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PubMed1998

Dual roles of amniotic fluid nitric oxide and prostaglandin E2 in preterm labor with intra-amniotic infection.

We hypothesized that induction of nitric oxide synthase and cyclo-oxygenase-2 by bacterial products in intra-amniotic infection could increase the production of proinflammatory nitric oxide and prostaglandin E2 (PGE2) and cause preterm labor. Thus, we sought to determine amniotic fluid levels of nitric oxide metabolites (NOx) and PGE2 in preterm labor patients with and without intra-amniotic infection. Amniotic fluid from 13 preterm labor patients with intra-amniotic infection and 24 without intra-amniotic infection were studied. Intra-amniotic infection was defined as the presence of a positive amniotic fluid culture. Amniotic fluid was tested for NOx, PGE2, glucose, leukocyte counts, Gram stains, creatinine, pH, and specific gravity. NOx was determined using Griess reagent after reduction of nitrate to nitrite with aspergillus nitrate reductase. PGE2 was measured by an enzyme-linked immunoassay. Both amniotic fluid NOx and PGE2 were normalized by amniotic fluid creatinine. We found that amniotic fluid concentrations of NOx and PGE2 were significantly higher in preterm labor patients with intra-amniotic infection compared to those without intraamniotic infection (NOx: median 1.8 micromol/mg creatinine, range 0.7 to 6.8 vs. 1.3 micromol/mg creatinine, range 0.9 to 2.1, p=0.03; PGE2: median 33.5 ng/mg creatinine, range 0.0 to 1048.6 vs. 0.0 ng/mg creatinine, range 0.0 to 33.6, p=0.004). In addition, amniotic fluid NOx and PGE2 were positively correlated (r=0.343, p=0.0398). We conclude that there may be an interaction between the nitric oxide and prostaglandin pathways in intraamniotic infection. Increased production of amniotic fluid pro-inflammatory nitric oxide and PGE2 may play an important role in the pathogenesis of preterm labor in patients with intra-amniotic infection.

Adolescent↗

PubMedDate not supplied

Cortisol and transcortin in human seminal plasma and amniotic fluid as estimated by modern specific assays.

Cortisol concentrations in human seminal plasma, as estimated by the very specific Amersham 'Amerlite' luminescence immunoassay, were 176 +/- 43 (85-260) nmol/l, that is, 63.7 +/- 15.5 (31-94) ng/ml (mean +/- SD, n = 21). This is about 60% of random levels in blood serum and is the first description of cortisol in seminal fluid. In human amniotic fluid at 16-22 weeks of gestation, cortisol concentrations were lower, at 72.6 +/- 14.6 (63-124) nmol/l, that is, 29.3 +/- 5.3 (23-45) ng/ml (n = 21). Concentrations were about 15% of random maternal serum levels in the second trimester of pregnancy. The cortisol concentrations in both fluids were considerably higher than those reported for saliva, which has a mean of about 10 nmol/l. Transcortin (corticosteroid binding globulin, CBG), has been found in human seminal plasma and amniotic fluid for the first time. Concentrations were low, with values up to 12 micrograms/ml, with no significant difference between the two fluids, when using the IRE-Megenix monoclonal iodinated radioimmunoassay. Transcortin concentrations were about 10% of levels in non-pregnant blood serum, compared with about 0.1% for saliva. The higher concentrations of transcortin could perhaps account for the greater diffusion of cortisol into seminal plasma and amniotic fluid. The presence of beta-endorphin, ACTH and cortisol in amniotic fluid, seminal fluid, ovarian follicular fluid, endometrial fluid and gastric fluid may possibly, indicate the existence of a small paracrine ACTH-cortisol axis in the relevant secretory tissues.

Amniotic Fluid↗

PubMed1999

Elevated amniotic fluid nucleosome levels in women with intra-amniotic infection.

