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At least 1,783 records · Page 99Linked to original sources
PubMed2005

An elevated maternal plasma, but not amniotic fluid, soluble fms-like tyrosine kinase-1 (sFlt-1) at the time of mid-trimester genetic amniocentesis is a risk factor for preeclampsia.

OBJECTIVE: The purpose of this study was to determine if an elevated concentration of soluble fms-like tyrosine kinase-1(sFlt-1) in maternal plasma and amniotic fluid is a risk factor for the subsequent development of preeclampsia. STUDY DESIGN: A case-control study was conducted to compare mid-trimester concentrations of maternal plasma and amniotic fluid sFlt-1 in patients who developed preeclampsia with those who did not. The study included 32 cases with preeclampsia (18 cases: severe preeclampsia) and 128 matched controls with normal outcomes. Patients with an abnormal fetal karyotype or major anomaly, multiple pregnancies, chronic hypertension, diabetes, and renal disease were excluded. Soluble Flt-1 concentration was measured by specific immunoassay. Nonparametric techniques were used for statistical analysis. RESULTS: 1) The median maternal plasma, but not amniotic fluid, sFlt-1 concentration in patients who developed preeclampsia was significantly higher than in the control cases (maternal plasma: median 730 pg/mL, range 60-3375 pg/mL vs median 441 pg/mL, range 58-1959 pg/mL, P < .05; amniotic fluid: median 10,504 pg/mL, range 5253-38,023 pg/mL vs median 10,236 pg/mL, range 4326-87,684 pg/mL, P = .65). 2) The median plasma concentration of sFlt-1 was higher in cases of severe preeclampsia than in those with mild preeclampsia without reaching statistical significance (median 762 pg/mL, range 261-3309 pg/mL vs median 334 pg/mL, range 60-3375 pg/mL; P = .07). However, there was no significant difference in the median amniotic fluid sFlt-1 concentrations between patients with severe preeclampsia and those with mild preeclampsia (P = .45). 3) An elevated maternal plasma sFlt-1 concentration (higher than 700 pg/mL) is a risk factor for the development of preeclampsia (OR 3.9, 95% CI 1.7-8.6) and severe preeclampsia (OR 7.4, 95% CI 2.5-22.1) after genetic amniocentesis. 4) The median interval from amniocentesis to the diagnosis of preeclampsia in patients with maternal plasma sFlt-1 concentrations higher than 700 pg/mL was 117 days (range 19-154 days). CONCLUSION: An elevated concentration of sFlt-1 in maternal plasma at the time of mid-trimester amniocentesis is a risk factor for the subsequent development of preeclampsia.

Adult↗
PubMed1998

[Ultrasonic methods for determining the volume of amniotic fluid in a complicated pregnancy: improved methods for the prognosis of the perinatal outcome].

Semiquantitative measurement of amniotic fluid volume (AFV) was used to predict the pregnancy outcome. In 229 high risk pregnancies, the AFV was assessed by 4 ultrasonographic methods, including our suggested one--the modified amniotic fluid index (MAFI). Abnormal perinatal outcome was defined as operative delivery sue to fetal distress (OD/FD), meconium passage, low 5 min. Apgar score, umbilical artery pH (< 7.2) and intrauterine growth retardation (IUGR). About 26.2%, 32.8%, 37.6%, 30.6% and 16.6% cases of OD/FD, meconium stained fluid, low 5 min. Apgar score, low pH and IUGR were identified with oligohydramnios compared with the normal fluid group, using MAFI (p < 0.000001). The MAFI showed higher significance than the other ultrasonographic (US) methods. With the relative screening performance the sensitivity of MAFI, amniotic fluid index (AFI), maximum vertical pocket (MVP) and tho-diameter pocket (TDP) depths were 91.9%, 70.2%, 58.9% and 32.8% respectively with OD/FD. Our results suggest that the AFV assessment by MAFI may be superior to the other US techniques and it may used in the testing protocols of antepartum fetal surveillance.

