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Distribution of alpha 1-fetoprotein in fetal plasma, allantoic fluid, amniotic fluid and maternal plasma of cows.

Maximal concentrations of AFP, measured by RIA, were obtained in fetal plasma and amniotic and allantoic fluid between the 3rd and 4th month of gestation, with levels declining thereafter until term. AFP values in maternal plasma were unchanged. Throughout gestation, AFP values were higher in allantoic than in amniotic fluid and the ratio of allantoic fluid/amniotic fluid AFP was significantly correlated with gestational age.

Allantois

Correlation of subjective assessment of amniotic fluid with amniotic fluid index.

We assessed the correlation between abnormal amniotic fluid volumes as defined by the two techniques of (1) subjective evaluation and (2) the amniotic fluid index. Ultrasound evaluation of amniotic fluid volume was conducted on 420 pregnant women with known gestational age greater than twenty weeks but less than 42 weeks. Amniotic fluid was evaluated subjectively and placed into one of three categories: normal, oligohydramnios or polyhydramnios. After fetal biometry was performed, the amniotic fluid volume was assessed semi-quantitatively by the amniotic fluid index technique and assigned to similar categories. We analyzed the data with 2 x 2 contingency tables, using amniotic fluid index as the 'gold standard test'. Our study demonstrates that there was moderate agreement (kappa.5) between both amniotic fluid techniques in the identification of oligohydramnios. However, agreement between the techniques was poor for the identification of polyhydramnios (kappa.16).

Amniotic Fluid

E. coli growth inhibition by amniotic fluid.

Amniotic fluid samples were collected aseptically from 29 normal pregnancies, between the 38th and 41st week of gestation and checked for sterility in the laboratory, in order to investigate in vitro the effect of the liquor on the growth of E. coli. Brain Heart Infusion (B.H.I.) and Ringer solution were used as controls. E. coli cultures were inoculated in amniotic fluid, B.H.I., Ringer solution and amniotic fluid plus B.H.I. and incubated at 37degreesC for 48 hours. At 0, 1, 3, 6, 12, 24, 36 and 48 hours of incubation, surface viable counts were performed to estimate the number of E. coli viable cells. The growth of E. coli in B.H.I. started furing the 1st hours after inoculation and continued over 48 hours; in Ringer solution the mean growth curve and almost identical to that of B.H.I. In amniotic fluid the growth of E. coli began from the 1st hour of inoculation but the growth curve was much lower, became static in 24 hours and a permanent inhibition was observed thereafter. The addition of a small amount of B.H.I. in amniotic fluid enhanced the growth of E. coli, but the growth curve was lower in comparison to the curves of the two controls studied. In conclusion, after 48 hours of inoculation in amniotic fluid, 26 of the 29 cases showed bacteriostatic or bactericidal activity of the liquor upon the growth of E. coli.

Amniotic Fluid

Isolation of prolactin from human amniotic fluid.

Amniotic fluid, obtained from women at term, was centrifuged and concentrated by ultrafiltration. The concentrated amniotic fluid was purified by gel filtration on Sephadex G-100 and ion-exchanged chromatography on DEAE-cellulose. The fractions obtained during purification procedures were assayed for prolactin and somatotropin activities by respective radioimmunoassays. The prolactin-rich fraction obtained from ion-exchange chromatography was further purified by isoelectric focusing. A yield of 0.21 mg of highly pruified prolactin containing 40 units/mg was obtained from 1 liter of the amniotic fluid. The prolactin was free of somatotropin and human placental lactogen.

Amniotic Fluid

Candida antibodies in amniotic fluid.

Amniotic fluid samples were tested for specific immunoglobulins against Candida albicans by indirect immunofluorescence. Nineteen of the 23 samples tested contained specific IgA while specific IgG antibodies were detected in only seven samples (P less than 0.01). None of the samples contained specific anticandidal IgM (P less than 0.001). These 23 samples and a further 30 amniotic fluid samples were tested for Candida mannan antigen by latex agglutination. Mannan was not detected in any of the samples tested. It is concluded that anticandidal IgA in amniotic fluid is naturally occurring.

Amniotic Fluid

Relationship between cortisol and lecithin/sphingomyelin ratios in human amniotic fluid.

Amniotic fluid was obtained from 85 women during the last trimester of gastation and analyzed for cortisol by a radioimmunoassay procedure and for lecithin/sphingomyelin (L/S) ratios by a combined thin-layer chromatography densitometer scanning technique. A total of 114 samples were examined. Cortisol values ranged from 38 to 438 ng. per milliliter; L/S ratios ranged from 0.3 to 9.2. Comparison of cortisol levels with L/S ratios by multiple regression analysis gave an "r" value of 0.371. From less than 32 weeks' gestation to 41 or 42 weeks there was an increase in cortisol levels from 139 plus or minus 124 to 290 plus or minus 78 ng. per milliliter whereas the L/S ratios increased from 1.8 plus or minus 2.3 to 3.9 plus or minus 2.0. These data indicate that there is no good correlation between cortisol and L/S ratios in the samples of amniotic fluid analyzed.

