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PubMed1980

Decidual production of prolactin in late gestation: further evidence for a decidual source of amniotic fluid prolactin.

The capacity of human decidual tissue to synthesize prolactin de novo throughout late gestation was investigated and correlated with the levels of prolactin (PRL) in amniotic fluid. Maximal concentrations of PRL in both amniotic fluid and samples of decidua were found prior to the thirtieth week of gestation and declined simultaneously until term. A high correlation (r = 0.90, p < 0.00005) was found when the levels of PRL in amniotic fluid and the initial (preincubation) content of PRL in decidua from the same patient were compared. A very high correlation (r = 0.96, p < 0.00005) was seen between the ability of the decidua to produce prolactin in vitro and the corresponding levels of prolactin in amniotic fluid. No significant difference in any parameter tested was noted with respect to either the sex of the fetus or the mode of delivery (p > 0.05). These data are interpreted as indicating (1) that decidual tissue varies throughout late gestation, in both its initial content of prolactin and its ability to synthesize prolactin de novo, in a manner which correlates to a high degree with variations in amniotic fluid prolactin levels and (2) that the decidual tissue is the major source of amniotic fluid prolactin.

Amniotic Fluid↗
PubMed1978

[Measuring the turbidity of amniotic fluid, a possibility to assess fetal maturity before birth (author's transl)].

At the end of gestation, depending on maturation of the fetus and especially of its skin, vernix caseosa is detached into amniotic fluid. The changes of amniotic fluid turbidity can be quantitatively verified with a fotometer (filter for 578 nm, 10 mm disposable cuvettes). The turbidity of amniotic fluid was measured in 125 cases. No correlation was found between turbidity and length of gestation from day 261 to day 287 after last menstruation. In contrast, there is strong and significant contingency between turbidity of amniotic fluid and maturity of fetal skin (quantity of vernix caseosa) or clinical maturity assessed according to Farr et al. Finding a turbidity below 0.5 U on extinction scale of the fotometer, the fetus is not fully mature in 50% of these cases; placental dysfunction can be excluded with high probability. In contrast, two thirds of the children with high turbidity of amniotic fluid (more than 1.0 U on extinction scale) had clinical signs of placental dysfunction.

Amniotic Fluid↗
PubMed1986

Measurement of TSH in human amniotic fluid: diagnosis of fetal thyroid abnormality in utero.

Using a highly sensitive immunoradiometric assay kit for human TSH, we measured TSH concentrations in unconcentrated amniotic fluids in normal pregnancies and those complicated for example by maternal hyper- and hypothyroidism, and compared them with those in maternal and cord sera. In normal pregnancies the mean concentration of TSH in amniotic fluid samples was 0.129 microU/ml, ranging from 0.065 to 0.278 microU/ml. In patients with premature delivery, the amniotic fluid TSH concentration was higher at 0.218 microU/ml. In four patients with abnormal thyroid function, TSH in amniotic fluid changed in parallel to that in cord serum, and there was a significant positive correlation between the two. No such correlation was observed between the concentrations of TSH in amniotic fluid and maternal serum. These results suggest that TSH in human amniotic fluid reflects fetal rather than maternal thyroid function and that the determination of TSH levels in amniotic fluid is useful in the diagnosis of abnormal thyroid function in fetuses.

Amniotic Fluid↗
PubMed1985

The role of ultrasound assessment of amniotic fluid volume in the management of the postdate pregnancy.

Antepartum assessments of amniotic fluid volumes and their relationship to nonstress test patterns and pregnancy outcomes were retrospectively analyzed in 234 postdate pregnancies. The incidence of clinical oligohydramnios and a nonstress test revealing fetal heart rate deceleration or bradycardia was found to increase as the sonographic estimates of the amniotic fluid volume decreased. Furthermore, the postdate pregnancy with sonographic evidence of an adequate amniotic fluid volume had a significantly better perinatal outcome than the pregnancy without an adequate fluid volume. These results suggest that the postdate pregnancy with evidence of reduced amniotic fluid volume should be considered for a trial of labor with continuous electronic fetal monitoring.

