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PubMed1986

Elevated concentrations of the beta-subunit of human chorionic gonadotropin and testosterone in the amniotic fluid of gestations of diabetic mothers.

Hyperplasia of testicular Leydig cells and ovarian theca-lutein cells is a common histologic finding in infants of diabetic mothers. The functional correlates of this histologic finding were investigated by measurement of the beta-subunit of human chorionic gonadotropin, testosterone, dihydrotestosterone, androstenedione, estradiol, and estrone in the amniotic fluid compartment of gestations with male and female fetuses in diabetic mothers (N = 34) and control women (N = 34) at term. When compared with those of control subjects, gestations of diabetic mothers had significantly higher amniotic fluid concentrations of the beta-subunit of human chorionic gonadotropin. Gestations with either male or female fetuses in diabetic mothers had significantly higher amniotic fluid testosterone and dihydrotestosterone levels when compared with those of their respective gender controls. In gestations with male fetuses in diabetic mothers there was a significant positive correlation between the beta-subunit of human chorionic gonadotropin and testosterone. There was no significant difference in amniotic fluid androstenedione, estradiol, or estrone levels between the gestations of diabetic mothers and those of control women. These results suggest that the testicular Leydig cell and ovarian theca-lutein cell hyperplasia seen in infants of diabetic mothers is due, in part, to elevated levels of human chorionic gonadotropin and is associated with elevated testosterone and dihydrotestosterone concentrations in the amniotic fluid.

Amniotic Fluid↗
PubMed2003

C-reactive protein in umbilical cord blood: a simple and widely available clinical method to assess the risk of amniotic fluid infection and funisitis.

OBJECTIVE: The purpose of this study was to determine whether concentrations of C-reactive protein (CRP) in umbilical cord plasma at birth were elevated in neonates with sepsis, an inflammatory lesion of the umbilical cord (funisitis) or who were born to mothers with microbial invasion of the amniotic cavity. METHODS: Umbilical cord plasma was collected at birth from 313 singleton preterm neonates (20-35 weeks of gestation). The results of amniotic fluid culture performed within 5 days of birth, the occurrence of congenital neonatal sepsis and the presence of funisitis were assessed. Amniocentesis was performed in 152 patients within 5 days of birth. Amniotic fluid was cultured for aerobic and anaerobic bacteria and for mycoplasmas. The CRP concentration was measured with a highly sensitive immunoassay. RESULTS: The median cord plasma CRP concentration was significantly higher in neonates with a positive amniotic fluid culture than in those with negative culture (median 245.9 (range 11.6-4885.5) ng/ml vs. median 44.3 (range 2.3-7401.8) ng/ml; p < 0.001), in those with congenital proven sepsis than in those without this complication (median 789.5 (range 20.4-2584.3) ng/ml vs. median 41.5 (range 1.3-7401.8) ng/ml; p < 0.005) and in neonates with funisitis than in those without funisitis (median 403.8 (range 4.9-10897.4) ng/ml vs. median 31.0 (range 1.3-7401.8) ng/ml; p < 0.001). The sensitivity of CRP in the identification of amniotic fluid infection, neonatal sepsis and funisitis was similar to that of interleukin-6 (> 17.5 pg/ml). However, the specificity of CRP in the identification of neonatal sepsis and funisitis was significantly higher than that of interleukin-6 (74% vs. 69%, p < 0.05; 83% vs. 76%, p < 0.01). CONCLUSION: Umbilical cord plasma CRP concentrations were elevated in patients with amniotic fluid infection, congenital neonatal sepsis and funisitis.

Adult↗
PubMed1986

Unconjugated pteridines in amniotic fluid during gestation.

Neopterin and biopterin concentrations were measured in amniotic fluid in 226 pregnancies from the 12th week of gestation to term. At mid-gestation, neopterin and biopterin levels were low and remained relatively constant between 12 and 26 weeks of gestation, whereas during the third trimester, a progressive increase was observed. Near term the values were greater than those in maternal serum and the higher neopterin to biopterin ratio suggested that pteridine concentration in amniotic fluid may reflect the maturation of pteridine metabolism in the fetus.

Amniotic Fluid↗
PubMed1988

Microvillar enzyme assays in amniotic fluid and fetal tissues at different stages of development.

A systematic study of microvillar enzyme activities in the amniotic fluid in correlation with their values in different fetal tissues during development has been undertaken. Microvillar enzymes appeared in the amniotic fluid at the time of disappearance of the anal membrane, 12-13 weeks, and declined from the 18th week until the 24th week. The study of fetal tissues and fluids has shown that gamma-glutamyltranspeptidase is mainly of liver origin. The significant decrease of the activities of these amniotic fluid enzymes has been the basis of prenatal diagnosis of cystic fibrosis. These assays may be useful for the diagnosis of certain digestive tract abnormalities at later stages of pregnancy.

Alkaline Phosphatase↗
PubMed1977

3,3',5'-Triiodothyronine (Reverse T3) in amniotic fluid and cord serum.

