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PubMed1981

Changes in the concentration of somatomedin-like activity in amniotic fluid and maternal plasma from rhesus monkeys during the last third of gestation.

Somatomedin-like activity (SLA) was measured in serial samples of amniotic fluid and maternal plasma from Rhesus monkeys (Macaca mulatta) using the porcine costal cartilage disc bioassay. Samples of both amniotic fluid and maternal plasma gave dose response curves which were parallel to the human plasma standard. Concentrations of SLA were consistently lower in amniotic fluid (0.42 +/- 0.02, mean +/- S.E.M., units/ml, n = 33) than in maternal plasma (0.60 +/- 0.03 units/ml, n = 31). No significant changes in concentrations of SLA with gestational age were found during the period studied (90-170 days of pregnancy). The presence of SLA in amniotic fluid is consistent with the possibility that somatomedin plays a role in the control of foetal or placental growth in the primate.

Amniotic Fluid↗
PubMed1991

Human chorionic gonadotrophin and alpha-fetoprotein levels in matched samples of amniotic fluid, extraembryonic coelomic fluid, and maternal serum in the first trimester of pregnancy.

Separately identified samples of amniotic fluid and extraembryonic coelomic fluid obtained by high resolution transvaginal ultrasound-guided amniocentesis from 32 women between 7 and 12 weeks of pregnancy were analysed for human chorionic gonadotrophin (hCG) and alpha-fetoprotein (AFP). There was a highly significant difference between the hCG levels in amniotic fluid (median level 6.3 U/ml; range 1.6-310.0 U/ml) and those in extraembryonic coelomic fluid (median level 400.0 U/ml; range 135.0-2250.0 U/ml) (p less than 0.001; Mann-Whitney U-test). The levels of AFP were very similar in amniotic fluid (median 26.0 kU/ml; range 10.0-116.5 kU/ml) and extraembryonic coelomic fluid (median level 24.1 kU/ml; range 12.4-94.4 kU/ml).

Abortion, Therapeutic↗
PubMed1982

Prenatal diagnosis of Duchenne muscular dystrophy: failure of amniotic fluid and maternal serum N tau-methylhistidine analyses to detect affected fetuses.

N tau-Methylhistidine (MH) and creatinine levels were determined in amniotic fluid and maternal serum from 81 women undergoing midtrimester amniocentesis for reasons other than the diagnosis of neuromuscular disease. Samples were also examined in three pregnancies with male fetuses who were subsequently found to have Duchenne muscular dystrophy (DMD). Between 16 and 20 weeks' gestation, amniotic fluid and maternal serum MH levels averaged 3.22 and 1.94 mumoles/L, respectively. No significant differences were found between the control and affected fetuses for MH and creatinine levels or for MH/creatinine ratios from amniotic fluid or maternal serum. Determination of amniotic fluid MH level thus has no apparent value in the prenatal diagnosis of DMD.

Amniotic Fluid↗
PubMed2006

Reduced nitric oxide in amniotic fluid of patients with chorioamnionitis.

OBJECTIVE: Levels of nitric oxide (NO) and cytokines were assessed in amniotic fluid obtained from patients with severe chorioamnionitis (CAM) and appropriate controls. METHODS: Amniotic fluid was obtained from 12 patients with CAM (17-24 weeks of gestation) and 89 patients undergoing diagnostic amniocentesis (16-18 weeks of gestation). The concentrations of NO, interleukin-6 (IL-6), and leukocyte elastase (LE) in amniotic fluid were then measured and compared. RESULTS: The concentrations of NO, IL-6, and LE were all higher in CAM cases than in normal pregnant women. Furthermore, an inverse correlation between NO and LE was suggested in the CAM group. CONCLUSIONS: These results indicate that in severe CAM, the action of NO might be reduced, not only due to blockage of action but also by degradation, despite increased production.

Amniocentesis↗
PubMed1988

[Results of prenatal amniotic fluid diagnosis in suspected hemolytic disease of newborn].