Amniotic Fluid↗
PubMed1998

[Antepartum amniotic fluid index and pregnancy outcome].

Our purpose was to evaluate prognostic value of antepartum amniotic fluid index (AFI) on fetal and newborn outcome, because oligohydramnion is associated with increased risk of fetal and newborn distress. Perinatal outcome was defined by 1' and 5' Apgar score, intrapartum fetal heart rate (FHR), blood gas, acid-base status in umbilical artery, mode of delivery and meconium-stained amniotic fluid. Data was analysed with CSS Statistica for Windows package by test t for independent samples and chi 2. Prospective observations was conducted with 84 singleton pregnancies complicated by oligohydramnion (AFI < or = 5 cm). A 336 pregnant women, with normal amniotic fluid index and no complicated pregnancy, was considered as controls. No increased operative delivery and meconium-stained amniotic fluid rate was noted. There was no significant effects AFI on blood gases in umbilical artery and Apgar score. Oligohydramnion was associated with increased risk of fetal acidosis (pH < 7.16) (p = 0.009) and abnormalities of FHR (variable decelerations) (p = 0.004). Reduced AFI had poor predictive value of fetal acidosis and newborn depression positive predictive value (8-13%). Summarizing the results, our investigation showed that amniotic fluid index is only one point in the prognosis of perinatal outcome.

Adult↗
PubMed1993

Erythropoietin concentrations in amniotic fluid and umbilical venous blood from Rh-immunized pregnancies.

We set out to investigate prospectively the levels of erythropoietin in amniotic fluid and umbilical venous blood, and to attempt to relate these to fetal haemoglobin and lactate concentrations and to pCO2 and PO2 in Rh immunised patients studied before the onset of labor. Fetal blood was obtained by cordocentesis, and amniotic fluid by amniocentesis from a consecutive series of 36 Rh immunized patients at the time of fetal blood sampling. There was a close correlation (tau = 0.357, P = 0.0001) between the concentrations of erythropoietin in umbilical venous blood and those in amniotic fluid. Erythropoietin in umbilical venous blood correlated inversely with hemoglobin (tau = 0.453, P = 0.0001), and directly with lactate concentrations (tau = 0.450, P = 0.0005). When all other variables were considered, multiple regression analysis demonstrated hemoglobin concentration to be the only variable to be related to the level of erythropoietin in umbilical venous blood taken before transfusion. When the same analysis was performed on the same variables, adding erythropoietin concentration in amniotic fluid as the dependent variable, only erythropoietin in umbilical venous blood was found to be related to the level of erythropoietin in amniotic fluid. We conclude that the erythropoietin concentration in umbilical venous blood from Rh-immunized patients before the onset of labor, is related to fetal anemia. We also conclude that erythropoietin concentration in amniotic fluid is related to that in fetal blood, thereby indicating that the fetus is an important source of amniotic fluid erythropoietin in non laboring patients.

Amniotic Fluid↗
PubMed1982

Fetal beta cell function in diabetic pregnancy. Amniotic fluid concentrations of proinsulin, insulin, and C-peptide during the last trimester of pregnancy.

Proinsulin, insulin C-peptide, insulin-binding antibody, and glucose concentrations were measured in amniotic fluid samples from 43 insulin-treated diabetic patients and 17 nondiabetic control patients between the thirty-six and thirty-ninth weeks of gestation. Insulin-binding antibodies in amniotic fluid were present in only three diabetic patients, although antibodies in maternal serum were found in 22 of the diabetic subjects. In the diabetic group, maternal serum insulin-binding antibodies were statistically unrelated to levels of C-peptide in amniotic fluid. The mean amniotic fluid concentrations of proinsulin (0.07 nmole/L), insulin (0.08 nmole/L), C-peptide (1.17 nmoles/L), and glucose (2.09 mmoles/L) were markedly elevated (p less than 0.001) in diabetic patients, as compared to nondiabetic control patients, thus suggesting exaggerated fetal beta cell function. C-peptide was correlated to both insulin (r = 0.69) and proinsulin (r = 0.35) in the diabetic group only. Infant birth weight and amniotic fluid C-peptide was significantly correlated in both the control group (r = 0.54) and the diabetic group (r = 0.38). Diabetic pregnancies associated with neonatal morbidity (n = 25) had significantly higher mean amniotic fluid concentrations of both insulin and C-peptide than did pregnancies without neonatal morbidity (n = 18). The amniotic fluid values of C-peptide and insulin in these latter two subgroups were overlapping and, therefore, could not serve to predict neonatal outcome in the individual case.

