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PubMed1984

Gamma-glutamyl transferase activity in fetal serum, maternal serum, and amniotic fluid during gestation.

Gamma-glutamyl transferase activity was measured in fetal serum, maternal serum, and amniotic fluid in 173 pregnancies from 15 to 40 weeks' gestation. Fetal serum was obtained in the second trimester by fetoscopy and in the third trimester by umbilical cord puncture at caesarian section or vaginal delivery. Enzyme activities in maternal blood (10 IU/1, SD 2) and fetal blood (88 IU/1, SD 20) remained relatively constant throughout gestation, whereas in the amniotic fluid there was a significant decrease at term from the value in the second trimester (p less than 0.001). Electrophoretic separation of the enzyme showed one isoenzyme in the fetal blood and at least two in the amniotic fluid. The fetal isoenzyme had the same mobility as the major isoenzyme in the amniotic fluid.

Amniotic Fluid↗
PubMed1998

Developmental alterations of alpha-fetoprotein sugar chain in amniotic fluids analyzed by lectin affinity electrophoresis.

Affinity electrophoresis of human alpha-fetoprotein (AFP) in amniotic fluid from pregnant women between 6 to 42 weeks of gestation and in the serum of a yolk sac tumor was performed with concanavalin A (Con A), lentil lectin (LCA), erythroagglutinating phytohemagglutinin (E-PHA) and Allomyrina dichotoma lectin (allo A). Separated AFP bands were detected by sensitive antibody-affinity blotting. In the first trimester, amniotic fluid AFP showed elevated percentages of Con A-nonreacting AFP (AFP-C1) and LCA weakly-reacting AFP (AFP-L2) as previously reported. Additionally, high percentages of E-PHA strongly-reacting AFP (AFP-P5) and E-PHA-reacting AFP (AFP-P4) were observed. E-PHA-nonreacting AFP (AFP-P1), E-PHA weakly-reacting AFP (AFP-P3f), allo A-nonreacting AFP (AFP-A1) and asialo-AFP, AFP-A1 s, were present only in amniotic fluids from 6 to 17 weeks of gestation. With advancing gestation, percentages of AFP-C1, AFP-P4 and AFP-P5 decreased and AFP-L2, AFP-P3f, AFP-A1, and AFP-A1 s disappeared by the end of 18 weeks. The glycoforms of serum AFP of the yolk sac tumor resembled those of amniotic fluid AFP in the early gestational stages.

Amniotic Fluid↗
PubMed1996

Interleukin-6, interferon-gamma, interleukin-8, and granulocyte-macrophage colony stimulating factor levels in human amniotic fluid at term.

Cytokines contribute to the maintenance of successful pregnancy and have also been implicated in the initiation of labour. This study has examined those cytokines which may be involved in normal term parturition. IL-6, IFN-gamma, IL-8 and GM-CSF levels were measured by ELISA in samples of amniotic fluid, peripheral and uterine venous blood plasma, and umbilical artery blood plasma from non-labouring women undergoing elective caesarean section at term and from women in spontaneous labour. IFN-gamma and IL-6 were detected only in amniotic fluid and not in blood plasma samples, unlike IL-8 which was found in all amniotic fluid and plasma samples from both labouring and non-labouring women; GM-CSF was undetectable in all samples examined. Levels of IL-6 were significantly raised in the amniotic fluid of women in labour compared with the control group (P = 0.008). IFN-gamma was detected in the amniotic fluid of both labouring women and the control group, and there was also a significant correlation (P = 0.003) between IFN-gamma and IL-6 levels in individual amniotic fluid samples. The presence of both IFN-gamma and IL-8 in amniotic fluid, as well as IL-6, suggests these cytokines are involved in important immunobiological events relevant to the latter half of gestation.

Adult↗
PubMed1997

Daily changes in plasma and amniotic fluid prolactin during the last third of pregnancy in the baboon.