759 amniotic fluid samples have been examined spectrophotometrically according to Liley and chemically for bilirubin from 286 patients with suspicion of morbus haemolyticus fetalis. The results obtained, gave the following findings for the procedure of Liley: sensitivity 75.0 per cent, specivity 96.5 per cent, accuracy 85.3 per cent, predictive value of positive test 95.6 per cent and predictive value of negative test 79.1 per cent and for the chemical test respectively: 88.2 per cent, 81.7 per cent, 85.0 per cent, 83.0 per cent and 87.2 per cent. A pathological delta E value is suspect of a serious erythroblastosis. But a serious morbus haemolyticus fetalis may be excluded with higher likelihood by concentration of bilirubin chemically determined below the pathological range then by correlated values of delta E. Finally we conclude that two different methods for amniotic fluid diagnostic are of higher predictability.

Amniocentesis↗
PubMed1985

Mutagenesis assays of human amniotic fluid.

Extracts of amniocentesis samples from 144 women were tested for the presence of mutagenic substances using tester strain TA1538 in the Ames Salmonella/mammalian-microsome mutagenicity test. Because the volume of amniotic fluid in these samples was limited (generally less than 10 ml), we investigated modifications of this mutagenesis assay that could increase its ability to detect effects from small quantities of test material. Using mutagenicity in samples of urine from smokers as a model, it appeared that improved ability to detect small amounts of mutagen could be obtained by reducing volumes of media and reagents while keeping the amount of test sample constant. This modification resulted in a test procedure capable of readily detecting mutagenicity in volumes of urine from smokers that were smaller than the volumes of amniotic fluid available. Tests of amniotic fluid extracts by this modified procedure showed small increases in revertants, about 50% above dimethylsulfoxide solvent control values. Results of procedures to control for technical factors possibly contributing to these increases suggested that the increased values could not be readily explained by contamination of test samples with mutagens during the extraction procedure. They also were not explained by alterations in spontaneous numbers of revertants associated with changes in the density of bacterial lawn growth. The increases suggest the presence of small amounts of mutagenic material in many of the amniotic fluid samples. At the doses employed, mutagenic activity in these samples was not associated with maternal smoking.

Amniotic Fluid↗
PubMed2001

[Prenatal evaluation of fetal lung maturity by determination of phosphatidylglycerol (PG) concentration in amniotic fluid].

Phosphatidylglycerol (PG) is considered to be the most important phospholipid of lung surfactant, responsible for its biological activity. The aim of the study was to investigate the predictive value of phosphatidylglycerol (PG) concentration in amniotic fluid in prediction of neonatal lung maturity. The study was carried out on 180 pregnant women, chosen by random selection, hospitalized in Polish Mother's Health Centre Hospital in the period from 15.06.1994 to 31.12.1995. 223 samples of amniotic fluid were tested--phosphatidylglycerol (PG) concentration was assayed by immunological test Amnio Stat FLM. In the study value PG < or = 0.2 microgram/ml was found in 110 (49.3%) samples of amniotic fluid, PG = 0.5 microgram/ml in 57 (25.6%) and PG > or = 2.0 micrograms/ml in 56 (25.1%). In our research predictive value of PG in relation to clinical lung maturity of neonates was verified. It turned out that PG concentration in amniotic fluid < or = 0.2 microgram/ml indicates a possibility of RDS occurring in neonates born before 72 hours of performed determination. Concentration PG in amniotic fluid PG > or = 2.0 micrograms/ml corresponds to complete clinical lung maturity of neonates with predictive value 98%.

Adult↗
PubMed1993

Stable microbubble test for predicting the risk of respiratory distress syndrome: II. Prospective evaluation of the test on amniotic fluid and gastric aspirate.

We determined prospectively if the stable microbubble (SM) test on gastric aspirate obtained at birth was as useful as that on amniotic fluid in predicting respiratory distress syndrome (RDS). One hundred and five paired samples of amniotic fluid obtained at delivery from 105 consecutive women with gestation of 35 weeks or less and gastric aspirates from their neonates obtained within 30 min of birth were studied. The SM test with the predefined cut-off value of less than 5 bubbles/mm2 for amniotic fluid and less than 10 bubbles/mm2 for gastric aspirate signified the risk of RDS with the positive predictive value of 100% and 96% and with the negative predictive value of 91% and 84%, respectively. We conclude that the SM test on both amniotic fluid and gastric aspirate obtained at birth is a rapid (< 10 min), simple and reliable procedure for predicting neonates who will develop RDS. It may be used as a bedside test to define a population of neonates with surfactant deficiency in clinical trials of prophylactic surfactant therapy.