Amniotic Fluid↗
PubMedDate not supplied

Amniotic fluid fibrinolytic system in fetal neural tube defects.

Second trimester amniotic fluid fibrinolytic system was examined in normal pregnancies and those complicated by anencephaly, spina bifida and fetal chromosome abnormalities. No significant difference was demonstrated between the fibrinolytic systems from normal pregnancies and those complicated by fetal chromosome abnormalities. In pregnancies complicated with anencephaly and spina bifida no significant difference was demonstrated for alpha-1-antitrypsin, alpha-1-antichymotrypsin and urokinase. Plasminogen was significantly lower (p less than 0.02) and plasmin significantly higher (p less than 0.001) than levels from normal amniotic fluid. Alpha-2-macroglobulin, fibrinogen, FDP-D and FDP-E were detected only in pregnancies complicated with anencephaly and spina bifida.

Amniocentesis↗
PubMed1992

[Transcervical vs. transabdominal amniocentesis in the bacterial evaluation of the amniotic fluid].

The authors compare the results of bacteriological research on amniotic fluid by transcervical and trans-abdominal amniocentesis. Eighty women at term of their pregnancy, scheduled for cesarean section, underwent a bacteriological vaginal test and a trans-cervical amniocentesis before and a trans-abdominal amniocentesis during cesarean section. The results obtained from both specimens of the amniotic fluid were the same in 90% of the cases. A negative bacteriological result of trans-cervical amniocentesis excluded a positive result of trans-abdominal amniocentesis. Instead, when a positive bacteriological result was obtained in trans-cervical amniocentesis, trans-abdominal amniocentesis gave a positive result in only 60% of the cases. We conclude that trans-cervical amniocentesis, besides being less dangerous, easy to perform and easily repeated, is sufficiently secure and reliable in bacteriological results as compared with trans-abdominal amniocentesis.

Abdomen↗
PubMed1992

Amniotic fluid and umbilical artery levels of sex hormones and prostaglandins in human cocaine users.

Biochemical evaluation of amniotic fluid contents is often used to monitor fetal secretory and excretory functions. To determine whether cocaine use during pregnancy affects fetal endocrine secretions, amniotic fluid and umbilical artery samples were collected at term, and selected gonadal hormones and prostaglandins were assayed. Gestational age, birth weights, and placental weights were recorded. The data showed that birth weights were significantly decreased (P less than 0.001) in cocaine users, but gestational age and placental weights were unaffected. Amniotic fluid levels of androstenedione and testosterone were decreased (P less than 0.05) in males born to cocaine users; females were not affected. Prostaglandins (PGF2 alpha and PGE2) were significantly increased (P less than 0.01) in cocaine users. In the umbilical artery, follicle-stimulating hormone was increased (P less than 0.01) in males and females, while luteinizing hormone was increased (P less than 0.01) only in males. We conclude that cocaine passes through the placenta and affects the fetal testes-hypophyseal endocrine system.

Adult↗
PubMed1988

Observations on the alkaline phosphatase isoenzyme distribution in maternal and amniotic fluid compartments in Nigerian parturients.

Estimation of the alkaline phosphates isoenzymes in paired maternal serum and amniotic fluids in term uncomplicated pregnancies and in patients with pre-eclampsia, showed poor correlation coefficients between the levels of both heat stable and heat labile isoenzymes. There was a statistically significant fall in AF (P less than .05) HSAP in pre-eclampsia and a highly significant rise of HLAP in meconial liquor. It is concluded that the poor correlation between the levels of HSAP in maternal serum and amniotic fluid (despite their common source of origin), the normal levels of HLAP in maternal serum in the presence of significantly high levels of HSAP in maternal serum in the presence of significantly diminished levels in amniotic fluid point to a state of relatively diminished permeability of the chorioamniotic membranes to the alkaline phosphatase isoenzymes in Nigerians.

Alkaline Phosphatase↗
PubMed2003

Amniotic fluid embolism causing catastrophic pulmonary vasoconstriction: diagnosis by transesophageal echocardiogram and treatment by cardiopulmonary bypass.