3,3',5'-triiodothyronine (reverse T3, rT3) was measured in 122 samples of amniotic fluid obtained between the 29th--40th weeks of gestation, and in the blood of 37 newborn and their mothers. The mean rT3 concentration in amniotic fluid was 0.769 +/- 0.47 ng/ml, with a slight decrease from the 29th--40th weeks of gestation which was not statistically significant. Because of the great scatter of rT3 concentrations in amniotic fluid, its estimation does not seem to be useful in prenatal diagnosis of hypothyroidism. The mean rT3 concentration in cord blood (2.62 ng/ml; range 1.4--4.9 ng/ml) was greatly elevated in comparison to the mean maternal level at delivery (0.34 ng/ml; range 0.08--0.69 ng/ml). The possible use of rT3 measurements in cord blood as a screening test for congenital hypothyroidism is discussed.

Amniotic Fluid↗
PubMed1999

Stromelysins in placental membranes and amniotic fluid with premature rupture of membranes.

OBJECTIVE: To determine the expression and site of production of stromelysins in fetal membranes and to measure stromelysin 1 levels in amniotic fluid and amniochorion culture media. METHODS: Amniochorionic membranes were cultured from organ explant. Membranes were stimulated with lipopolysaccharide for 24 hours after a 48-hour preincubation period. Membranes were also collected from women after vaginal deliveries. RNA samples from those tissues were subjected to reverse transcriptase-polymerase chain reaction using primers specific for stromelysin 1, stromelysin 2, stromelysin 3, and matrilysin. In situ hybridization and immunohistochemistry were used to localize stromelysin mRNA and peptide. Levels of stromelysin 1 in culture media and amniotic fluid collected from women with preterm premature rupture of membranes (PROM) and at term with intact membranes were compared using enzyme-linked immunosorbant assay. RESULTS: Amniochorion in culture and from laboring and nonlaboring women expressed all three stromelysins. In situ hybridization showed stromelysin mRNA in amnion, chorion, and extracellular matrix. Immunohistochemical analysis localized stromelysin 1 protein to those same regions. Amniotic fluid levels of stromelysin 1 were higher in preterm PROM amniotic fluids (median 3.2 ng/mL) compared with term deliveries with intact membranes (median 1.3 ng/mL) (P = .02). Lipopolysaccharide stimulation in culture increased the release of stromelysin 1 from fetal membranes compared with control (median 70.35 versus 15.8 ng/mL, respectively, P = .05). CONCLUSION: Human fetal membranes are a source of stromelysins 1, 2, and 3. Increased stromelysin 1 during preterm PROM and in vitro after lipopolysaccharide stimulation suggests a possible effect of that matrix metalloproteinase in PROM.

Amniotic Fluid↗
PubMed1989

5-Hydroxyeicosatetraenoic acid, leukotriene C4, and prostaglandin F2 alpha in amniotic fluid before and during term and preterm labor.

Arachidonic acid is metabolized by cyclooxygenase leading to prostaglandins and by lipoxygenases leading to hydroxyeicosatetraenoic acids (HETE) and leukotrienes (LT). Prostaglandins are potent uterine constrictors. 5-HETE and LTC4 also stimulate uterine contractions but their role in labor is not known. To estimate the activities of these pathways before parturition and their relationship to uterine contractility, amniotic fluid concentrations of 5-HETE, LTC4, and prostaglandin F2 alpha (PGF2 alpha) were determined in five chronically catheterized rhesus monkeys. Uterine contractility was continually assessed by recording changes in amniotic fluid pressure. The results obtained indicate the following conclusions: (1) 5-HETE and LTC4, but not PGF2 alpha, are associated with uterine contractility after preterm intrauterine surgery. Surprisingly, amniotic fluid PGF2 alpha, levels were nondetectable for 1 to 2 weeks after surgery. (2) 5-HETE and LTC4 are present in higher concentrations than PGF2 alpha in amniotic fluid. (3) 5-HETE, LTC4, and PGF2 alpha all increase with the onset of labor. Amniotic fluid concentrations of 5-HETE and LTC4 are significantly higher than those of PGF2 alpha before and during term and preterm labor. (4) Labor can occur with suppressed PGF2 alpha levels but with increasing 5-HETE and LTC4 levels. (5) These data suggest that 5-HETE and LTC4 are important components of the parturitional process.

Amniotic Fluid↗
PubMed1978

Human fetal respiration. IV. Failure of severe distress to stimulate aspiration of amniotic fluid by the immature human fetus.

Reported herein are studies on fetal breathing, specifically the inhalation of labeled amniotic fluid, by immature human fetuses so severely distressed that they subsequently died in utero. Decreased rather than increased amounts of the amniotic fluid label were found in the lungs of the distressed fetuses compared to the amounts in fetuses of comparable weight that were not distressed. We conclude from this study of the immature human fetus that severe distress depresses rather than stimulates aspiration of amniotic fluid.

Abortion, Induced↗
PubMed1979

Reactivity of amniotic fluid alpha-fetoprotein with concanavallin A in diagnosis of neural tube defects.