Amniotic Fluid↗
PubMed1983

Alkaline phosphatase activity in amniotic fluid in pregnancies with fetal disorders.

Alkaline phosphatase (ALP) activity was determined in 255 amniotic fluid samples collected by amniocentesis between 15 and 39 weeks of gestation. The samples were originally used for chromosomal analysis and/or alpha-fetoprotein measurements. The mean ALP activity in early amniotic fluid from pregnancies with fetal trisomy 18 and 21 syndromes was half of that found in the controls. Highly elevated ALP activity (over 10 times the median level) was found in 14 samples. Two of these pregnancies had normal outcome. Three samples were from pregnancies with intrauterine fetal death. Fetal disorders, including abdominal wall defect (four cases), Meckel's syndrome (two), hydrops fetalis syndrome (two) and genital anomaly (one), were observed in nine cases. Moderately elevated ALP activity (over three times the median) was found in 10 cases, including five pregnancies with a preterm labour shortly after the sample collection. The results indicate that elevated ALP activity in the third trimester amniotic fluid is often associated with fetal disorders.

Alkaline Phosphatase↗
PubMed1985

Alpha-fetoprotein subfractions in amniotic fluid identified by a modification of the method of concanavalin A, lentil lectin or phytohemagglutinin-E affinity crossed-line immunoelectrophoresis.

Using a modified method of concanavalin A (Con A), lentil lectin (LCH) or phytohemagglutinin-E (PHA-E) affinity crossed-line immunoelectrophoresis, alpha-fetoprotein (AFP) subfractions were studied in 33 samples of human amniotic fluid obtained between 41 and 287 days of gestation. Fetal tissues (yolk sac, liver, stomach and small intestine) obtained from a fetus of 68 days' gestation were incubated for 24 hours and AFP subfractions in the culture fluid examined. AFP in control amniotic fluids yielded two subfractions (types a and b) with Con A, three subfractions (types A, B and C) with LCH, and four subfractions (types W, X, Y and Z) with PHA-E. Serial changes of AFP subfractions in the amniotic fluid, as well as in the incubation study, indicated that the yolk sac and the gastrointestinal tract were responsible for the production of the Con A non-reactive subfraction (type b), the LCH weakly-reactive subfraction (type B) and the PHA-E reactive subfraction (types W and X), at an early stage of gestation. The Con A reactive subfraction (type a), LCH reactive subfraction (type A), PHA-E weakly-reactive subfraction (type Y) and PHA-E non-reactive subfraction (type Z) were assumed to be produced mainly by yolk sac, liver or gastrointestinal tract. We also found that the LCH non-reactive subfraction (type C) was synthesized either by liver or by the gastrointestinal tract at an early stage of gestation. At term, type a of Con A, type C of LCH and types Y and Z of PHA-E were the main subfractions in amniotic fluid, assumed to be produced by the fetal liver.

Amniotic Fluid↗
PubMed1975

Amniotic fluid macrophages and the antenatal diagnosis of anencephaly and spina bifida.

The macrophage content of amniotic fluid has been measured and the upper limit of normal on an arbitrary scale is 41. Amongst 65 amniotic fluids collected for antenatal diagnostic studies before 22weeks' gestation there were eight which had macrophage counts ranging from 82 to 6226,three of these were shown to have anencephaly and two spina bifida. The reasons for three apparently false positives are as yet undetermined. Rhesus iso-immunized amniotic fluids were found to have macrophage counts of up to 276 and a possible explanation for this is considered. It is argued that an elevated aminotic fluid macrophage count may indicate a CNS defect or possibly other fetal abnormality.

