediate filaments and surface antigens. Cell proliferation rates were determined by oxidation assay. After cell expansion, colonies of amniocytes were statically and dynamically seeded onto both unwoven, 1-mm-thick polyglycolic acid polymer scaffold and acellular human dermis for 72 hours. The resulting constructs were analyzed by scanning electron microscopy. RESULTS: Amniocytes stained positively for smooth muscle actin, vimentin, cytokeratin 18, and fibroblast surface protein, and negatively for desmin, cluster of differentiation 31, and von Willebrand's factor (Dako, Carpenteria, CA). These findings are consistent with a mesenchymal, fibroblast-myofibroblast cell lineage. Mesenchymal amniocytes could be rapidly expanded in culture, based on results of the proliferation assay. Scanning electron microscopy of amniocyte constructs revealed dense, confluent layers of cells surrounding the polymer matrices and firm cell adhesion to both PGA and Alloderm (Lifecell Corp, Branchburg, NJ) scaffolds. No evidence of cell death was observed. CONCLUSIONS: Subpopulations of fetal mesenchymal cells can be consistently isolated from human amniotic fluid and rapidly expanded in vitro. Human mesenchymal amniocytes attach firmly to both polyglycolic acid polymer and acellular human dermis. The amniotic fluid can be a valuable and practical cell source for fetal tissue engineering.

Amniotic Fluid↗