OBJECTIVE: To compare amniotic fluid (AF) soluble nucleosome levels in pregnant women with and without intra-amniotic infection. METHODS: Amniocentesis was performed in 74 pregnant women with preterm contractions, labor, or premature rupture of membranes. Intra-amniotic infection was defined as a positive AF culture. Amniotic fluid tests for Gram stain, glucose, neutrophils, creatinine, pH, and specific gravity were performed. Amniotic fluid soluble nucleosome levels were determined by enzyme-linked immunosorbent assay and were normalized by AF creatinine levels. RESULTS: Twenty-eight patients had intra-amniotic infection and 46 did not. Amniotic fluid soluble nucleosome levels were significantly higher in pregnant women with intra-amniotic infection than in those without infection (48.1+/-21.3 compared with 0.0+/-0.0 U/mg creatinine; P = .005). The AF nucleosome levels were positively correlated with AF neutrophil counts and negatively correlated with AF glucose concentrations. CONCLUSION: Our data indicate that elevated AF nucleosome levels are associated with intra-amniotic infection and may have potential as a clinical marker to detect intra-amniotic infection.

Adult↗

PubMed1988

Amniotic fluid concentrations of fibronectin and intra-amniotic infection.

A cohort study with four groups of pregnant women was designed to evaluate if a decrease in the concentration of fibronectin (FN) in amniotic fluid plays a role in the genesis of premature rupture of the membranes (PROM) and/or intra-amniotic infection: group 1, 15 patients with PROM and intra-amniotic infection; group 2, 15 patients with PROM but without intra-amniotic infection; group 3, 15 patients with preterm labor without PROM or intra-amniotic infection; and group 4, 15 patients who underwent elective amniocentesis for fetal lung maturity studies. No significant differences in amniotic fluid concentrations of FN among any of the four groups was observed (F = 0.146; P = 0.931). These results suggest that a deficiency of FN in amniotic fluid is not a critical factor in determining which patients may be affected by PROM or which of them will develop an intra-amniotic infection.

Amniocentesis↗

PubMed1998

Clinical utility of amniotic fluid volume assessment.

Abnormal amniotic fluid volume is associated with increased maternal risk and perinatal morbidity and mortality. Until the advent of ultrasonography, the invasive nature of amniotic fluid volume assessment limited its clinical utility. Refinements in quantifying the noninvasive sonographic assessment of oligohydramnios and hydramnios have improved the ability of clinicians to identify at-risk pregnancies. This article reviews the available methods of amniotic fluid volume assessment and outlines a comprehensive approach to sonographic screening and monitoring.

Amniotic Fluid↗

PubMed1981

Human amniotic fluid alpha-glucosidase.

Amniotic fluid in midpregnancy contains significant alpha-glucosidase activity. This enzyme is distinguishable from the lysosomal acid alpha-glucosidase, deficiency of which is associated with Pompe's disease. The two enzymes differ in optimum pH, thermal stability, electrophoretic migration, isoelectric point, molecular mass, and immunological response. Amniotic alpha-glucosidase is also different from the classical neutral form. Immuno-cross reactions suggest that the amniotic fluid enzyme has a double fetal origin: renal and intestinal. It seems that alpha-glucosidase in amniotic fluid is linked to lipids.

Amniotic Fluid↗

PubMed1995

[Fluorides in the body of the mother and in the fetus. III. Fluorides in amniotic fluid].

Fluoride concentrations in amniotic fluid as well as in venous and arterial cord blood serum were determined in 20 women during the perinatal period. The mean concentrations of fluoride from amniotic fluid, venous cord blood serum and arterial cord blood serum were 1,6 +/- 0,18 mumol/l, 3,2 +/- 0,28 mumol/l and 2,9 +/- 0,39 mumol/l respectively. Amniotic fluid fluoride concentrations were significantly higher in the older age group of pregnancies (39-42 weeks) in comparison with the younger age group of pregnancies (34-38 weeks) p < 0,01. The reasons for mentioned relations were discussed.

Amniotic Fluid↗

PubMed1982

Significance of amniotic fluid glucose in pregnancy.

Amniotic fluid glucose values were measured in 285 women with normal and abnormal pregnancies. A progressive decrease in glucose values was observed with advancing gestation. Complications in pregnancy did not influence the amniotic fluid glucose value for the given gestational age. In patients with diabetes, very high levels were found, but these progressively decreased with advancing gestation. Since abnormal conditions in pregnancy, other than diabetes, do not affect the amniotic fluid glucose level, it seems to be a reliable tool in assessing fetal maturity. Values above 15 mg/100 ml rule out term pregnancies and those below 5 mg/100 ml, prematurity.

