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PubMed1984

Radioimmunoassay of vasotocin, vasopressin, and oxytocin in human neonatal cerebrospinal and amniotic fluid.

Arginine vasotocin (AVT) has been measured in neonatal cerebrospinal fluid (CSF) and human amniotic fluid using a newly developed specific radioimmunoassay system. There were significant amounts of AVT in all samples. Vasopressin and oxytocin also were measured in the samples and could not account for the levels of vasotocin found. The source and function of these neurohypophyseal peptides in CSF and amniotic fluid remains speculative.

Adult↗
PubMed2006

Amniotic-fluid embolism and medical induction of labour: a retrospective, population-based cohort study.

BACKGROUND: Amniotic-fluid embolism is a rare, but serious and often fatal maternal complication of delivery, of which the cause is unknown. We undertook an epidemiological study to investigate the association between amniotic-fluid embolism and medical induction of labour. METHODS: We used a population-based cohort of 3 million hospital deliveries in Canada between 1991 and 2002 to assess the associations between overall and fatal rates of amniotic-fluid embolism and medical and surgical induction, maternal age, fetal presentation, mode of delivery, and pregnancy and labour complications. FINDINGS: Total rate of amniotic-fluid embolism was 14.8 per 100,000 multiple-birth deliveries and 6.0 per 100,000 singleton deliveries (odds ratio 2.5 [95% CI 0.9-6.2]). Of the 180 cases of amniotic-fluid embolism in women with singleton deliveries during the study period, 24 (13%) were fatal. We saw no significant temporal increase in occurrence of amniotic-fluid embolism for total or fatal cases. Medical induction of labour nearly doubled the risk of overall cases of amniotic-fluid embolism (adjusted odds ratio 1.8 [1.3-2.7]), and the association was stronger for fatal cases (crude odds ratio 3.5 [1.5-8.4]). Maternal age of 35 years or older, caesarean or instrumental vaginal delivery, polyhydramnios, cervical laceration or uterine rupture, placenta previa or abruption, eclampsia, and fetal distress were also associated with an increased risk. INTERPRETATION: Medical induction of labour seems to increase the risk of amniotic-fluid embolism. Although the absolute excess risk is low, women and physicians should be aware of this risk when making decisions about elective labour induction.

Adult↗
PubMed1991

Correlation of amniotic fluid glucose concentration and intraamniotic infection in patients with preterm labor or premature rupture of membranes.

Amniotic fluid glucose concentration has previously been suggested as a rapid and sensitive test for diagnosing intraamniotic infection. In this study, 204 patients less than or equal to 34 weeks estimated gestational age with preterm labor or premature rupture of membranes underwent amniocentesis to detect subclinical intraamniotic infection. Amniotic fluid was cultured for aerobic and anaerobic bacteria, as well as for Mycoplasma species. Amniotic fluid glucose levels were significantly lower in patients with positive amniotic fluid cultures than in patients with negative cultures (median, 10 mg/dl; range, 1 to 62 mg/dl vs median, 31 mg/dl; range, 2 to 126 mg/dl, respectively; p less than 0.001). In terms of predicting amniotic fluid culture results, an amniotic fluid glucose concentration of less than or equal to 16 mg/dl had a sensitivity of 79%, specificity of 94%, positive predictive value of 87%, and negative predictive value of 90%. The determination of amniotic fluid glucose concentration is useful in detecting subclinical intraamniotic infection in patients less than or equal to 34 weeks estimated gestational age with preterm labor or premature rupture of membranes.

Amnion↗
PubMed2003

Endothelin-1 and macrophage colony-stimulating factor are co-localized in human amnion membrane cells and secreted into amniotic fluid.

We have examined the cellular localization and human amniotic fluid content of endothelin-1 (ET-1) and macrophage colony-stimulating factor (M-CSF). The study material consisted of amniotic fluid from 20 patients referred for amniocentesis, and placental samples from normal deliveries. ET-1 and M-CSF were analysed by radioimmunoassay and enzyme-linked immunosorbent assay respectively. The cellular localization of ET-1 and M-CSF in the amnion membranes was analysed by double-labelling immunocytochemistry using fluorescein isothiocyanate- and Cy3-labelled secondary antibodies. Release of ET-1 and M-CSF was studied in cultured amniocytes. We found that the mean +/- SD concentrations of ET-1 and M-CSF in fetal amniotic fluid were 45.6 +/- 17.3 pmol/l (range 16.8-85.5) and 7323 +/- 3415 ng/l (range 2640-12 110) respectively. Double-labelling immunocytochemistry showed that both M-CSF and ET-1 were co-localized in the same cells to a high extent. Further analysis revealed that levels of M-CSF, but not ET-1, were significantly correlated with pregnancy length. Both M-CSF and ET-1 were released from cultured amniocytes in response to interleukin-1. These findings show that ET-1 and M-CSF are partly co-localized to specific cells in the human amniotic membrane. As both M-CSF and ET-1 were released from cultured amniocytes in vitro, this suggests that they both may be secreted into fetal amniotic fluid in vivo as well.