Alterations in plasma and amniotic fluid prolactin (PRL) levels have not been previously described in the pregnant baboon. In addition, PRL increases dramatically in response to estrogens and thus might be a good marker for expression of estrogen's biologic action. Therefore, the purpose of this study was to characterize the changes in plasma and amniotic fluid PRL with advancing gestational age and assess whether there was a correlation between plasma estradiol and PRL levels. A tethered pregnant baboon model was utilized for these studies. Blood was collected from five animals every day at 0900-1000 h (AM value) and 1800 h (PM value) from 125 to 135 days of pregnancy until delivery. Amniotic fluid was collected every day in the morning. Samples were analyzed by RIA for PRL, estradiol, and progesterone. PRL did not change with advancing gestational age. However, PRL showed a significant diurnal variation, with the PM values significantly higher (p < 0.05) than the AM values. In contrast to findings for PRL, AM values for estradiol and progesterone were on average higher that PM values (p < 0.05). A significant correlation was observed between the log10 estradiol (AM+PM) and log10 PRL (AM) from the following day (r = 0.52; p < 0.05). Finally, amniotic fluid PRL was present in high concentrations (200-400 ng/ml) but did not vary with gestational age. In conclusion, PRL, estradiol, and progesterone show distinct diurnal variations during the last one-third of pregnancy in the baboon. In addition, plasma PRL is positively correlated with estradiol.

Amniotic Fluid↗
PubMed2005

The effect of short-term indomethacin therapy on amniotic fluid volume.

OBJECTIVE: The purpose of this study was to determine the effect of short-term (48 hour) indomethacin therapy on amniotic fluid volume. STUDY DESIGN: Patients who were admitted to Northwestern Memorial Hospital in preterm labor and who received indomethacin tocolysis were eligible for the study. Thirty-five patients with singleton gestations and 26 patients with twin gestations were enrolled. Amniotic fluid volumes were measured at baseline, at 48 hours after the initiation of indomethacin, and then every 24 hours thereafter for a maximum of 7 days. RESULTS: There were no significant changes in mean amniotic fluid volume subsequent to the administration of indomethacin at any of the time points that were measured. Among the 61 patients who received indomethacin, there were 2 cases of oligohydramnios (3.3%; 95% CI, 0.03%, 11.3%). In both cases, the amniotic fluid index returned to normal within 24 hours after the discontinuation of indomethacin. CONCLUSION: Short-term indomethacin therapy, in either singleton or twin gestations, does not cause a clinically significant change in amniotic fluid volume.

Amniotic Fluid↗
PubMed1987

Gamma-glutamyl transferase activity in the amniotic fluid of fetuses with chromosomal aberrations and inborn errors of metabolism.

The activity of gamma-glutamyl transferase (GGT) was measured in amniotic fluid collected between the 16th and 30th weeks of gestation from 81 pregnancies with fetuses affected by chromosomal aberrations, nine with different types of inborn errors of metabolism, two with hemophilia A and one with fragile X syndrome. The GGT activity was compared with that from 1000 normal pregnancies and deliveries resulting in healthy newborns. Contamination of amniotic fluid by blood did not affect the GGT activity. Pathologically decreased activity was found in 25 of 56 amniotic samples from pregnancies with fetal autosomal chromosomal aberrations (44.6%). It was decreased in 15 of 35 pregnancies with fetal trisomy 21 (43%), in 11 of 19 pregnancies with fetal trisomy 18 (58%), in one of three pregnancies with fetal trisomy 13 and in two pregnancies with fetal trisomy 8 and triploidy, respectively. In only three of 16 pregnancies with fetal sex chromosomal aberrations was the GGT activity low. Increased GGT activity was found in three of six pregnancies with unbalanced structurally rearranged karyotypes of the fetuses. Normal GGT activity was observed in all nine amniotic fluid samples from pregnancies with fetuses affected with different forms of inborn errors of metabolism diseases, in the two pregnancies with hemophilia A and in the pregnancy with a male fetus with fragile X syndrome. These and earlier findings indicate that the GGT activity in amniotic fluid is mostly decreased in pregnancies with severe fetal developmental abnormalities, such as autosomal chromosomal aberrations, which could possibly be secondary to an alteration of the microvillar transport system of GGT to the amniotic fluid.(ABSTRACT TRUNCATED AT 250 WORDS)

Amniotic Fluid↗
PubMed1980

Amniotic fluid alpha-fetoprotein in fetal obstructive uropathy.