Adult↗
PubMed1999

Hepatocyte growth factor concentration in the early second-trimester amniotic fluid does not predict fetal growth at birth.

The purpose of this study was to evaluate whether hepatocyte growth factor (HGF) concentrations in the early second-trimester amniotic fluid predict fetal growth at birth. HGF and insulin-like growth factor-I (IGF-I) concentrations in the early second-trimester amniotic fluid were measured in 12 pregnancies with small for gestational age (SGA) infants, 84 pregnancies with appropriate for gestational age (AGA) infants, and eight pregnancies with large for gestational age (LGA) infants. HGF concentrations were measured from the early second-trimester amniotic fluid samples using an enzyme-linked immunosorbent assay. IGF-I concentrations were measured from the early second-trimester amniotic fluid samples using an immunoradiometric assay. Maternal age in AGA group (34.2 +/- 5.5 years) was significantly lower than in SGA (37.9 +/- 3.0 years) and LGA (37.6 +/- 3.3 years) groups (P < 0.05). There were no significant differences for parity or gestational age at amniocentesis among the groups. There were significant differences for birth age, birth weight, neonatal height, and placental weight among the groups (P < 0.05). HGF concentrations in SGA, AGA and LGA groups were 16.9 +/- 6.6, 16.7 +/- 9.0 and 20.2 +/- 14.8 ng/ml respectively (not significant). There was no correlation between amniotic fluid HGF concentrations and birth weight, height or placental weight. There were also no significant differences for amniotic fluid IGF-I concentrations among the three groups. These results suggest that differences in HGF concentrations in the early second-trimester amniotic fluid do not predict fetal growth at birth. Further study is needed to clarify the role of high HGF concentrations in early second-trimester amniotic fluid during pregnancy.

Adult↗
PubMedDate not supplied

Relationship between meconium staining and amniotic fluid volume in term pregnancies.

OBJECTIVE: Our purpose was to evaluate the relationship between meconium-stained amniotic fluid (MEC-AF) and amniotic fluid volume (AFV) and their impact on the risk of cesarean delivery for fetal indications in term pregnancies. METHODS: 1,655 live-born singleton gestations delivering at > or = 37 weeks within 7 days of sonographic assessment of the amniotic fluid index (AFI) were studied. AFI was categorized as: oligohydramnios (< or = 5.0 cm); decreased (5.1-8.0 cm); normal (8.1-18.0 cm); increased (18.1-23.9 cm), and polyhydramnios (> or = 24.0 cm). Frequencies of MEC-AF for each AFV category were stratified by gestational age (GA) and rates of cesarean delivery for fetal indications compared between patients with clear amniotic fluid and those with MEC-AF. Stepwise logistic regression analyses were performed for determinants of MEC-AF and the need for cesarean delivery for fetal indications. RESULTS: The frequency of MEC-AF at birth in term pregnancies was not related to AFV: oligohydramnios (16.7%); decreased (16.7%); normal (20.1%); increased (24.4%), and polyhydramnios (22.1%). The only factor associated with the occurrence of MEC-AF was increasing GA at delivery (p < 0.01). Both MEC-AF (p < 0.02) and decreasing neonatal ponderal index (p < 0.02) were independently associated with cesarean delivery for fetal distress. CONCLUSIONS: MEC-AF does not appear to be related to AFV in term pregnancies, and its presence increases the risk of cesarean delivery for fetal distress independent of AFV and neonatal ponderal index.