Adolescent↗
PubMed2006

Comparison of the acoustic streaming in amniotic fluid and water in medical ultrasonic beams.

AIM: Acoustic streaming in amniotic fluid has been investigated under a variety of conditions relevant to the diagnostic use of ultrasound. METHOD: An ultrasonic Doppler method has been used for measurement. Streaming velocities have been compared with those generated in water for the same exposure conditions. Beams were generated by laboratory equipment simulating beams from clinical systems. The fluids were insonated IN VITRO using 3.5 MHz, 5 MHz and 7.5 MHz transducers in continuous wave (CW) and pulsed mode. RESULTS: Acoustic streaming was measured in both amniotic fluid and water at the power levels 50 mW and 140 mW. Enhancement of velocities due to non-linear effects in high amplitude pulses was demonstrated for amniotic fluid as well as for water. The potential and limitations of present numeric methods for the prediction of acoustic streaming were explored. CONCLUSION: Pulsed ultrasound caused similar streaming velocities in amniotic fluid and water while continuous wave beams induced significantly faster streaming in amniotic fluid than in water.

Amniotic Fluid↗
PubMed1983

Relationships among human amniotic fluid dipalmitoyl lecithin, postpartum respiratory compliance, and neonatal respiratory distress syndrome.

The major molecular species of amniotic fluid phosphatidylcholine were determined as diacylglycerol trimethylsilyl ether derivatives by gas-liquid chromatography with use of glass capillary columns. We studied amniotic fluid specimens from 48 pregnancies. As expected, the major disaturated species of amniotic fluid phosphatidylcholine, dipalmitoylphosphatidylcholine, and palmitoylmyristoylphosphatidylcholine increased with gestational age, whereas phosphatidylcholine species with 34, 36, and 38 carbon atoms in the acyl radicals decreased. Although the amniotic fluid samples were obtained shortly before parturition (4.2 +/- 3.7 h, mean +/- SD), the correlation between dipalmitoylphosphatidylcholine concentration in amniotic fluid and gestational age was better than between dipalmitoylphosphatidylcholine concentration and the compliance of the respiratory system of the newborns. In addition, the percentage of amniotic fluid phosphatidylcholine species present as dipalmitoylphosphatidylcholine seemed to be a more reliable predictor of lung maturity than was the absolute dipalmitoylphosphatidylcholine concentration in amniotic fluid.

Amniotic Fluid↗
PubMed1994

The isolation of activin from ovine amniotic fluid.

During a study of the levels of inhibin and follistatin in ovine amniotic fluid, we noted that although detectable levels of immunoactive inhibin and follistatin were found throughout gestation, the addition of amniotic fluid to a rat anterior pituitary cell culture resulted in a stimulation, rather than the expected suppression, of FSH concentrations. These data suggested the possibility that activin was present in amniotic fluid. We, therefore, set out to isolate the molecules responsible for this activin-like activity and determine their structure. Amniotic fluid, collected from pregnant sheep between 120-140 days gestation, was used as starting material in the purification and diluted in parallel to a human activin-A standard in the activin RIA employed to monitor the purification. A total pool of 7.4 liters amniotic fluid was processed by dye affinity chromatography, hydrophobic interactive chromatography, gel filtration, and a series of reverse phase HPLC steps. Polyacrylamide gel electrophoresis of fractions from the final HPLC step, which showed both activin immunoactivity and bioactivity, revealed a band with a mol wt of 25.3 kilodaltons (kDa), which reduced to 15.8 kDa, and a minor band of 45 kDa, which reduced to 25 kDa. NH2-terminal amino acid sequences of several active fractions from the same region were identical to the known sequence of ovine activin-A. The identification of immunoactive activin, follistatin, and inhibin in amniotic fluid raises the question of the sites of production of these proteins and their interactions and role in fetal physiology.