Amniotic Fluid↗

PubMed1985

Immunoreactive oestrogens and progesterone in amniotic fluid in twin pregnancies.

Amniotic fluid concentrations of immunoreactive oestrogens and progesterone were measured at the time of caesarean section in 32 twin pregnancies; 25 women had an elective section and seven were in labour at the time of operation. No significant differences between concentrations in the amniotic fluid of the first and second twin were found in respect of conjugated and unconjugated oestrone, oestradiol, oestriol, oestetrol and unconjugated progesterone either before or during labour. It is unlikely that changes in oestrogens or progesterone in the amniotic fluid are responsible for the selective changes seen in prostaglandins and fetal adrenal steroid during labour in the first twin.

Amniotic Fluid↗

PubMed1993

Quantification of 3-methylglutaconic acid in urine, plasma, and amniotic fluid by isotope-dilution gas chromatography/mass spectrometry.

A method is described for quantification of the trace metabolite, 3-methylglutaconic acid, by isotope-dilution gas chromatography/mass spectrometry using synthetic 3-[2,4,6-13C3]methylglutaconic acid. Results are shown for quantification of 3-methylglutaconic acid in plasma, urine, cerebrospinal fluid and amniotic fluid for both normal controls and patients with different forms of 3-methylglutaconic aciduria. A simple method for the synthesis and purification of 3-[2,4,6-13C3]methylglutaconic acid is also described.

Adult↗

PubMed1995

Alpha-fetoprotein and acetylcholinesterase activity in first- and early second-trimester amniotic fluid.

Normal ranges of amniotic fluid alpha-fetoprotein (AFP) and acetylcholinesterase activity (AChE) are described for gestational weeks 11-14 using rocket gel immunoelectrophoresis for AFP quantitation and a monoclonal antibody (4F19) enzyme antigen immunoassay for AChE activity measurement. The normal ranges were established by the examination of 281 amniotic fluid samples from 281 normal pregnancies. AFP was found to increase from a median level of 14.0 MIU/l at 11 weeks to a maximum at 13 weeks (median = 18.0 MIU/l) (P < 0.05), thereafter falling (not significant). No AChE test result exceeded 4.8 nkat/l. In addition, AFP and AChE values for three cases of fetal malformation, identified by the biochemical analyses of amniotic fluid, are given. These cases included two fetuses with a neural tube defect and one fetus with an abdominal wall defect. Amniocentesis was performed at 10, 11, and 14 weeks, respectively. The AFP and AChE values were all high.

Abdominal Muscles↗

PubMed1981

Comparative studies on amniotic fluid and plasma fibronectins.

Human fibronectin was isolated from second-trimester amniotic fluid, from amniotic fluid obtained at term and from adult plasma. The amniotic-fluid fibronectins had a slightly higher apparent molecular weight on sodium dodecyl sulphate/polyacrylamide-gel electrophoresis than the plasma fibronectin. Early- and late-amniotic-fluid fibronectin had 9.5 and 9.6% carbohydrate respectively, whereas plasma fibronectin had 5.8%. The amniotic-fluid fibronectins had similar mannose and sialic acid contents to plasma fibronectin, but greater amounts of glucosamine, galactosamine, galactose and fucose. There were no detectable differences in the amino-acid composition of amniotic-fluid and plasma fibronectins, and the patterns of peptides obtained after tryptic digestion of fibronectin from the two sources showed extensive similarities. Fibronectins from plasma and amniotic fluid were equally active in promoting cell attachment and were immunologically indistinguishable. These results show that fibronectin from amniotic fluid is more heavily glycosylated than plasma fibronectin or previously analysed fibronectins from cultured fibroblasts. The observed differences in glycosylation may be related to cell type and/or stage of development.

Amino Acids↗

PubMed1988

Dose-dependent enhancement of morphine-induced analgesia by ingestion of amniotic fluid and placenta.

