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Cultured human amniotic fluid cells characterized with antibodies against intermediate filaments in indirect immunofluorescence microscopy.

Cells cultured from second trimester human amniotic fluid were characterized in indirect immunofluorescence (IIF) microscopy using specific antibodies against the subunit proteins of different types of cytoskeletal intermediate filaments. Most of the amniotic fluid cell cultures contained only epithelial cells as indicated by the positive keratin-fluorescence in IIF. Five distinct types of keratin-positive cells could be characterized. A dominating cell type (E-1) in most cultures were rapidly proliferating epithelial cells, previously called amniotic fluid cells (AF-cells). These cells showed a fibrillar cytoplasmic fluorescence both with keratin antibodies and with antibodies against vimentin, the fibroblast type of intermediate filament protein. E-1 cells did not show the typical cell-to-cell arrangement of keratin fibrils between the adjacent cells, a characteristic previously found in most cultured epithelial cells. Most of the cultures also contained large epitheloid cells (E-2), showing a fine fibrillar cytoplasmic organization of both keratin- and vimentin filaments, clearly different from that seen in E-1 cells. Several cultures contained two additional epithelial cells both showing the typical cell-to-cell arrangement of keratin fibrils (E-3 and E-4). These two cell types could be distinguished because of their distinct difference in size. E-4 cells typically grew as small cell islands among other epitheloid cells. Amniotic fluid cell cultures occasionally contained also large multinucleated cells (E-5), which appeared to contain large amount of fibrillar keratin. Fibroblastic cells, identified by their decoration only with antibodies against vimentin, were rarely found in amniotic fluid cell cultures. Interestingly, in such cultures some cells with a fibroblastoid appearance were identified as epithelial cells on the basis of the positive keratin-fluorescence. The results show the suitability of IIF with cytoskeletal antibodies in characterization of heterogenous cell populations and indicate that normal amniotic fluid cell cultures mostly contain epithelial cells.

Amniotic Fluid↗

Fetal intestinal and renal origins of trehalase activity in human amniotic fluid.

Intestinal and renal trehalase isozymes have been distinguished in normal human amniotic fluid on the basis of their membrane-bound character and isoelectric point (pI). The intestinal trehalase was mostly membrane bound in amniotic fluid and had a pI around 4.60. In contrast, the renal form of trehalase was soluble and had a pI around 4.37. These pI values were consistent with those found in extracts of fetal intestinal (pI 4.60) and renal (pI 4.24) tissues. The determination of trehalase isozyme composition of amniotic fluid from pathological pregnancies with anal imperforation and polycystic kidney disease confirmed our findings on the origin of amniotic fluid trehalase. In the sample from a fetus with anal imperforation, low or absent intestinal trehalase isozyme was observed whereas a higher than normal level of renal trehalase activity was found in a fetus with polycystic kidney disease.

Amniotic Fluid↗

Detection of group B streptococcal antigens in amniotic fluid of rhesus monkeys.

To simulate group B streptococci (GBS) amniotic fluid infections common in humans and to examine bacterial growth and the appearance of GBS antigens in vivo, GBS were injected into the amniotic cavity of 19 near-term rhesus monkeys. Transabdominal aspirates of amniotic fluid were obtained before bacterial challenge, after 2 and 6 h, and during cesarean section delivery (24 h). Each fluid was quantitatively cultured for GBS. Specimens of amniotic fluid and gastric aspirate from each infant were tested for the presence of GBS antigens with a commercial latex particle agglutination test (Wellcogen Strep B; Wellcome Diagnostics, Dartford, England). To eliminate nonspecific latex particle agglutination reactivity, presumably caused by proteins, a processing procedure was required. Despite active proliferation of bacteria, only 12% of the 2-h amniotic specimens were latex particle agglutination positive. In contrast, 94% of th3 6-h and 100% of the 24-h specimens had detectable antigens, as did 89% of the gastric fluid specimens aspirated from the 19 newborns. Latex particle agglutination tests, after proper processing, will readily detect GBS antigens in amniotic or gastric aspirate fluid from experimentally infected rhesus monkeys.

Amniotic Fluid↗

Differential stabilities of fetal intestinal disaccharidases determine their relative amounts released into amniotic fluid.

Comparison of relative disaccharidase activities in jejunal mucosa, amniotic fluid, and meconium samples taken from the ileum, proximal and distal colon of 5 human fetuses, indicates that trehalase and lactase are more sensitive to the denaturation conditions existing in the fetal intestinal lumen than maltase, sucrase, palatinase and turanase . Relative activities of sensitive disaccharidases (trehalase and lactase) were also low in the amniotic fluid of these fetuses as compared to the jejunal mucosa. These results suggest that the in vivo stability of disaccharidases, exposed to proteolytic digestion and other denaturing conditions in the fetal intestinal lumen, governs the relative activities of these enzymes released into the amniotic fluid.