Activins↗
PubMed1986

[Sonographic evaluation of the amount of amniotic fluid. I. Polyhydramnios--significance for the course of pregnancy and labor].

In this study, 3,274 pregnant patients were sonographically examined. Special attention was paid to the classification of the quantity of amniotic fluid according to sonographic criteria. An increase in amniotic fluid was observed in 6% of the patients examined. Cases in which the largest sonographically demonstrable amniotic fluid was significantly larger than the transverse thoracoabdominal diameter were classified as polyhydramnios. An amniotic fluid depot that was either as large as or up to 10% larger than the transverse thoracoabdominal diameter of the fetus was regarded as the upper normal range for the amount of amniotic fluid. These cases were compared with a randomly chosen control group with normal quantities of amniotic fluid with regard to the occurrence of complications during pregnancy and birth and to the incidence of fetal malformation. Patients with increased quantities of amniotic fluid more frequently had symptoms of toxemia (p less than 0.01). In patients with manifest diabetes mellitus the quantity of amniotic fluid was frequently in the upper normal range (p less than 0.01), while women with gestation diabetes frequently suffered from polyhydramnios (p less than 0.001). Fifteen percent of women with quantities of amniotic fluid in the upper normal range beared macrosomatic children (p less than 0.001). Twenty-seven percent of cases with polyhydramnios (p less than 0.001) and 8% of cases with a quantity of amniotic fluid in the upper normal range (p less than 0.01) were associated with serious fetal malformation.

Adult↗
PubMed2004

Chorionic plate vessels as an origin of amniotic fluid neutrophils.

The present study was conducted to investigate the potential anatomical source of amniotic fluid neutrophils. Microdissection of neutrophils from the chorioamnion of the fetal membranes and the amnion of the chorionic plates of 10 preterm placentas with acute chorioamnionitis was performed and the genotypes of the neutrophils were compared with those of the mother and fetus using polymerase chain reaction of nine autosomal STR loci. In separate analyses, we reviewed eight cases of fetal autopsies with increased amniotic fluid neutrophils for the presence of neutrophils in the alveoli, and also analyzed the relationship between the amniotic fluid white blood cell (WBC) count and the histological pattern of placental inflammation. The genotypes of all of the neutrophils found in the chorioamnion of the fetal membrane matched those of the mother (n = 10). The genotypes of neutrophils found in the chorionic plate were of mixed maternal and fetal origin (n = 4). In the autopsy series of the fetuses with amniotic fluid WBC (n = 8), only five cases showed neutrophils in the alveolar space, while all the placentas had chorioamnionitis. There was no significant difference in amniotic fluid WBC count between the cases with or without acute membranitis, while among the cases with placental inflammation, those with inflammation of the chorionic plate had a significantly higher amniotic fluid WBC count than both the membranitis-only cases (P < 0.001) and the membranitis and funisitis cases (P < 0.05). These results imply that fetal vasculature at the chorionic plate is the main source of amniotic fluid neutrophils, especially in the cases without funisitis.

Adult↗
PubMed1997

[Effects of amniotic fluid embolism-like plasma on isolated perfused rabbit lungs].

OBJECTIVE: In order to investigate whether amniotic fluid could induce the release of mediators from blood cells which would damage the lungs, an isolated perfused rabbit lung (IPRL) was exposed to amniotic fluid embolism-like plasma (AFEP) and the injury of AFEP to lungs and the protective effects of ibuprofen were studied. METHODS: 10 ml human amniotic fluid and 50 ml heparized rabbit blood were incubated together with or without ibuprofen (600 micrograms) at 37 degrees C for 30 min and centrifuged. Supernatants were taken and were referred to as AFEP or ibuprofen AFEP. IPRL was perfused with AFEP, ibuprofen AFEP, simple amniotic fluid (SAF), supernatant of amniotic fluid (SnAF), rabbit plasma (RP) and control NS. The changes of pulmonary artery pressure (PAP), respiratory pressure (RP) and lung weight were recorded by computer and compared with control NS group. RESULTS: In groups of SAF, SnAF and RP PAPs were slightly elevated (0.13-0.6 kPa, P > 0.05), and lung weights were not changed. AFEP induced the increase of PAP (3.52 +/- 0.64 kPa, P < 0.05) and lung weight (4.0 +/- 1.0 g, P < 0.01) with the development of lung edema. Administration of ibuprofen prevented partially the APEP-induced increase of PAP (1.87 +/- 0.43 kPa, P < 0.05) and lung weight (0.4 +/- 0.3 g, P < 0.01). CONCLUSION: Amniotic fluid may induce the release of mediators from blood cells, and the latter is the important cause resulting in the pathological changes of lungs in amniotic fluid embolism. Ibuprofen may reduce partially the APEP-induced lung injury.