BACKGROUND: Amniotic fluid embolism is a rare yet often lethal peripartum complication resulting from rapid cardiovascular collapse. Progress toward a better understanding of this entity has failed to identify either the underlying hemodynamic pathophysiology or an effective evidence-based treatment. CASE: A 45-year-old woman with a documented placenta previa experienced an amniotic fluid embolism during scheduled cesarean delivery. Transesophageal echocardiogram examination revealed catastrophic pulmonary vasoconstriction. The use of cardiopulmonary bypass, heparin, epinephrine, and high-dose steroids resulted in a successful outcome. CONCLUSION: Timely placement of transesophageal echocardiogram revealed catastrophic pulmonary vasoconstriction as the cause of circulatory collapse in a patient with amniotic fluid embolism, supporting the use of cardiopulmonary bypass as an effective intervention.

Cardiopulmonary Bypass↗
PubMed1991

Prenatal diagnosis of cystic fibrosis by microvillar membrane enzyme analysis in amniotic fluid.

Prenatal diagnosis was performed in 92 pregnancies high-risk for cystic fibrosis during six years. Amniotic fluid samples obtained by amniocentesis were examined with regard to their microvillar membrane enzyme activity. Though trehalase, alkaline phosphatase isoenzymes and L-gamma-glutamyltransferase in the amniotic fluid are not specific markers of cystic fibrosis, their activity is significantly lower than in normal pregnancies. By measuring the three enzymes simultaneously, sensitivity, specificity and reliability of the method were found to be over 92%. It is concluded that mid-trimester amniotic fluid diagnosis is indispensable for some heterozygotic couples for cystic fibrosis even in the possession of DNA (desoxyrobonucleic acid) methods.

Amniotic Fluid↗
PubMed1980

Kinetics of bilirubin photodegradation with application to amniotic fluid.

By spectrophotometric methods we have studied the photodegradation of bilirubin in simple solution and in amniotic fluid and have found that: (1) the photodegradation process can be described by kinetics which are first-order in concentration and second-order in time; (2) the photodegradation products of bilirubin do not prevent the determination of the absorbance of the parent compound; (3) although the rate of the photodegradation process depends upon both the oxygen partial pressure and the irradiation intensity, the determination of the original bilirubin absorbance is independent of both of these parameters so long as they are constant over the period of photodegradation; (4) other chromagens in amniotic fluid (including hemoglobin and methemoglobin) experience little photodegradation in the time required to degrade bilirubin; (5) several absorbance measurements over a short (approximately five-minute) period of photodegradation are sufficient for the determination of the original bilirubin absorbance for the complete range of interest in amniotic fluid with an accuracy of about five percent.

Amniotic Fluid↗
PubMed1998

Elevated interleukin-8 concentrations in amniotic fluid of mothers whose neonates subsequently develop bronchopulmonary dysplasia.

OBJECTIVE: To determine if an intrauterine sub-clinical inflammatory process is a risk factor for the development of bronchopulmonary dysplasia. METHODS: A cohort study was conducted in patients who met the following criteria: (1) Singleton gestation; (2) preterm labor or preterm premature rupture of the membranes; (3) amniocentesis for microbiologic studies of the amniotic fluid and (4) delivery between 24 and 28 weeks of gestation. Bronchopulmonary dysplasia was defined as the need for supplemental oxygen for 28 days or longer after birth, associated with compatible chest radiographic findings. Amniotic fluid interleukin-8, was measured using a specific immunoassay. Logistic regression analysis and bootstrap procedure were used for statistical purposes. RESULTS: Forty-seven patients met the inclusion criteria for this study. Among these patients, the prevalence of bronchopulmonary dysplasia was 23.4% (11/47). Amniotic fluid culture was positive in 21 out of 47 (44.7%) patients. Median (range) amniotic fluid interleukin-8 concentration was higher in patients whose neonates subsequently developed bronchopulmonary dysplasia than in those who did not (17 [9.8-583.7] ng ml(-1) versus 9.6 [0.91-744] ng ml(-1), P=0.057). An amniotic fluid IL-8 level greater than 11.5 ng ml(-1) was far more common in mothers whose fetuses went on to develop bronchopulmonary dysplasia than in those who did not (10/11 [90.9%] versus 17/36 [47%]; P=0.01). This relationship remained significant even after correcting for the effect of gestational age and birthweight (Odds ratio: 11.9; P<0.05). CONCLUSION: Sub-clinical intrauterine inflammation is a risk factor for the subsequent development of bronchopulmonary dysplasia. We propose that in utero aspiration of fluid with high concentration of pro-inflammatory mediators may contribute to the lung injury responsible for the development of bronchopulmonary dysplasia.