Amniotic fluid alpha-fetoprotein has been associated with various congenital anomalies. A diagnosis in utero of urinary obstruction associated with elevated alpha-fetoprotein is reported. Subsequent fulguration of type I posterior urethral valves was done. A possible mechanism for elevated alpha-fetoprotein with obstructive uropathy in utero is discussed. Pediatrics 66:537-539, 1980; alpha-fetoprotein, amniotic fluid, obstructive uropathy, posterior urethral valves, polyhydramnios.

Adult↗
PubMed1985

Zinc concentration in amniotic fluid of zinc-deficient rats and its relation to fetal weight.

Zinc concentration in amniotic fluid and its relation to fetal weight were investigated in three groups of pregnant rats: group A received a zinc-adequate diet, and the rats of groups B and C were fed a zinc-deficient diet. Group C also received zinc supplementation in water. The daily food consumption, weight and plasma zinc levels on days 1, 10 and 20, zinc concentration in amniotic fluid, the number of implantation sites, the number of resorptions, the number of live fetuses and fetal weight were determined. Plasma zinc concentrations were significantly different at the end of gestation between group B (Zn = 167.6 +/- 26.6 micrograms/dl) and the other two groups (group A = 199 +/- 18.6 micrograms/dl; group C = 204 +/- 13.7 micrograms/dl). The number of resorptions was significantly higher in group B and the number of live fetuses was significantly lower in this same group (p less than 0.025). Fetal weight was significantly lower in group B (p less than 0.001). The zinc concentrations of the amniotic fluid were significantly lower in group B (14 +/- 4.7 micrograms/dl) as compared to group A (83 +/- 11.4 micrograms/dl) and C (82 +/- 21 micrograms/dl; p less than 0.001). There was a positive linear correlation between zinc concentrations in amniotic fluid and fetal weight, being r: 0.7379 (p less than 0.001).

Amniotic Fluid↗
PubMed1995

[Study of amniotic fluid bacterial colonization sampled by amniocentesis in cases with premature rupture of membranes. Prospective multicenter study].

OBJECTIVE: To determine the relationship between bacterial colonization of the amniotic fluid sampled by amniocentesis and premature rupture of the membranes. METHODS: A prospective multicentric study conducted over a one year period in 6 maternity wards in the suburban area of Paris. Thirty-six women with premature rupture of the membranes were studied. RESULTS: There were 11 patients (30%) with contaminated fluid at the first amniocentesis. Twenty-five patients had sterile fluid. In 7 patients with prolonged rupture for more than one week, repeated amniocentesis. Twenty-five patients had sterile fluid. In 7 patients with prolonged rupture for more than one week, repeated amniocenteses were used to follow bacterial colonization. In one patient, Proteus mirabilis in the amniotic fluid was eradicated by adapted antibiotic therapy. In patients with sterile amniotic fluid, there was no secondary colonization. In the 11 cases with colonized liquid, the vaginal swab could only be considered as positive in 4 cases. Amniocentesis was able to discover 7 bacterial colonizations of the amniotic fluid in patients with an indeterminant vaginal swab. Likewise, C-reactive protein levels were raised only in 26% of the cases with a colonized amniotic fluid.

Amniocentesis↗
PubMed1987

Umbilical cord size and amniotic fluid volume in prolonged pregnancy.