Amniotic Fluid↗

Surface properties of the amniotic fluid in normal pregnancy.

The surface properties of the amniotic fluid were determined in 96 normal pregnancies between weeks 23 and 41. The y-max, y-min, hysteresis areaa, and stability index were used as parameters for evaluation of the surface tension are diagrams. These results were plotted against the gestation week and a curve for the normal course of surface tension of the amniotic fluid during the second half of gestation was obtained. The influence of addition of blood, vernix, and meconium to amniotic fluid as well as that of changes in the pH and dilution were examined. The results were unaffected by either blood, vernix, or pH changes. The slight scatter of the y-min values makes this parameter particularly suitable for determining fetal lung maturity.

Amniotic Fluid↗

Amniotic fluid acetylcholinesterase is found in gastroschisis but not omphalocele.

Amniotic fluid acetylcholinesterase (ACHE) has been used to evaluate neutral tube defects. It has also been detected in ventral wall defects. However, the role of ACHE to differentiate between omphalocele and gastroschisis has not been established. We examined amniotic fluid ACHE in 16 pregnancies complicated by gastroschisis and 8 by omphalocele. One ruptured omphalocele was excluded. ACHE was negative in all 7 omphaloceles and either positive or suspicious in all gastroschises (chi 2 = 17.3, p < 0.0001). Amniotic fluid ACHE may be useful to differentiate between omphalocele and gastroschisis.

Abdominal Muscles↗

Amniotic fluid embolism: analysis of the national registry.

OBJECTIVE: We analyzed the clinical course and investigated possible pathophysiologic mechanisms of amniotic fluid embolism. STUDY DESIGN: We carried out a retrospective review of medical records. Forty-six charts were analyzed for 121 separate clinical variables. RESULTS: Amniotic fluid embolism occurred during labor in 70% of the women, after vaginal delivery in 11%, and during cesarean section after delivery of the infant in 19%. No correlation was seen with prolonged labor or oxytocin use. A significant relation was seen between amniotic fluid embolism and male fetal sex. Forty-one percent of patients gave a history of allergy or atopy. Maternal mortality was 61%, with neurologically intact survival seen in 15% of women. Of fetuses in utero at the time of the event, only 39% survived. Clinical and hemodynamic manifestations were similar to those manifest in anaphylaxis and septic shock. CONCLUSIONS: Intact maternal or fetal survival with amniotic fluid embolism is rare. The striking similarities between clinical and hemodynamic findings in amniotic fluid embolism and both anaphylaxis and septic shock suggest a common pathophysiologic mechanism for all these conditions. Thus the term amniotic fluid embolism appears to be a misnomer.

Adolescent↗

[The pattern of distribution of free amino acids in human amniotic fluid related to the duration of pregnancy. Part II: Changes in concentration in pathological pregnancy (author's transl)].

18 free amino acids from 196 specimens of amniotic fluid of pathological pregnancies between the 28th and 41st week of pregnancy were measured by gaschromatography. The concentrations of the amino acids in amniotic fluid in normal and pathological pregnancies were analysed by statistical methods. There were only minor differencies of concentration of free amino acids in the amniotic fluid between normal and pathological pregnancies with the exception of hydroxyproline. This was found in a significantly higher concentration in the amniotic fluid of the pathological group. Supposing that the materno-fetal as well as the feto-maternal amino acid exchange may be reduced by the placenta insufficiency, the significantly higher concentration of hydroxyproline in the amniotic fluid during pathological pregnancies may be caused higher fetal urine excretion of hydroxyproline into the amniotic fluid. The increase of hydroxyproline in the amniotic fluid of pathological pregnancies is probably an early diagnostic parameter of an impaired transplacental exchange -- placenta insufficiency.

Amino Acid Metabolism, Inborn Errors↗

Elevation of amniotic fluid interleukin-4 concentrations in women with preterm labor and chorioamnionitis.