Amniotic Fluid

Alpha 1-antitrypsin in amniotic fluid.

Amniotic fluid a1-antitrypsin values were determined by radial immunodiffusion of 317 samples obtained between the 10th and 43rd weeks of gestation in normal pregnant patients and those with complications. Serial determinations of a1-antitrypsin values revealed that in normal patients values decreased as pregnancy advanced while values increased as pregnancy advanced in cases in which there was severe Rh-alloimmunization and hydramnios. A wide range of values was observed for each week of gestation. Although there was a definite tendency for values to decrease as pregnancy advanced (60.8 mg/100 ml before 30 weeks and 17.9/100 ml after 40 weeks); the method must be regarded as unreliable for determining fetal maturity in clinical practice. In the case of newborn infants with hyaline membrane disease, no decrease in amniotic fluid a1-antitrypsin values has been found.

Amniotic Fluid

The predictability of intrauterine infection by analysis of amniotic fluid.

Amniotic fluid samples from 95 internally monitored patients were examined to determine whether the appearance of polymorphonuclear leukocytes or bacteria could predict intrauterine infection. All patients delivered vaginally. More than one polymorphonuclear leukocyte per oil field were seen in specimens of 32% of patients; bacteria were seen in specimens of 52% of patients, and organisms were grown in 93% of specimens, yet, the overall maternal infection rate was only 6.3%. Moreover, infection developed in only 10% of patients with polymorphonuclear leukocytes in the fluid and 6% of patients with positive gram stain or cultures. For patients who deliver vaginally, the appearance of polymorphonuclear leukocytes or bacteria does not predict infection.

Amniocentesis

Genetic counselling and prenatal diagnosis of cystic fibrosis in Debrecen (Hungary)--prenatal diagnosis by microvillar enzyme assay from amniotic fluid.

Amniotic fluid intestinal alkaline phosphatase, gammaglutamyltransferase and trehalase activity were quantitated to assess their reliability for the prenatal diagnosis of cystic fibrosis. To obtain optimal diagnostic discrimination, the three enzyme values obtained for each sample were combined into a single linear discriminant function that proved to be a more accurate indicator of the outcome of the pregnancy. From the cases studied here, it appears that this method can be expected to give a correct prediction in 92.0% of all high risk pregnancies.

Amniotic Fluid

Determination of fetal sex in cattle by cytologic examiantion of amniotic fluid.

Amniotic fluid smears (n = 134) of bovine fetuses (69 males, 65 females) at various stages of gestation were stained by the Papanicolaou method. Percentage counts of eosinophilic, orangeophilic, and cyanophilic cells were determined by examining 500 cells per sample. The cyanophilic cell count was significantly (P less than 0.001) higher for the females (37% +/- 3% to 47% +/- 3%) than for the males (19% +/- 2% to 32% +/- 3%). Significant differences, however, were not recorded with the eosinophilic and the orangeophilic cell counts. The percentage cyanophilic count could therefore be used as a method of prenatal sex determination.

Amniotic Fluid

Identification and characterization of cyclo(His-Pro)-like immunoreactivity in amniotic fluid.

Amniotic fluid (AF) from 25 term pregnancies was analyzed for cyclo(His-Pro)-like immunoreactivity (CHP-LI). CHP-LI was detected in all AF samples and was indistinguishable from synthetic CHP by immunoidentity, by gel chromatography on Sephadex G-25, and by high pressure liquid chromatography. The mean concentration of CHP-LI in AF was 13,622 +/- 1288 pg/ml (+/- SE) and concentrations were not altered by maternal labor. Plasma concentrations of CHP-LI were similar in 4 pregnant and 4 control subjects [2260 +/- 432 pg/ml vs. 2162 +/- 419 pg/ml (+/- SE), respectively]. We conclude that 1) CHP-LI is readily detected in AF from term pregnancies and is indistinguishable from synthetic CHP, and 2) concentrations of CHP-LI in human AF are significantly higher than concentrations of maternal plasma CHP-LI, suggesting CHP AF originates by mechanisms other than diffusion from maternal plasma.

Amniotic Fluid

Correlation of absorbance at 650 nm with the presence of phosphatidylglycerol in amniotic fluid.