Amniotic Fluid↗
PubMed1982

Quantitative bacteriology of amniotic fluid from women with clinical intraamniotic infection at term.

Amniotic fluid was collected through an intrauterine catheter from 52 women with clinical intraamniotic infection and from 52 uninfected matched control women. The amniotic fluid was cultured quantitatively for anaerobes and aerobes. Patients with intraamniotic infection were matched with the control women on the basis of gestational age, interval from membrane rupture to specimen collection, and interval from membrane rupture to delivery. The patients with intraamniotic infection had a significantly higher mean temperature (38.4 vs. 37.1 C) and a higher mean leukocyte count (15,740 vs. 11,740 cells/mm3). In 80.6% of specimens from the women with intraamniotic infection and 30.8% of those from the control subjects, greater than or equal to 10(2) colony-forming units (cfu)/ml were isolated from the amniotic fluid (P less than 0.001). Also, in 69.2% of the former and 7.7% of the latter, there were greater than or equal to 10(2) cfu of isolates considered to be "high-virulence" isolates/ml (P less than 0.001).

Adolescent↗
PubMed1983

Attraction and repulsion by amniotic fluids and their olfactory control in the ewe around parturition.

The reaction of ewes towards amniotic fluids was studied in intact multiparous ewes in various physiological states (oestrus, luteal phase, mid-pregnancy and around parturition), using a test of preference for food associated or not with the presence of amniotic fluids in the food. Fluids were collected on alien newborn lambs. Results indicate that ewes are strongly repelled by amniotic fluid at all of the times tested except for a short period around parturition. Immediately before expulsion of the foetus ewes become strongly attracted by amniotic fluids. This attraction persists just after parturition, but fades within 4 hours in most animals. This attraction-repulsion behavior appears to rely heavily on olfactory cues. Ewes made anosmic with zinc sulphate do not show repulsion or attraction towards amniotic fluids at any of the physiological states studied. These results are discussed in the light of our knowledge about the factors controlling the onset of maternal behavior in the ewe (hormones and genital stimulation).

Amniotic Fluid↗
PubMed1980

Phosphatidic acid phosphohydrolase and phospholipids in tracheal and amniotic fluids during normal ovine pregnancy.

Samples of amniotic fluid and fetal tracheal fluid were obtained from 36 ovine pregnancies which were studied either acutely or chronically during the last two-thirds of gestation (65 to 149 days). The specific activity of phosphatidic acid phosphohydrolase (PAPase), disaturated lecithin (DS-L), total phospholipids (TLP) and the L/S ratio were assayed in the amniotic and tracheal fluids. There was a significant and progressive increase in the specific activity of PAPase in tracheal fluid beginning after 110 days, increasing from 66+/- 7 nmoles phosphate released X mg-1 protein x hour-1 (Mean +/- S.E.M.) less than or equal to 110 days, to 107 +/- 6 at 111 to 120 days, and to 277 +/- 70 at 131 to 144 days. The rise in PAPase specific activity was followed by a parallel rise in the DS-L fraction of the TPL (DS-L/TPL ratio), increasing from a DS-L/TPL ratio of 0.06 +/- 0.-1 in fetuses less than or equal to 120 days, to 0.29 +/- 0.06 at 121 to 130 days, and to 0.50 +/- 0.18 at 131 +/- 135 days. The PAPase specific activity and the L/S ratio in amniotic fluid did not change during pregnancy. Neonatal respiratory distress syndrome is the result of inadequate production of surface active material by the fetal and neonatal lung. The enzyme PAPase occupies a central role in the biosynthesis of the glycerophospholipids, and increases in the specific activity of PAPase in human amniotic fluid and in fetal rabbit lung tissue precede or are parallel with the increase in the L/S ratio and pulmonary surfactant synthesis, respectively. We have shown that this sequence is also demonstrable in ovine fetal tracheal fluid, thus providing an animal preparation in which the formation and regulation of surfactant biosynthesis during fetal lung maturation can be investigated in vivo.