Animals↗
PubMedDate not supplied

Proteomic analysis using protein chips to detect biomarkers in cervical and amniotic fluid in women with intra-amniotic inflammation.

Intra-amniotic inflammation (IAI) may cause preterm birth with poor neonatal out-come. To identify novel biomarkers for IAI, we analyzed amniotic and cervical fluid samples from 27 patients with signs of threatening preterm birth with or without IAI by surface-enhanced laser desorption ionization time-of-flight mass spectrometry (SELDI-TOF-MS). Seventeen proteins were significantly overexpressed in amniotic fluid from IAI cases and more often in women with preterm labor than those with rupture of membranes. Five of these were identified as human neutrophil protein 1-3, calgranulin A and B.

Amniocentesis↗
PubMed1987

The four-quadrant assessment of amniotic fluid volume: an adjunct to antepartum fetal heart rate testing.

Amniotic fluid volume assessment using a semiquantitative four-quadrant technique, the amniotic fluid index, was evaluated in relationship to fetal heart rate (FHR) testing and perinatal morbidity in 330 high-risk pregnancies. An inverse relationship was found between the amniotic fluid index and nonreactive nonstress tests (NST), FHR decelerations, meconium staining, cesarean section for fetal distress, and low Apgar scores. More important, adverse perinatal outcome was significantly more frequent with diminished compared with normal amniotic fluid volume, even if the NST was reactive.

Amniotic Fluid↗
PubMedDate not supplied

Amniotic fluid interleukin-6 determinations are of diagnostic and prognostic value in preterm labor.

PROBLEM: The purpose of this study was to determine if amniotic fluid concentrations of the interleukin-6 (IL-6) are of value in diagnosis of microbial invasion of the amniotic cavity and in the prediction of failure of tocolysis, preterm delivery and perinatal morbidity and mortality. METHOD: Amniotic fluid was obtained by transabdominal amniocentesis from 146 consecutive patients admitted with the diagnosis of preterm labor and intact membranes. Fluid was cultured for aerobic and anaerobic bacteria as well as for mycoplasmas. Amniotic fluid IL-6 levels were measured using a monoclonal antibody-based enzyme-linked immunosorbent assay with a sensitivity of 0.03 ng/ml. Logistic regression and Cox's proportional hazards model were used to examine the effect of several variables on dichotomous outcomes or interval to delivery. RESULTS: Patients with a positive amniotic fluid culture had a significantly higher amniotic fluid IL-6 concentrations than patients with a negative culture (median 91.2 ng/ml, range 0.9 to 437 ng/ml versus median 0.4 ng/ml, range < 0.3 to 195 ng/ml, respectively; P < .0001). An amniotic fluid IL-6 concentration of greater than or equal to 11.3 ng/ml had a sensitivity of 93.3% (14 of 15) and a specificity of 91.6% (120 of 131). All patients with an amniotic fluid IL-6 concentration above 11.3 ng/ml and a negative amniotic fluid culture (N = 11) delivered preterm and all placenta available for examination (N = 7) had histologic evidence of chorioamnionitis. Amniotic fluid concentrations of IL-6 were an independent predictor of preterm delivery, amniocentesis-to-delivery interval and neonatal morbidity and mortality. Moreover, IL-6 concentrations added significant information to the prediction of these outcomes to that provided only by clinical information such as cervical dilatation, gestational age at admission or at delivery. CONCLUSION: IL-6 is a sensitive and rapid test for the detection of microbial invasion of the amniotic cavity and for identifying women at risk for spontaneous preterm delivery and neonates at risk for morbidity and mortality.

Adult↗
PubMedDate not supplied

[Thyroxine-binding globulin and its molecular variant in human amniotic fluid].