Preterm labor associated with intrauterine infection is characterized by increased amniotic fluid concentrations of various proinflammatory cytokines, including interleukin-1beta (IL-1beta), tumor necrosis factor-alpha (TNF-alpha), IL-6, IL-8, and macrophage inflammatory protein-1alpha (MIP-1alpha). The purpose of this study was to determine if preterm labor in women with clinically evident chorioamnionitis is marked by elevations of the anti-inflammatory cytokine interleukin-4 (IL-4) and the T cell growth factor IL-2. Amniotic fluid samples were obtained from (1) women at term, not in labor (n = 10); (2) women at term, in labor (n = 10); (3) women with preterm contractions but undelivered within 1 week of amniotic fluid collection (n = 10); (4) women with preterm labor and delivery without clinically evident chorioamnionitis (n = 10); (5) women with preterm labor associated with chorioamnionitis (n = 8); and (6) women with preterm labor and delivery without infection matched with patients with chorioamnionitis (n = 8). Amniotic fluid concentrations of IL-4 and IL-2 were determined for each sample with a specific and sensitive enzyme-linked immunoassay. We found that women with infection-associated preterm labor and delivery had significantly higher concentrations of IL-4 when compared to appropriately matched controls (p < 0.05). Additionally, women with preterm labor and delivery not associated with infection had higher amniotic fluid IL-4 concentrations than women with preterm contractions but no labor (p < 0.05). Women with term labor had rare modest elevations of amniotic fluid IL-4. No IL-2 was detected in any sample. Our data indicate that amniotic fluid IL-4 is elevated in women with preterm labor and delivery, particularly in association with chorioamnionitis. We suggest that IL-4, although previously considered an anti-inflammatory agent, may have a paradoxical proinflammatory role in the pathogenesis of infection-associated preterm labor.

Adult↗

Enhancement of opioid-mediated analgesia by ingestion of amniotic fluid: onset latency and duration.

Ingestion of placenta and amniotic fluid has been shown to enhance opioid-mediated analgesia produced by morphine injection, footshock, vaginal/cervical stimulation, and during late pregnancy in rats. The present study was designed to determine how soon after ingestion the enhancement begins and how long it lasts. Tail-flick latencies in Long-Evans rats were determined before and during vaginal/cervical stimulation; analgesia was measured as the percent increase in tail-flick latency during vaginal stimulation. After determination of baseline, rats were intubated with 0.25 ml of either amniotic fluid or beef bouillon. We found that analgesia enhancement was detectable as early as 5 minutes after ingestion of amniotic fluid, and the effect lasted at least 30 minutes, but no longer than 40 minutes.

Amniotic Fluid↗

Simultaneous measurement of human prolactin and growth hormone levels in maternal and fetal serum and amniotic fluid.

Growth hormone (GH) and prolactin (PRL) in maternal and fetal serum and amniotic fluid were measured simultaneously by radioimmunoassay at term deliveries of 20 normal mothers. The PRL level of amniotic fluid was significantly higher than that of maternal and fetal serum. The fetal GH level was significantly higher than the maternal and amniotic levels of GH. There was no significant correlation among hormone levels of maternal and fetal sera and amniotic fluid. These data suggest that PRL and GH levels of maternal and fetal sera and amniotic fluid are controlled separately.

Amniotic Fluid↗

Assay of gamma-glutamyl transpeptidase activity in amniotic fluid offers a possible prenatal diagnosis of biliary atresia in the rat model.

Muller et al. analysed gamma-glutamyl transpeptidase (GGTP) activity in the amniotic fluid of more than 2000 pregnant women for a prenatal diagnosis. They reported that at 18-19 weeks' gestation, two fetuses associated with lower amniotic fluid GGTP levels were diagnosed after birth as having biliary atresia (BA). If low GGTP values correlate closely with BA, chemical assay of amniotic fluid GGTP could possibly be used in the prenatal diagnosis of BA. A fetal model of cholestasis in the rat was created by the administration of the toxic cytopharmacological agent phalloidin on day 15 of gestation, after which amniotic fluid was aspirated and analysed for GGTP. Fetal liver specimens were examined histopathologically. In the normal rats, amniotic fluid GGTP values rose rapidly after 18 days 8 h, reaching a maximum value at 19 days of gestation. Significantly lower GGTP values were observed in the cholestasis models between 18 days 16 h and 19 days 16 h of gestation (P < 0.05). Our data corroborate Muller et al.'s suggestion that fetuses with cholestasis might demonstrate lower GGTP values in their amniotic fluid at a given stage of gestation. Prenatal diagnosis of BA using the amniotic fluid GGTP assay therefore has considerable potential.

Amniotic Fluid↗

A progestagen-dependent endometrial protein in human amniotic fluid.

A protein was detected in human amniotic fluid that had properties identical to those of the progestagen-dependent endometrial protein. The concentration of the amniotic fluid protein was maximal during Weeks 15-18 of pregnancy and then declined rapidly. The protein was not detected in immature and mature placentae, ovary, Fallopian tube, myometrium and cervix. We conclude that a specific protein synthesized by the human uterine decidua is transported to the amniotic sac.

Adult↗

Glial origin of rapidly adhering amniotic fluid cells.