Amniotic Fluid↗
PubMed1981

Origin of amniotic fluid cells in mid-trimester pregnancies.

Amniotic fluid cells provide important information about the fetus. Studies of the surface ultrastructure of such cells identified four cell populations in mid-gestational fluids. A parallel study of tissue surfaces in contact with or communicating with the amniotic fluid showed that some tissues made no contribution to the cell populations, while others contributed extensively. Two principal cell shedding mechanisms were found in mid-trimester--exfoliation of whole cells and detachment of cellular fragments. The latter mechanism was observed from skin and umbilical cords during a limited period in mid-pregnancy. The majority of cells were derived from exfoliation of squamous epithelia.

Amniotic Fluid↗
PubMed2005

Global gene expression analysis of the living human fetus using cell-free messenger RNA in amniotic fluid.

CONTEXT: No molecular biological tests are available to monitor the ongoing development of human fetuses in vivo. OBJECTIVE: To determine whether cell-free fetal messenger RNA (mRNA) in amniotic fluid can be detected using oligonucleotide microarrays to study large-scale gene expression in living human fetuses, with analysis of sex, gestational age, and fetal pathology as variables. DESIGN, SETTING, AND PATIENTS: Four samples of cell-free amniotic fluid were analyzed from pregnant women between 20 and 32 weeks' gestation and undergoing amnioreduction for polyhydramnios associated with twin-twin transfusion syndrome or hydrops fetalis (cases). The control consisted of 6 pooled amniotic fluid samples from women at 17 weeks' gestation and undergoing genetic amniocentesis. After extraction from the normally discarded fraction of amniotic fluid, RNA was amplified twice, labeled, and analyzed using gene expression microarrays. MAIN OUTCOME MEASURE: Relative mRNA expression in cell-free samples of amniotic fluid from fetuses with polyhydramnios at different gestational ages vs cell-free amniotic fluid from a pooled control. RESULTS: Thirty-six percent of 22,283 probe sets represented on the arrays were present in the cell-free amniotic fluid, and a median of 20% of all probe sets differed between cases and the pooled control. Only male samples expressed 1 Y chromosome transcript. The expression of some developmental transcripts, such as surfactant proteins, mucins, and keratins, changed with gestational age by up to 64-fold. A water transporter gene transcript was increased up to 18-fold in both twin-twin transfusion samples. Placental gene transcripts were not present in any samples. CONCLUSIONS: This pilot study demonstrates that cell-free fetal mRNA can be extracted from amniotic fluid and successfully hybridized to gene expression microarrays. Preliminary analysis suggests that gene expression changes can be detected in fetuses of different sexes, gestational age, and disease status. Cell-free mRNA in amniotic fluid appears to originate from the fetus and not the placenta.

Amniocentesis↗
PubMed1998

The role of deoxyribonuclease I in amniotic fluid during pregnancy and labour.

The purpose of this study was to detect the presence, and determine the normal values and the significance of DNase I in the amniotic fluid and in human placentas. Fifty-one pregnant women at 16-22 weeks of gestation and 89 women in spontaneous labour at term were recruited to the study. DNase I activity was measured in amniotic fluid and cytoplasmic extracts from the fetal portion of placentas by using a spectrophotometric technique (DNA precipitation assay) and nucleic acid electrophoresis, following degradation of the DNA by the enzyme. DNase I activity was undetectable in the placental cytoplasmic extracts. In the second trimester of pregnancy DNase I activity was detectable in amniotic fluid (2.3+/-0.64x10(5) U/l). During labour DNase I activity was also detectable, but reduced levels were observed in the presence of clear amniotic fluid, compared to second trimester levels, (1.9+/-0.44x10(5) U/l, P<0.001), whereas higher levels were found in the presence of meconium-stained amniotic fluid compared to both second trimester and clear amniotic fluid at labour (11.4+/-4.1x10(5) U/l, P<0.001 and P<0.001, respectively). Three out of 17 fetuses with meconium-stained amniotic fluid (18%) developed perinatal infection. In conclusion, the detection of DNase I activity in the amniotic fluid of second and third trimester indicates a physiological role in human pregnancy. DNase I activity normally decreases at term, compared to second trimester levels, but increases significantly in the presence of meconium.