Amniotic Fluid↗
PubMed1976

Behaviour of cell cultures from human amniotic fluid.

The growth pattern of cell cultures originating from 11 amniotic fluid specimens have been observed. From each specimen 2 to 12 primary cultures were set up. In most cases growth started simultaneously in the primary cultures originating from one sample. The primary cultures lasted from 7 to 30 days. A variation was found both between cultures from different pregnancies as well as among cultures obtained from single amniotic fluids. The growth period from setting up the cultures until harvest of the cell lines for biochemical analysis ranged from 20 to 54 days. No connexion was noticed between the time spent in primary culture and the behaviour of the cell line before harvest. The effects of two types of serum (fetal calf serum and pooled human serum) on the behaviour of the cultures were compared. The cells grown in human serum were harvested a few days before those grown in fetal calf serum. The influence of different batches of medium was also examined; no significant effect of the growth pattern was found. The appearance of epithelial-like and fibroblast-like cells in cultures from 6 specimens was observed concurrently. At the time of harvest the cell lines originating from the same amniotic specimen contained the cell types in different proportions.

Amniocentesis↗
PubMed1990

[Prenatal diagnosis of cystic fibrosis by analysis of microvillar enzymes of the amniotic fluid].

Prenatal diagnosis was performed in 92 pregnancies high-risk for cystic fibrosis during six years. Amniotic fluid samples obtained by amniocentesis were examined with regard to their microvillar membrane enzyme activity. However, trehalase, alkaline phosphatase isoenzymes and L-gamma-glutamyl-transferase in the amniotic fluid are not specific markers of the cystic fibrosis, their activity is significantly lower than in normal pregnancies. By measuring the three enzymes simultaneously, sensitivity, specificity and reliability of the method were found to be over 92%. It is concluded that the mid-trimester amniotic fluid diagnosis is useful for some heterozygotic couples for cystic fibrosis even in the possession of the DNA methods.

Amniocentesis↗
PubMed1981

Effect of short-term bromocriptine treatment on amniotic fluid prolactin concentration in the first half of pregnancy.

The effect of short-term bromocriptine treatment on amniotic fluid and maternal prolactin concentrations was studied in 9 pregnant women in the first half of pregnancy. Bromocriptine suppressed the maternal serum prolactin level, but had no effect on the amniotic fluid level. Since both foetal and maternal prolactin secretion are suppressed by bromocriptine our results suggest that amniotic fluid prolactin is produced by extrapituitary tissues, which do not contain dopamine receptors.

Amniotic Fluid↗
PubMed1990

[A study of fetal pulmonary maturity using amniotic fluid obtained from the vagina after premature rupture of membranes].

Amniotic fluid was obtained from the vagina not more than 24 hours before delivery in 100 patients who had premature rupture of the membranes. Thirty per cent of these cases had contamination with blood or with meconium. Phosphatidylglycerol (PG) estimate the degree of lung maturity using an immunological method (AMNIOSTAT-FLM test). In the 22 cases where the gestational age was 35 weeks or less there were two cases of hyaline membrane disease. In 68% of the 22 cases, the PG was negative, intermediate in 14% and positive in 18%. One of the cases of hyaline membrane disease was accompanied by fluid that was not infected and that was negative for PG; the other case had infection with S. faecalis and the PG was intermediate. On the other hand in the 78 cases when the pregnancies had lasted longer than 35 weeks there were no children who had hyaline membrane disease. The PG reaction was positive in only 57% of these cases. Search for bacteria showed infection in 10 cases (three with alpha-haemolytic streptococci, four with group B beta-haemolytic streptococci and three with E. coli). Determination of PG on the supernatant of reference strain cultures showed positive results for S. faecalis and E. coli. In conclusion, the poor specificity of the test (48%) and the possibility that when there was bacterial contamination false positive results were obtained shows that looking for fetal maturity by testing amniotic fluid from the vagina is unreliable and is contra-indicated.