Total thyroxine--binding globulin (TBGt) and its pregnancy-associated molecular variant (TBG-1) were detected by radioimmunoassay in human amniotic fluid collected at the time of delivery. TBGt purified from amniotic fluid by affinity chromatography and hydroxylapatite chromatography, displayed electrophoretic properties, immunoreactivity, a molecular mass, affinity for thyroxine and TBG-1 content identical to those of pure TBGt from human pregnancy serum. The concentrations of TBGt and TBG-1 in maternal venous blood serum were 49 +/- 7 mg/ml and 3.8 +/- 1.3 mg/ml (n = 23), respectively, and those in amniotic fluid were 2.0 +/- 0.5 mg/ml and 0.19 +/- 0.12 mg/ml (n = 30), respectively. The analysis of paired samples showed that the serum and amniotic fluid TBGt levels closely correlated (r = 0.91), whereas the correlation between the respective TBG-1 levels was poor (r = 0.63). The TBG-1/TBGt ratio in amniotic fluid was 20% higher than that in serum. These findings suggested a maternal origin of the most of the amniotic fluid TBG which may possibly enter amniotic fluid by passive diffusion through fetal membranes. An alternative mechanism can exist for TBG-1 transfer from maternal serum to amniotic fluid. It corresponds to a special role that TBG-1 may play in the fetoplacental system.

Amniotic Fluid↗
PubMed1990

Amniotic fluid glucose concentration: a rapid and simple method for the detection of intraamniotic infection in preterm labor.

The purpose of this study was to determine whether amniotic fluid glucose concentrations is of value in the rapid diagnosis of intraamniotic infection. Amniocenteses were performed in 168 patients with preterm labor and intact membranes. Amniotic fluid was cultured for aerobic and anaerobic bacteria, as well as Mycoplasma species. The prevalence of positive amniotic fluid cultures was 13.6% (23/168). Patients with positive amniotic fluid cultures for microorganisms had significantly lower median amniotic fluid glucose concentrations than patients with negative amniotic fluid cultures (median 11 mg/dl, range 2 to 30 mg/dl vs median 28 mg/dl, range 3 to 74, respectively; p less than 0.001). Amniotic fluid glucose concentrations below 14 mg/dl had a sensitivity of 86.9% (20/23), a specificity of 91.7% (133/145), a positive predictive value of 62.5% (20/32), and a negative predictive value of 97.8% (133/136) in the detection of a positive amniotic fluid culture. Amniotic fluid glucose determination is a rapid, sensitive, inexpensive, and simple test for the detection of intraamniotic infection in women with preterm labor and intact membranes.

Amniotic Fluid↗
PubMed1976

[Improved diagnosis fetal erythroblastosis due to Rh factors by combination of spectrophotometry (delta E 450) and a modified amniotic fluid ratio].

154 tests of amniotic fluid of 70 rh-sensitized women, won by transabdominal amniocentesis in the time between the 28th and 39th week of gestation were analysed. Besides experiential carried out spectrophotometric after Liley (estimation of delta E 450) liquor ratio were scrutinized concerning its value of statement for antenatal diagnosis in 2 variations (original liquor ratio and liquor ratio II). An equivalent pertinent judgment of delta E450 and Original liquor ratio was won. The best results were obtained with liquor ratio II and the combination of this method with delta E450. For further improvement of diagnostic reliability 2 methods of amniotic fluid analysis should be combined.

Amniocentesis↗
PubMed1986

[Sonographic evaluation of the quantity of amniotic fluid. II. Oligohydramnios--significance for the course of pregnancy and labor].

3,274 pregnant women were examined sonographically in this study, with particular emphasis on the quantity of amniotic fluid present. In 8% of the patients a reduced amount of amniotic fluid was seen. If the largest pocket of amniotic fluid was less than 2 cm that particular case was classified as oligohydramnios. If the largest pocket of amniotic fluid was between 2 cm and 3 cm, it was assumed to be in the lower standard range. These cases were compared with a randomly selected control group with normal amounts of amniotic fluid, in respect of the occurrence of complications during gestation and delivery and of the incidence of fetal malformations. Patients with reduced amounts of amniotic fluid showed signs and symptoms of gestosis more often (p less than 0.001) and delivered more often before the 36th week of pregnancy (p less than 0.001) and growth-retarded children (p less than 0.001) than women with standard amounts of amniotic fluid. The incidence rate of Caesarean section was 42%, and hence far above the standard level (p less than 0.001). In oligohydramnios, 13% (p less than 0.001) of the children had severe fetal malformation, whereas, with an amount of amniotic fluid in the lower standard range, only 5.5% (not significant) showed severe foetal malformation. The stated sonographic criteria are suitable as an objective measure for quantifying the amount of amniotic fluid.

Adult↗