Amniotic fluid absorbance at 650 nm was correlated with the presence of phosphatidylglycerol (PG) in the isolated surfactant fraction (10,000-g pellet). Shake test results were included. Two hundred ninety-seven samples were analyzed. PG was present in 222 of 226 samples in which the absorbance was greater than or equal to 0.250 and absent from 48 of 71 with an absorbance less than 0.250. PG was present in all 166 samples with a positive shake test and absent in 52 of 131 samples with a negative one. In 65 samples in which the shake test was negative and the absorbance greater than or equal to 0.250, PG was present in all but 4. The false-positive rate for the prediction of respiratory distress syndrome was 0.8% for the Shake test and 0.6% for the absorbance measurement. The results support the usefulness of the absorbance measurement as a simple and reliable procedure for assessing fetal lung maturity.

Amniotic Fluid

Amniotic fluid index: correlation with amniotic fluid volume.

We calculated the amniotic fluid indexes (AFIs) of 310 women on 459 occasions. Normative data were analyzed and compared with data in several high-risk groups. In the normal gestations there was a progressive increase in AFI with advancing gestation until 32 weeks, after which there was a decline. The mean AFIs in abnormal gestations varied with the clinical diagnoses. These values were compared to those obtained by assessing amniotic fluid volume (AFV), that is a pocket more than 2 cm. There were 51 patients with abnormal AFVs. Forty-two had decreased fluid, six also had decreased AFIs; nine had increased AFVs and five (all with diabetes) also had increased AFIs. Thus, AFIs in normal pregnancies showed an orderly pattern of change with gestational age, and there was no accurate correlation between AFI and AFV. Thus, using AFV alone may lead to false interpretations of amniotic fluid status.

Amniotic Fluid

Comparison of gram stain, leukocyte esterase activity, and amniotic fluid glucose concentration in predicting amniotic fluid culture results in preterm premature rupture of membranes.

OBJECTIVE: The purpose of this study was to prospectively compare three rapid and inexpensive tests that have been proposed as predictors of amniotic fluid culture results in preterm premature rupture of membranes. STUDY DESIGN: Amniocentesis was performed on 117 patients < or = 34 weeks' gestational age with premature rupture of membranes and no clinical evidence of infection. Amniotic fluid was sent for Gram stain and aerobic, anaerobic, and Mycoplasma cultures. Leukocyte esterase activity and glucose concentration were also determined on the amniotic fluid. RESULTS: Amniotic fluid cultures were positive in 56 patients (47.8%). Leukocyte esterase activity of 1+ or 2+ and an amniotic fluid glucose concentration < or = 16 mg/dl were significantly more sensitive (p < 0.005) than Gram stain in detecting positive amniotic fluid cultures (73%, 68%, and 41%, respectively). CONCLUSIONS: Although each of these rapid tests is useful in assessing for subclinical intraamniotic infection, none of them have sufficient accuracy to make clinical decisions solely on the basis of their results.

Amniotic Fluid

Amniotic fluid particles: are they related to a mature amniotic fluid phospholipid profile?

In a prospective, blinded clinical study, the relationship between amniotic fluid free-floating particles measured by a dynamic ultrasound imaging method and phospholipid profile was studied in 82 women undergoing amniocentesis between 26-42 weeks' gestation. None of 11 patients with sonographically clear amniotic fluid had a mature phospholipid profile (lecithin-sphingomyelin ratio greater than 2 and detectable phosphatidylglycerol). Thirty-eight of 71 women (53%) with turbid or markedly turbid amniotic fluid had a mature phospholipid profile. The sensitivity of this method was 100%, specificity 25%, positive predictive value 53%, and negative predictive value 100%. Although the finding of sonographically clear amniotic fluid may eliminate unnecessary amniocentesis, markedly turbid amniotic fluid is not a reliable indicator of a mature amniotic fluid phospholipid profile.

Amniotic Fluid

Amniotic fluid embolism and leukotrienes--the role of amniotic fluid surfactant in leukotriene production.

Surfactant rich lipid (lipid) was extracted from cell free 10,000 x g pellets of amniotic fluid. White blood cells (WBC) were isolated from human donors. 36 x 10(7) WBC and 5 g rabbit lung were incubated with pretreated lipid or dipalmitoyl lecithin (lecithin). Leukotrienes (LTs) were identified by high performance liquid chromatography (HPLC) and bioassay, and quantified by radioimmunoassay. Peaks of LTC4 and LTD4 on HPLC and guinea-pig ileum contraction could be identified in lipid and lecithin groups, but not in the control group. LTC4 production by lipid and lecithin groups was significantly higher than that by the control group. An involvement of amniotic fluid surfactant in leukotriene production is suggested.

1,2-Dipalmitoylphosphatidylcholine