Amniotic Fluid↗
PubMed1980

Amniotic fluid acetylcholinesterase isoenzyme patterns in the diagnosis of neural tube defects.

Acetylcholinesterase isoenzyme patterns were determined in amniotic fluid from 140 normal pregnancies and from 68 pregnancies with various fetal abnormalities. A fast acetylcholinesterase isoenzyme was detected in all cases of neural tube defect, exomphalos and intrauterine death. The fast isoenzyme was not seen in any of the normal pregnancies. Blood-contaminated amniotic fluids with false positive elevation of alphafetoprotein gave a single isoenzyme band. The qualitative demonstration of a fast acetylcholinesterase isoenzyme in amniotic fluid provides a useful adjunct to the alphafetoprotein assay in the prenatal diagnosis of neural tube defects.

Acetylcholinesterase↗
PubMed1978

Bile acid pattern in human amniotic fluid.

Individual bile acids were determined in twenty-nine amniotic fluid specimens obtained from twenty-six women between the 32nd and 41st week of gestation. Total bile acid concentration ranged from 0.4 to 4.8 mumol/l with a mean of 1.57 mumol/l. Besides the two major bile acids of man, cholic acid and chenodeoxycholic acid, 3beta-hydroxy-5-cholenoic acid was found in all, lithocholic acid in ten and deoxycholic acid in nine of the twenty-nine amniotic fluid samples. 3beta-Hydroxy-5-cholenoic acid averaged 39.8% of total bile acids during 32-37 weeks of gestation and 20.2% at term (P less than 0.01). These findings point towards important differences between fetal and adult bile metabolism and may reflect maturation of hepatic bile acid biosynthesis near term.

Amniotic Fluid↗
PubMed1994

Low levels of amniotic fluid pregnancy specific beta-1-glycoprotein in Down's syndrome.

Amniotic fluid levels of beta-1-glycoprotein (SP1) were measured in 46 cases of Down's syndrome and compared with levels in 106 pregnancies of normal karyotype from 10 to 23 weeks of gestation. In normal pregnancies, levels rose from 87.5 iu/l at 10 weeks to a peak of 610.0 iu/l at 19 weeks of gestation. In cases of Down's syndrome, levels were reduced prior to 19 weeks of gestation (median multiple of the median, MoM = 0.75, P = 0.02). This effect was most marked prior to 16 weeks of gestation when the median multiple of the median (MoM) was 0.51 (P = 0.006). These data demonstrate that amniotic fluid levels of SP1 are low in Down's syndrome before 19 weeks of gestation.

Amniotic Fluid↗
PubMed1990

Amniotic-fluid ingestion by parturient rats enhances pregnancy-mediated analgesia.

Amniotic fluid and placenta contain a substance (POEF, for Placental Opioid-Enhancing Factor) that, when ingested, enhances opioid-mediated analgesia in nonpregnant rats; ingestion of the substance by rats not experiencing opioid-mediated analgesia, however, does not produce analgesia. It is highly likely that periparturitional analgesia-enhancement is a significant benefit of ingestion of the afterbirth (placentophagia) during delivery. Here we report that prepartum ingestion of amniotic fluid (via orogastric infusion) does indeed enhance the endogenous-opioid-mediated analgesia evident at the end of pregnancy and during delivery; that the degree of enhancement is greater with 0.75 ml than with 0.25 ml; and that the prepartum enhancement of analgesia can be blocked with the opioid antagonist naloxone.

Amniotic Fluid↗