Expectant management of prolonged pregnancy is predicated on reassuring biophysical testing. However, even the combination of a reactive nonstress test and normal amniotic fluid volume may not prevent subsequent morbidity. To test the hypothesis that diminished cord Wharton's jelly incurs risk of peripartum cord compression in addition to decreased amniotic fluid, 68 patients with confirmed gestational age greater than or equal to 41 weeks were evaluated prospectively with semiweekly nonstress tests and weekly ultrasound examinations. Amniotic fluid volume was assessed, and umbilical cord diameter was measured and then correlated with the quantity of Wharton's jelly at delivery, determined by cord circumference. A significant correlation between cord circumference and umbilical cord diameter was observed, even in those patients with decreased amniotic fluid volume. Either an amniotic fluid volume less than 3.8 cm or an umbilical cord diameter less than 1.6 cm was associated with significant cord compression patterns. Peripartum morbidity was greatest in the presence of a smaller cord and decreased fluid, suggesting a synergism between these two factors for the risk of cord compression in prolonged pregnancy.

Amniotic Fluid↗
PubMed1993

Amniotic fluid insulin values in women with gestational diabetes as a predictor of emerging diabetes mellitus.

Amniotic fluid insulin levels were estimated in 30 women with insulin-dependent diabetes, 216 with gestational diabetes and 27 with normal glucose tolerance. Results were correlated with birth-weight, incidences of fetal macrosomia and neonatal hypoglycaemia, and the risk of the mothers with gestational diabetes developing diabetes mellitus on follow-up. The women with prepregnancy diabetes had significantly higher amniotic fluid insulin values and showed a significant correlation between raised liquor insulin values (> 97th percentile) and hypoglycaemia in the infant (p = 0.039). In the gestational diabetic pregnancies there were highly significant associations between elevated liquor insulin values and macrosomia (p < 0.0045) and birth-weight (p < 0.00004), and a weak correlation with neonatal blood glucose levels (p = 0.042). Women with gestational diabetes who later developed permanent diabetes mellitus had higher mean amniotic fluid insulin levels than those whose glucose tolerance remained normal on follow-up (p < or = 0.0072) and more of them had a level greater than the 97th percentile than those whose glucose tolerance remained normal (odds ratio 6.48, 95% confidence interval 1.51-27.8, p = 0.0094). However a high amniotic fluid insulin level was of less clinical value for detection of women destined to develop diabetes (7 of 25, 28%) than was the need for insulin therapy during pregnancy (18 of 39, 46%).

Amniotic Fluid↗
PubMed1980

The implications of detecting an extra metacentric microchromosome on amniotic fluid cell culture.

A patient was referred for amniotic fluid cell culture because of advanced maternal age. A decisional dilemma presented itself as a result of the detection of a metacentric bisatellited microchromosome (47,XX + marker) in the amniotic fluid cell culture. The decision whether to terminate the pregnancy had to be considered because the literature revealed a number of cases of an extra marker in patients with single or multiple congenital abnormalities, although other patients with a similar marker were phenotypically completely normal. The finding of an identical marker chromosome in the phenotypically normal mother and two of her off-spring favoured the continuation of the pregnancy. It would appear as if this is the first reported case in which a familial marker chromosome was detected prenatally and the pregnancy permitted to continue to term with the birth of a normal infant.

Adult↗
PubMed1997

Three-dimensional method for determination of amniotic fluid volume in intrauterine pockets.