Ingestion of amniotic fluid and placenta by rats has been shown to enhance opioid-mediated analgesia. The present studies were designed to examine the effect of several doses and volumes of placenta and amniotic fluid on tail-flick latency in rats treated with 3 mg/kg morphine. The optimal dose of amniotic fluid was found to be 0.25 ml, although 0.50 and 1.0 ml also produced significant enhancement. Doses of 0.125 and 2 ml of amniotic fluid were ineffective, as was a dose of 0.25 ml diluted to 2 ml with saline. The optimal dose of placenta was found to be 1 placenta, although the resulting enhancement was not significantly greater than that produced by 025, 0.50, 2.0 or 4.0 placentas. Doses smaller than 0.25 placenta or larger than 4.0 placentas were ineffective. The most effective doses of amniotic fluid and placenta correspond to the amounts delivered with each pup during parturition.

Amniotic Fluid↗

PubMed1992

Endothelin-1,2 levels are increased in the amniotic fluid of women with preterm labor and microbial invasion of the amniotic cavity.

The purpose of this study was to determine the effect of gestational age, labor, and microbial invasion of the amniotic cavity on amniotic fluid concentrations of endothelin-1,2. Amniotic fluid was retrieved by amniocentesis from 148 women: patients at term with and without labor, patients with preterm labor with and without intraamniotic infection, and women in the second trimester of pregnancy. Endothelin-1,2 was measured by a sensitive and specific radioimmunoassay. Immunoreactive endothelin-1,2 was detectable in all samples of human amniotic fluid. Advancing gestational age and spontaneous term labor did not result in changes in amniotic fluid concentrations of endothelin-1,2. Women with preterm labor and positive amniotic fluid cultures for microorganisms had higher amniotic fluid concentrations of endothelin-1,2 than did those without microbial invasion of the amniotic cavity (p less than 0.05). These results support a role for endothelins in the mechanisms responsible for preterm delivery associated with intraamniotic infection.

Adult↗

PubMed2005

[Maternal blood and amniotic fluid insulin-like growth factor detection and amniotic cavity drug delivery for early diagnosis and management of fetal growth restriction].

OBJECTIVE: To explore the relationship between insulin-like growth factors (IGFs) and fetal growth restriction (FGR) and early treatment of FGR. METHODS: The levels of IGF-I and IGF-II were detected with radioimmunoassay in maternal blood and amniotic fluid samples of 44 pregnant women with FGR and 36 normal gravidas. The 44 gravidas with FGR were randomized into treatment group with amino acid by a pediatric administration to the amniotic cavity formula and control group with intravenous infusion of compound amino acid. The therapeutic effects were compared between the two groups on the basis of B-type ultrasound findings. RESULTS: Maternal blood IGF-I and amniotic fluid IGF-I and IGF-II levels in the pregnant women with FGR were significantly lower than those in normal gravidas (P<0.01). After therapy, IGF-I and IGF-II levels were significantly increased in the treatment group (P<0.01), but no obvious changes in IGF-I and IGF-II levels were observed in the control group (P>0.05). Compared with the control group, IGF-I and IGF-II levels increased significantly in the amniotic fluid in the treatment group, with also marked elevation of IGF-I levels in maternal blood (P<0.01). Better therapeutic effects were achieved in the treatment group than in the control group (P<0.01), and the birth weights of the neonates in the treatment group were basically normal. CONCLUSIONS: Detection of amniotic fluid IGF-I and IGF-II and maternal blood IGF-I can help predict the condition and facilitate early diagnosis of FGR. Injection of pediatric amino acid into the amniotic cavity can be effective for treatment of FGR.

Adult↗

PubMed1982

Acetylcholinesterase in neural tube defects: a model using chick embryo amniotic fluid.