Alpha-fetoprotein (AFP) concanavallin-A-affinity molecular variant patterns were determined in amniotic fluid samples from 10 pregnancies complicated by anencephaly (6), spina bifida (1), Turner's syndrome (1), osteogenesis imperfecta congenita (1), and fetal death (1) and 20 normal pregnancies between 14.6 and 25.5 weeks of gestation. With the exception of one anencephalic pregnancy, the AFP concentrations in samples from women with a fetal abnormality were more than 5 SD above normal for gestational age. In every case, however, the proportion of total amniotic fluid AFP that was not reactive with concanavallin A was significantly smaller in the presence of a fetal abnormality (mean 2%) than when the fetus was normal (mean 20%). The results suggest that measuring the amount of concanavallin-A-non-reactive amniotic fluid AFP will be a valuable test for diagnosing fetal abnormality, especially when an increase in total amniotic fluid AFP concentration is equivocal or gestational age is uncertain.

Amniotic Fluid↗
PubMed1994

Immunoreactive tumor necrosis factor-alpha is elevated in maternal plasma but undetected in amniotic fluid in the second trimester.

OBJECTIVE: We investigated the participation of the cellular arm of the immune system in adaptation to pregnancy by assessing plasma and amniotic fluid levels of the cytokine tumor necrosis factor-alpha. STUDY DESIGN: Fifty-five healthy pregnant women who underwent second-trimester genetic amniocentesis at a mean gestational age of 17.0 +/- 1.4 weeks composed study group A. Blood was drawn from each patient before amniocentesis, and an aliquot of amniotic fluid was obtained for this study. Twenty-one healthy patients at a mean gestational age of 35.5 +/- 4.8 weeks composed study group B, and blood was obtained from each patient at an outpatient prenatal visit. Twenty-two healthy, nonpregnant women of reproductive age composed the control group (C). All specimens were stored at -70 degrees C and collectively assayed for tumor necrosis factor-alpha by a specific enzyme-linked immunoassay. RESULTS: All patients in group A had a normal karyotype and all patients in groups A and B had uneventful pregnancies. Tumor necrosis factor-alpha was detected in the plasma of 43 of 55 (78.2%) patients in group A compared with 7 of 21 (33.3%) patients in group B (p < 0.001); tumor necrosis factor-alpha was not detected in any of the 22 women in group C. The median plasma tumor necrosis factor-alpha level for group A was 135 pg/ml (range 0 to 625 pg/ml) compared with 0 pg/ml (range 0 to 110 pg/ml) in group B (p < 0.001). Tumor necrosis factor-alpha was not detected in any of the amniotic fluid specimens studied. CONCLUSIONS: Levels of tumor necrosis factor-alpha were elevated in the plasma but not detected in the amniotic fluid of normal pregnant patients in the second trimester. These findings suggest involvement of the cellular branch of the immune system and its products, the cytokines, in the normal adaptation of the mother to the fetal allograft, with a possible role in regulating trophoblast growth and invasion.

Adult↗
PubMedDate not supplied

Are amniotic fluid alpha-fetoprotein levels influenced by the gender in twin pairs?

OBJECTIVES: To examine the assumption that amniotic fluid alpha-fetoprotein (AFAFP) levels are different in female and male twin fetuses. DESIGN: Amniotic fluid levels of AFP in pregnancies with female and male fetuses in gender-concordant and gender-discordant twins were compared. A t test of p < 0.05 was considered significant. MATERIAL AND METHODS: Between 1995 and 1999, 332 genetic amniocenteses on twin pregnancies were performed at Meir Hospital, Kfar Saba, and Rambam Hospital, Haifa, Israel. One hundred and sixty-six were concordant for gender (84 females and 82 males) while 166 pairs differed in their gender. The amniotic fluid AFP levels of each sac were measured using fluorescent immunoassay methods by an AutoDELFIA machine. RESULTS: The mean levels of AFAFP were lower in female twins compared to their male counterparts in same-gender twins (p = 0.07), although the difference was quite small. Nevertheless, there was no such difference between AFAFP of male versus female fetuses in gender-discordant twins. CONCLUSIONS: The levels of AFAFP were higher in the male twins of gender-concordant twins in comparison to female twins. No such difference was found between female versus male fetuses in gender-disconcordant twins.

Amniocentesis↗
PubMed1978

Investigations on prostaglandin levels in amniotic fluid and maternal blood during late pregnancy.

Prostaglandin E and F equivalents have been measured during late pregnancy in amniotic fluid and maternal venous blood by radioimmunoassay after purification on silicic acid columns. In amniotic fluid levels of both prostaglandins exhibit a tendency to increase, in particular after 36 weeks of gestation, possibly most markedly 20--4 h before the onset of labour. The PG E/F-ratio in amniotic fluid may slightly decrease during the late gestational age. In maternal venous blood variable low levels of both prostaglandins were observed without any correlation to the age of gestation.

Amniotic Fluid↗