BACKGROUND: Although current ultrasound techniques provide a linear (amniotic fluid index; AFI) or two-dimensional area index of amniotic fluid (AF), these indices have limited correlation with actual AF volume. We sought to quantify the three-dimensional volume of ultrasound-identified AF pockets, as assessed by the AFI and two-dimensional area methods. The BVI 2500 (Bladder Volume Instrument 2500; Diagnostic Ultrasound Corp., Redmond, WA) has been used to quantify the volume of residual urine in the bladder. INSTRUMENT AND METHOD: The BVI 2500 (Diagnostic Ultrasound Corp.) ultrasound uses a rotating 2-MHz transducer, computer-defined fluid interface, and computer integration of 12 cross-sectional images to calculate three-dimensional fluid volume. After providing written informed consent, 14 term pregnant patients (36-42 weeks) were evaluated using the BVI 2500 and an Ultramark 8 sector scan (Advanced Technology Laboratory, Bothell, WA). The largest vertical fluid pocket in each quadrant of the abdomen was identified with the sector scan, and vertical and horizontal measurements for AFI and two-dimensional area were recorded. Simultaneous AF volume measurements of each pocket were performed three times with the bladder volume instrument, and maximum values were used. Three-dimensional volume, two-dimensional area, and AFI values were compared by correlation analysis, with P < or = .05 considered statistically significant. EXPERIENCE: Among all patients, the average (+/- standard deviation) AFI was 7.6 +/- 4.1 (range 1.5-16.4) cm, and the average two-dimensional area was 30.9 +/- 21.1 (range 4.3-81.3) cm2. This corresponded to an average three-dimensional volume of 215 +/- 134 (range 23-497) cm3. Three-dimensional volume correlated highly with both AFI (r = 0.9; P < .001) and two-dimensional area (r = 0.86; P < .001). One AFI centimeter was equivalent to a volume of 30 cm3. CONCLUSION: There are highly significant linear correlations of three-dimensional amniotic fluid volumes with AFI and two-dimensional area. The four pockets used in AFI determination account for only 50% of total AF volume. Three-dimensional determinations may aid in clinical assessments of AF volume.

Adult↗
PubMed1984

Vasopressin concentration in amniotic fluid as an index of fetal hypoxia: mechanism of release in sheep.

Hypoxia is a potent stimulus to the release of vasopressin in fetal sheep, and plasma concentrations of the hormone correlate inversely with fetal oxygenation. Since the fetal kidney contributes to vasopressin clearance, we propose that measurement of increased amounts of vasopressin in amniotic fluid would be indicative of fetal hypoxia. Therefore, we measured concentrations of vasopressin in amniotic fluid under resting conditions, during and after fetal hypoxia, and with intravenous and intra-amniotic administration of vasopressin in 15 chronically instrumented fetal lambs between 111 and 141 days gestation. In the resting state, mean (+/- SE) vasopressin concentrations in amniotic fluid (1.6 +/- 0.3 pg ml-1) did not differ from those in maternal (1.4 +/- 0.4 pg ml-1) or fetal (1.8 +/- 0.2 pg ml-1) plasma. Following exposure of the ewe to 10% O2 or partial occlusion of the umbilical cord, vasopressin concentrations in fetal plasma increased significantly (P less than 0.001) to 200 +/- 59 pg ml-1 with a delayed increase in amniotic fluid concentrations (P less than 0.03) to 15.8 +/- 4.5 pg ml-1. This rise in concentration of vasopressin in amniotic fluid was sustained for at least 24 h and levels at that time were highly correlated with peak plasma concentrations (r = 0.83; P less than 0.001). Intravenous infusion of vasopressin into the fetus was accompanied by an equally significant (P less than 0.02) and sustained increase of vasopressin in amniotic fluid. Following intra-amniotic injection of vasopressin, levels remained increased for at least 24 h.(ABSTRACT TRUNCATED AT 250 WORDS)

Amniotic Fluid↗
PubMed1998

Amniotic fluid prolactin is decreased by experimental intrauterine infection or interleukin-1beta infusion but not via prostaglandins in pregnant rhesus macaques.