Amniotic Fluid↗
PubMed1993

Longitudinal assessment of amniotic fluid index.

OBJECTIVE: To derive a longitudinal gestational reference range for amniotic fluid index and to compare it with the established cross-sectional reference range. DESIGN: Longitudinal prospective study. SETTING: Liverpool Maternity Hospital and Mill Road Maternity Hospital, both teaching hospitals in central Liverpool. SUBJECTS: One hundred and fifteen pregnant women, in whom the expected date by the last menstrual period and ultrasound scan at 18 to 19 weeks were in agreement by seven days, were recruited. They were divided into two groups and scanned at four weekly intervals as follows: Group A: scanned at 20, 24, 28, 32, 36, 40; and Group B: scanned at 22, 26, 30, 34, 38, 42. RESULTS: Amniotic fluid index varies with gestation, rising from early gestation to peak at 30 weeks and then falling from 36 to 42 weeks. Comparison of our reference range with that of Moore and Cayle (1990) shows obvious differences at the lower limit. CONCLUSION: We have established a normal longitudinal reference range for the amniotic fluid index. Our ranges, derived from longitudinal data, would seem a more appropriate reference than the established reference ranges derived from cross-sectional data. In particular, the differences at the lower limits may have considerable clinical implication in the use of amniotic fluid index in the prediction of fetal compromise.

Amniotic Fluid↗
PubMedDate not supplied

Evaluation of interleukin concentrations in amniotic fluid in preterm and term parturition and in oligohydramnios.

BACKGROUND: The goal of our work was to evaluate the activity of interleukin 1 beta, 6, 8, 12, and 18 in the amniotic fluid in preterm and term deliveries, and to specify the dependency between the amniotic fluid index (AFI) and the concentration of these interleukins. MATERIAL AND METHODS: Amniotic fluid (27 samples from preterm deliveries and 49 from term deliveries) was collected during cesarean section or in the course of amnioinfusion performed when the pregnancy was accompanied by oligohydramnios (AFI< or = 5cm). The amniotic fluid thus obtained was centrifuged at 1000 xg for 15 min. at a temperature of 4 degrees C, and the filtrate was kept at a temperature of -80 degrees C until assayed. The assays were done by the ELISA method, using ready antibody kits from 'R&D Systems'. A comparative analysis was done for the concentrations (expressed in pg/ml) of the individual interleukins found in the amniotic fluid from preterm and term deliveries, and for the amniotic fluid index (AFI< or = L5 and >5). The statistical analysis was performed using the Wilcoxon test. RESULTS: The increased level of IL-12 we found in the amniotic fluid from preterm deliveries and those complicated by oligohydramnios may indicate the participation of immunological mechanisms in the pathogenesis of oligohydramnios.

Amniotic Fluid↗
PubMed1980

Somatomedin-A (Sm-A) bioactivity in serum and amniotic fluid as related to weight in the fetal pig.

Serum and amniotic fluid Sm-A bioactivity has been assayed in the fetal pig using a double labelling technique. 3H-thymidine activity was always higher in fetuses and lower in sows than 35S activity. 35SO4 uptake was not stimulated or was inhibited in about 30 p. 100 of the fetal sera. 3H-thymidine uptake was stimulated in all of them. There was a significant correlation (P less than 0.001) between fetal weight and serum Sm, as judged with both 35SO4 and 3H-thymidine. No correlation was found between fetal weight and amniotic fluid Sm, between amniotic fluid and serum Sm or between 35SO4 and 3H activities. It is concluded that the latter activities were due to two or more factors instead of only one.

Amniotic Fluid↗