Rapidly adhering cells (RA cells) from the amniotic fluid of a pregnancy with fetal anencephaly were investigated by immunofluorescence assay with an antiserum against glial cells. After 24 hours' cultivation a high proportion of the cells showed positive glial-specific fluorescence, whereas no staining was seen in cells from samples of normal amniotic fluid. At the 24th week the mother was delivered of a stillborn infant with anencephaly. Immunofluorescence staining of RA cells with glial-specific antiserum may be used for the differential diagnosis of fetal abnormalities associated with a high alpha-fetoprotein concentration in amniotic fluid.

Adult↗

Amniotic fluid cortisol as an index of fetal lung maturity.

Amniotic fluid cortisol concentration was compared with lecithin/sphingomyelin ratio, gestational age, and eventual birth-weight in a large series of normal and high-risk human pregnancies in an effort to determine whether cortisol could be used as a reliable indicator of fetal maturity. It appears that when used alone amniotic fluid cortisol is of limited clinical value as an antepartum predictor of fetal respiratory status because of unacceptable percentages of false positive and false negative predictions. Whether amniotic fluid cortisol can be used as an adjunct in the evaluation of high-risk pregnancies with "transitional" L/S ratios remains to be explored.

Amniotic Fluid↗

Immunosuppressive activity of human amniotic fluid of normal and abnormal pregnancies.

Twenty specimens of amniotic fluid (AF) obtained between week 16 and 18 of gestation from normal pregnant women and six specimens from pregnant women in which trisomia of chromosome 21 was found were tested for immunosuppressive activity. Incubation of normal human donor lymphocytes with 0.2-1 mL of AF from normal pregnant women for one hour at 37 degrees C was sufficient for induction of significant inhibition of the ability of these cells to induce a local xenogeneic graft-versus-host reaction (GVHR) as well as inhibition of E and E-active rosette formation, the GVHR being the most sensitive test. On the other hand, amniotic fluid obtained from the six pregnant women in which trisomia of chromosome 21 was found showed no inhibitory activity in either the E or E-active rosette formation, nor in the local xenogeneic graft-versus-host reaction. AF from all the women tested was found to have no effect on phenotype expression of the lymphocytes, as tested by the monoclonal antibodies OKT4+ and OKT8+, nor on B-lymphocytes, as tested by surface immunoglobulins. No correlation was found between the alpha-fetoprotein levels in the sera of those women and the immunosuppressive activity. These findings indicate that genetic defects of the conceptus are not limited to the embryo but may affect the composition of immunosuppressive components present in normal amniotic fluid.

Amniotic Fluid↗

Glycodelin and amniotic fluid transferrin as inhibitors of E-selectin-mediated cell adhesion.

Human amniotic fluid contains a variety of glycoproteins. Several of these substances have been shown to exert immunomodulatory effects. Glycodelin, previously known as placental protein 14, is one of these glycoproteins. It has a unique carbohydrate configuration, consistent with fucosylated LacdiNAc structures that are very unusual for mammals. Oligosaccharides with fucosylated LacdiNAc antennae have previously been shown to block selectin-mediated cell adhesion. Another glycoprotein, human transferrin, is also present in amniotic fluid in relatively high concentrations. This transferrin shows a different glycosylation compared with serum transferrin. Amniotic fluid transferrin carries sialylated Lewis X antigens. Glycodelin and transferrin were isolated from amniotic fluid and for comparison from serum of pregnant women by chromatographic methods. The purified proteins were used as ligands to block E-selectin-mediated HepG2 cell adhesion. Two types of binding assays with distinct receptor accommodations (immobilised E-selectin and activated HUVECs) were used to quantify inhibition efficiencies of the different proteins. We found that glycodelin is a strong inhibitor with a 10(3)-fold potency compared to the monovalent tetrasaccharide sialyl Lewis X whereas the potency of transferrin is rather low.

Adult↗

Fetal H-Y typing using human amniotic fluid.

The H-Y (male) antigen is phylogenetically conserved among vertebrate species, including the species man. Previous studies have indicated the presence of a "soluble" H-Y antigen in male serum and culture fluids of male cells. We examined over 50 samples of amniotic fluid from male and female fetuses to determine if H-Y typing could be correlated with the sex of the fetus. Samples of amniotic fluid were tested to inhibit the reactivity of monoclonal antibodies in a standard H-Y assay with protein A sheep red blood cells. We found that amniotic fluids from male fetuses inhibited 40% of the reactivity and that amniotic fluids from female fetuses inhibited 0.5% of reactivity. We could also correctly identify the sex of 90% of male fetuses and 100% of female fetuses. We have not yet identified the exact nature of the inhibiting antigen(s) in the amniotic fluids, but our results clearly indicate the feasibility of fetal H-Y typing.

Amniocentesis↗