Amniotic fluid contains a high concentration of prolactin produced and secreted by the decidua. In vitro models have suggested that bacterial products inhibit prolactin secretion by decidual cells. To further examine this potentially important regulatory mechanism in the whole animal, chronically instrumented pregnant rhesus monkeys were prepared. Experimental infection was induced by intraamniotic or choriodecidual inoculation of 10(3)-10(6) group B streptococcus. Alternatively, interleukin (IL)-1beta was infused into the amniotic cavity. Finally, indomethacin was coadministered with IL-1beta to block the production of prostaglandins (PGs). The average prolactin level prior to inoculation (0 h) equaled 34.0 +/- 6.4 microg/ml. There was a 40% decrease in prolactin by 37 h postinfection (n = 6) and a 71% decrease between 61 and 72 h postinfection (n = 3, p < 0.01 vs. before infection). Infusion of IL-1beta also caused a decrease in amniotic fluid prolactin. There was a 42% decrease in prolactin between 0 and 24 h postinfusion (p < 0.05) and a 66% decrease between 25 and 72 h after IL-1beta infusion (p < 0.05; n = 6). Coadministration of indomethacin with IL-1beta prevented the accompanying increase in PGs but did not prevent the decrease in prolactin (n = 5). Amniotic fluid prolactin levels in untreated monkeys were stable and without a prepartum decline during the sampling period from 130 to 166 days of gestation. In summary, intrauterine bacterial infection decreases amniotic fluid prolactin, and IL-1beta mimics this effect. The effect of IL-1beta on amniotic fluid prolactin does not appear to be mediated by PGs and may involve a direct effect of IL-1beta on decidual cells.

Amnion↗
PubMed1976

Role of fetal deglutition and micturition in the production and turnover of amniotic fluid in the monkey.

In order to determine the precise role played by the absence of fetal swallowing or urine contribution in the disposal and production of amniotic fluid, we surgically occluded the fetal esophagus in 5 monkeys and the urethra in 2 monkeys. The amniotic fluid volume was then measured daily with an indicator dilution technic. Sham operations were performed on 3 monkeys of similar gestational age. It was found that in late pregnancy failure of fetal deglutition resulted in transient hydramnios which appeared to be followed by a readjustment in water exchange rates in other pathways by which the amniotic fluid volume returned to normal range. In midpregnancy fetal deglutition seems to have no appreciable effect upon the amniotic fluid volume. Diversion of fetal urine, however, appeared to result in a persistent decrease in the volume of the amniotic fluid.

Amniotic Fluid↗
PubMed1990

Amniotic fluid lysozyme activity in fetal distress.

Lysozyme activity was measured in amniotic fluid samples from 90 pregnant women with gestational age ranging from 30 to 41 weeks. Twenty-nine samples were from high-risk subjects with different pathologies and signs of fetal distress. The control group consisted of 20 normal and 41 pathological pregnant women, whose disorders included Rh isoimmunization, diabetes, systemic arterial hypertension and pre-eclampsia without signs of fetal distress. Amniotic fluid lysozyme levels in normal controls were similar to those detected in abnormal pregnant women without signs of fetal distress (means = 156.0 vs 131.8 micrograms/ml for 34-37 weeks of gestation), with a tendency toward higher values as pregnancy progressed to term (means = 182.1 vs 155.4 micrograms/ml for 38-41 weeks of gestation). Lysozyme levels were significantly lower in high-risk pregnant women with signs of fetal distress, regardless of neonate birth weight, than in subjects showing no such signs (means = 40.3 and means = 25.4 micrograms/ml at 34-37 and 38-41 weeks of gestation, respectively). These data support the possibility of using amniotic fluid lysozyme activity levels as an indicator of fetal distress.

Amniotic Fluid↗
PubMed1991

Amniotic fluid N-acetyl-beta-D-glucosaminidase activity and renal abnormalities.

Amniotic fluid N-acetyl-beta-D-glucosaminidase (NAG) activity was measured in 21 normal pregnancies to determine reference values, and in 10 pregnancies with fetuses who had prenatally recognised renal and urinary tract malformations. The normal values obtained at 17-19 and 28-31 gestational weeks did not differ, and an activity of 105 units NAG/mmol creatinine was the upper limit of the normal range. Raised NAG activities were found in four fetuses with oligohydramnios and severe bilateral renal disease, and also in two infants with a normal amount of amniotic fluid, only unilateral renal lesions, and a normal renal function after birth. Three of four cases with normal NAG activities had malformations without kidney damage, but one baby with prune belly syndrome was subsequently found to have dysplastic kidneys and renal failure. Our preliminary results suggest that a high level of NAG activity in the amniotic fluid indicates unilateral or bilateral kidney damage but is not proof of intrauterine renal failure.

Acetylglucosaminidase↗