Acetylcholinesterase was measured in amniotic fluid from normal chick embryos and embryos with neural tube defects. Neural tube defects were induced in the chick embryos by three procedures, removal of albumen, mechanical disruption of the closed neural tube or injection of tetanus toxin. The concentration of acetylcholinesterase in amniotic fluid from untreated normal embryos changed throughout the period examined (5-14 days incubation) but was stable at 0.5 U1(-1) over the time period 6-11 days. Amniotic fluid taken from treated embryos with neural tube defects at 8 days always contained a higher concentration of acetylcholinesterase than fluid from sham operated but otherwise normal embryos, mean 40.9 U1(-1), S.E.M. = 10. U1(-1), versus 1.0 U1(-1), S.E.M. = 0.2 U1(-1). The range of values (6.1-393 U1(-1)) was clearly separated from the normal values, range 0.0-5.5 U1(-1). In 13 cases with developmental abnormalities other than neural tube defects, the concentration of acetylcholinesterase was elevated in only one. Two different forms of acetylcholinesterase, as shown by gel electrophoresis, were present in fluid form both normal and defective embryos. These forms were also present in blood plasma, cerebrospinal fluid and in the high speed supernatant from brain extracts, the latter tissue contained an additional form of greater electrophoretic mobility. After irreversible inhibition, enzyme activity in amniotic fluid recovered slowly; only half the control value was reached by 140 h compared with complete recovery in the tissues of the embryo within 19 h. Histochemical staining for acetylcholinesterase showed that the spinal cord in the region of the lesion contained high concentrations of the enzyme. The possible sources of acetylcholinesterase in amniotic fluid are discussed. This chicken model of neural tube defects provides support for the use of acetylcholinesterase tests in the detection of neural tube defects clinically, and provides a model for experimentation with this system.

Acetylcholinesterase↗

PubMed1979

Suppression of lymphocyte reactivity in vitro by porcine allantoic and amniotic fluids.

Porcine allantoic and amniotic fluids from early, mid and late pregnancy were analyzed for protein constituents and ability to suppress phytohemagglutinin (PHA)-induced lymphocyte transformation. All fetal fluids contained alpha-fetoprotein as evaluated by polyacrylamide gel electrophoresis (PAGE), with the highest concentrations appearing in mid-pregnancy amniotic fluids. In addition, allantoic fluids from mid-pregnancy contained proteins assumed to be secreted by the uterus. Both allantoic and amniotic fluids from mid-pregnancy were suppressive to PHA-induced lymphocyte transformation (P<.01). Thus it was concluded that substances, potentially able to suppress the immune response locally, exist within porcine fetal fluids, but it was not determined whether this material is of solely fetal or maternal origin, or a combination.

Journal Article↗

PubMed2005

Ultrasonographic determination of amniotic fluid volume in normal pregnancy.

Ultrasonographic assessment of amniotic fluid has important implications because documentation of abnormalities of amniotic fluid volume may provide valuable information to enhance fetal health assessment. But in our country no study was conducted to establish normal values of amniotic fluid volume. So, this study was designed to find out normal values of amniotic fluid volume at various stages of gestation. The study was conducted in the department of Radiology and Imaging, BIRDEM in collaboration with the department of Obstetrics and Gynaecology, BIRDEM from 1(st) July, 2001 to 30(th) June, 2002. One hundred and twenty patients of normal pregnancy between 15 to 38 weeks' gestation were scanned by ultrasonography and their amniotic fluid volume was measured. For each gestational age between 15 and 38 weeks, 5 patients were recruited, and only one examination was done per pregnancy. Currently, the three semi-quantitative methods of assessing amniotic fluid volume include the amniotic fluid index (AFI), single deepest pocket (SDP) and two diameter pocket (TDP). Amniotic fluid volume of the study population was measured by the three methods. The values were plotted against each week in tabulated form. Thus the normal range of amniotic fluid volume in three methods (AFI, SDP, TDP) across gestational age in normal pregnancies was established. The mean value of amniotic fluid volume in AFI, SDP and TDP were 13.224 cm, 4.679 cm and 19.252 cm(2) respectively. AFI and SDP showed amniotic fluid volume increased with increasing gestational age up to early third trimester, but volume decreased thereafter. The prevalence of false positive result for oligohydramnios was 0.83% for AFI, 0% for SDP and 23% for TDP. The prevalence of false positive result for hydramnios was 1.66% for AFI, 0.83% for SDP and 0% for TDP. Thus the normal values of amniotic fluid volume for each of the three ultrasonographic techniques in the perspective of our country were obtained from the study. As the study was conducted with a limited number of patients, further study may be carried out with a large number of observations to reevaluate the results of the study.

Adult↗