Amniocentesis↗
PubMed1981

Concanavalin A binding of alpha-fetoprotein in amniotic fluid as an aid in the diagnosis of neural tube defects.

Concanavalin A nonreactive alpha-fetoprotein was determined in samples of amniotic fluid from 16 abnormal pregnancies complicated by anencephaly (7), open spina bifida (6), intra-uterine death (1), anencephaly with exomphalos (1), or open spina bifida with exomphalos (1), and in amniotic fluid from 50 normal pregnancies with gestational age between 13 and 24 weeks. In all 16 cases with fetal malformations, the proportion of nonreactive alpha-fetoprotein was significantly decreased (median 5.3%) as compared with amniotic fluid from pregnancies with a normal outcome (median 39.7%). The results confirm that this measurement is useful in the diagnosis of neural tube defects, especially when the concentration of alpha-fetoprotein in amniotic fluid is normal or only slightly above normal and gestational age is uncertain.

Amniotic Fluid↗
PubMed2003

Racial disparity in meconium-stained amniotic fluid and meconium aspiration syndrome in the United States, 1989-2000.

OBJECTIVE: To estimate the prevalence of meconium-stained amniotic fluid and meconium aspiration syndrome, as well as the differences in case fatality from meconium aspiration syndrome, between non-Hispanic black and non-Hispanic white infants. METHODS: We studied non-Hispanic black and non-Hispanic white live births with weights greater than 2.5 kg and gestational ages greater than 35 weeks, using the linked US birth and infant death cohorts for three periods: 1989-1991, 1995-1997, and 1998-2000. We used logistic regression to estimate the risks of meconium-stained amniotic fluid and meconium aspiration syndrome and to estimate the case fatality of meconium aspiration syndrome by maternal race, birth weight, period, and pregnancy complications. RESULTS: Risk of meconium-stained amniotic fluid was 80% higher in non-Hispanic blacks when compared with non-Hispanic whites (birth weight-adjusted odds ratio [OR], 1.81, 95% confidence interval [CI] 1.80, 1.82). The prevalence of pregnancy complications did not explain this racial disparity. Risk of meconium aspiration syndrome in non-Hispanic blacks was 67% higher when compared with non-Hispanic whites (birth weight-adjusted OR 1.67, 95% CI 1.64, 1.70). The case fatality rate of meconium aspiration syndrome was similar between non-Hispanic blacks and non-Hispanic whites in the three periods, with rates of 15.5, 15.2, and 11.2 per 1000 in non-Hispanic blacks and 13.5, 11.2, and 10.1 per 1000 in non-Hispanic whites in 1989-1991, 1995-1997, and 1998-2000, respectively. CONCLUSION: Our results suggest that when compared with non-Hispanic whites, non-Hispanic blacks are at significantly greater risk for meconium-stained amniotic fluid and meconium aspiration syndrome but not for meconium aspiration syndrome case fatality.

Amniotic Fluid↗
PubMedDate not supplied

Amniotic fluid glucose and cytokines values in the early diagnosis of amniotic infection in patients with preterm labor and intact membranes.

OBJECTIVE: Our goal was to compare sensitivity, specificity, and predictive values of glucose and cytokines [interleukin-1 (IL-1), interleukin-6 (IL-6), interleukin-8 (IL-8), and tumor necrosis factor (TNF)] in amniotic fluid (AF) to detect an AF-positive culture. METHODS: Amniocentesis was performed on 113 patients with preterm labour (PTL) and intact membranes. Fluid was cultured for aerobic and anaerobic bacteria, and for mycoplasmas. AF analysis included cytokines and glucose determinations. RESULTS: The prevalence of positive AF cultures was 11.5% (13/113). Anaerobic bacteria were isolated in 9 patients (69.2%). The glucose <16 mg/dl and cytokines values; IL-1 >640 pg/ml, IL-6 >55,000 pg/ml, IL-8 >1,000 pg/ml, TNF >672 pg/ml, were significantly correlated (P < 0.01) with AF culture result. Glucose had a sensitivity of 69.2% and a specificity of 96% for the prediction of positive AF culture. The sensitivity and specificity of the cytokines ranged from 61.5-53.4% and 79.8-8.99%, respectively. CONCLUSIONS: In the diagnosis of the AF-positive culture, glucose <16 mg/dl is more sensitive than cytokines.

Amniocentesis↗
PubMed1989

Total complement activity in maternal sera, amniotic fluids and cord sera in women with premature labor, premature rupture of membranes or chorioamnionitis.

Total hemolytic complement activity (CH50) was determined in maternal sera, amniotic fluids or cord sera, or all, from 119 patients with preterm uterine contractions, premature rupture of membranes or chorioamnionitis, or all, at 24 to 40 weeks of gestation. The mean CH50 of maternal sera exceeded the mean CH50 of both amniotic fluids and cord sera. The mean CH50 of amniotic fluids exceeded that of cord sera and increased significantly at 32 weeks. This rise preceded that of the mean CH50 of cord sera, which occurred at a fetal weight of approximately 2,500 grams. The mean CH50 of amniotic fluids varied significantly and inversely with that of cord sera. The levels of CH50 in these three fluids did not distinguish between patients with preterm uterine contractions who delivered prematurely and those who delivered at term. The CH50 in patients with premature rupture of membranes did not differ from a control population of women with uncomplicated pregnancies. The mean CH50 of maternal sera was increased in patients with chorioamnionitis but was not predictive of chorioamnionitis. The mean CH50 of maternal sera was decreased in patients who smoked cigarettes and in patients who received intravenous ritodrine.

Amniotic Fluid↗
PubMed1978

Isolation and characterization of a pulmonary glycoprotein from human amniotic fluid.

A glycoprotein of the molecular weight of 36 000 has been isolated from human amniotic fluid. The glycoprotein was found to contain sialic acid, galactose, mannose, fucose, glucosamine, hydroxyproline and relatively high amounts of glycine. End-group analyses resulted in a single NH2-terminal residue indicating that the glycoprotein was homogeneous. The data indicate that this unique collagen-like glycoprotein, which is immunologically identical to a major alveolar glycoprotein found in alveoli of patients with alveolar proteinosis, is also a major protein in the human amniotic fluid. The idea that the pulmonary constituents enter the amniotic fluid cavity during fetal lung development is also confirmed by this report.

Amino Acids↗
PubMedDate not supplied

Glial fibrillary acidic protein in amniotic fluids from pregnancies with fetal neural tube defects.

The glial fibrillary acidic protein (GFAP) is the subunit protein of intermediate filaments in astrocytes and closely related cell types. By means of an enzyme immunoassay we have determined the concentration of GFAP in amniotic fluids from normal pregnancies and from pregnancies complicated by various fetal malformations. The group of 20 cases of fetal anencephaly had a significantly higher mean amniotic fluid GFAP concentration (115 micrograms/l +/- 133.6 (S.D.), range 6-378 micrograms/l) than the control group of 117 normal pregnancies (13 micrograms/l +/- 5.5 (S.D.), range 0-31 micrograms/l), (P less than 0.001). Two cases of fetal encephalocele likewise had very high amniotic fluid GFAP concentrations. None of the other cases of fetal malformations investigated, including 12 cases of spina bifida, had increased amniotic fluid GFAP concentrations. We conclude that determination of the amniotic fluid GFAP concentration may give additional information in the prenatal diagnosis of fetal nervous system malformations.

Amniocentesis↗
PubMed1976

Progesterone levels in amniotic fluid and maternal plasma in prostaglandin F2alpha-induced midtrimester abortion.

Progesterone concentrations in amniotic fluid and maternal plasma were determined in 11 midtrimester pregnant patients following the intraamniotic administration of prostaglandin F2alpha. Samples were obtained at 3-hour intervals until abortion or spontaneous rupture of membranes occurred or fetal heart tones disappeared. In amniotic fluid, the mean progesterone concentrations increased throughout the sampling period. The plasma progesterone levels declined by about one-third of basal values in the first 3 hours after prostaglandin administration. The paradoxic increase in amniotic fluid progesterone is probably secondary to alterations in uterine blood flow and intrauterine pressure.

Abortion, Induced↗