ABSTRACT
Amniotic fluid is an indicator of normal placental function and is essential for normal fetal lung maturation. Amniotic fluid index (AFI) is the most preferred method of amniotic fluid measurement in pregnancy although single deepest pocket (SDP) is also used. To measure AFI, the examiner divides the uterus into four equal quadrants. AFI is the sum of deepest pocket from each quadrant. The normal AFI ranges between 5~24 cm while any value above 24 cm is considered as hydramnios and that below 5 cm is indicated as oligohydramnios. An adequate volume of amniotic fluid is critical to allow normal fetal movement and growth, while also cushioning the fetus and umbilical cord. Regardless of the etiology, oligohydramnios may inhibit these processes and may lead to fetal deformation, umbilical cord compression, and death in some instances. Oligohydramnios can be due to underproduction, loss, or sometimes, isolated. Isolated oligohydramnios has been found to be responsive maternal hydration and is neither a malformation of the urinary system in the fetus, nor a rupture of amnion and due to genetic cause. The author would like to introduce a way to increase amniotic fluid volume in isolated oligohydramnios which is expect to improve the perinatal outcomes.
Subject(s)
Female , Pregnancy , Amnion , Amniotic Fluid , Fetal Movement , Fetus , Lung , Methods , Oligohydramnios , Polyhydramnios , Rupture , Umbilical Cord , UterusABSTRACT
Background: Fetal distress in labour is a common occurrence and is of great concern. Evaluation in early labor which could predict the risk of fetal distress could aid in the management of labour. Aim: The purpose of the study was to determine the value of routine intrapartum amniotic fluid assessment on perinatal outcome. Materials and methods: Study was done on 240 admitted patients in labou. They had an intrapartum AFI determined by four-quadrant technique subsequently these patients delivered during the same hospitalization. AFI determined was graded as Oligohydramnios was defined as AFI ≤ 5 cm (n = 48), Borderline as AFI 5.1- 8 cm (n = 50), Normal as AFI 8.1-24 cm (n = 142) and Women with AFI > 24 cm were not included in the study. The three groups were compared with regard to intrapartum and postpartum variables. Results: In present study, 20% of women were in oligohydramnios group, 21% in borderline group and 59% in normal group. Hence, the cesarean section rate for fetal distress was 54% in oligohydramnios and 28% in borderline group. The incidence of instrumental delivery for fetal distress was 12% in oligohydramnios and 14% in borderline. The incidence of APGAR score < 7 at 1 min and 5 min in oligohydramnios and borderline group were respectively 54%, 35%; and 30%, 14%. The incidence of birth weight <2500 gms in oligohydramnios group was 37% and borderline was 24%. NICU admissions in oligohydramnios group were 40% and 8% in borderline group. The percentage of neonatal deaths among oligohydramnios group was 4.2% and nil in borderline. The efficacy of intrapartum determination of oligohydramnios predicting cesarean delivery for fetal distress gave a sensitivity of 64%, specificity of 89%, positive predictive value of 53% and negative predictive value of 93%. Conclusion: Intrapartum detection of oligohydramnios is a valuable screening test for subsequent fetal distress requiring cesarean delivery
ABSTRACT
Abstract Purpose The amniotic fluid volume (AFV) is known as a predictor for the wellness of a fetus. We aimed to investigate whether N-terminal pro-brain natriuretic peptide (NTproBNP) levels reflect AFV abnormalities in otherwise normal fetuses. Methods We recruited 24 women with isolated oligohydramnios, 23 women with isolated polyhydramnios, and 36 women with normal AFV at a tertiary referral center. NT-proBNP levels in umbilical venous samples and the individual characteristics of the three groups were compared. One-way ANOVA and Kruskal-Wallis analysis of variance were used for multi-group comparisons of continuous variables. When a significant difference was detected, the Scheffe test was performed as a post-hoc analysis. Proportions were compared using the Chi-square (2) test. Results Maternal age, body mass indices, weight gained in pregnancy and NT-proBNP levels were similar among the three groups. Apgar scores at 1 and 5 minutes significantly correlated with NT-proBNP levels in all newborns (Spearman's r = 0.23 ; p = 0.03 and Spearman's r = 0.24; p = 0.02, respectively). The umbilical venous NTproBNP levels did not differ between newborns who needed mechanical ventilation and those who didn't (p = 0.595). Conclusions NT-proBNP is a biomolecule that may provide insights into the pathogenesis of fetal circulatory problems and subsequent renal failure. Further investigations are warranted.
Resumo Objetivo Investigar se os níveis de peptídeo natriurético pró-cerebral N-terminal (NTproBNP) refletem anormalidades no volume de líquido amniótico (VLA) em fetos normais. Métodos Reunimos 24 mulheres com oligoidrâmnios isolados, 23 com poli-hidrâmnios isolados, e 36 com VLA normal em um centro de referência. Comparamos os níveis de NT-proBNP em amostras venosas umbilicais e características individuais em três grupos. Usamos análise de variância simples (One-way ANOVA) e a análise de variação Kruskal-Wallis para comparação de variáveis contínuas em múltiplos grupos. Quando identificada uma diferença significativa, o teste de Scheffe foi aplicado como uma análise post-hoc. Comparamos proporções usando o teste Qui-quadrado (2). Resultados Idade fértil, índice de massa corporal, ganho de peso na gestação e níveis de NT-proBNP foram similares nos três grupos. Apgar em 1 e 5 minutos correlacionaram significativamente com os níveis de NT-proBNP em todos os recém-nascidos (Spearman's r = 0,23; p = 0,03 e Spearman's r = 0,24; p = 0,02, respectivamente). Os níves de NT-proBNP venoso umbilical não se distinguiram entre os recém-nascidos que precisaram de ventilação mecânica e aqueles que não precisaram (p = 0,595). Conclusões NT-proBNP é um candidato biomolecular que pode contribuir na patogênese de problemas circulatórios fetais e subsequente insuficiência renal. São necessárias futuras investigações.
Subject(s)
Humans , Female , Pregnancy , Adult , Amniotic Fluid , Natriuretic Peptide, Brain/blood , Peptide Fragments/blood , Case-Control Studies , Fetal Blood , Prospective Studies , Umbilical VeinsABSTRACT
Objective:To determine the expression of aquaporin 8 and its localization in human WISH cells and to explore the molecular and cellular mechanisms for water absorption across the amniotic membranes.Methods:Human amnion-derive WISH cells were cultured.Western analysis was used to quantify AQP8 expression level.Reverse transcripton-polymerase chain reaction(RT-PCR)was used to quantify AQP8 mRNA expression levels.Immunofluorescence was used to determine localization of AQP8 in WISH cells.Results:AQP8 mRNA protein was found in human WISH cells.By western-blot,the AQP8 proteim was detected at 34ku in human WISH cells.AQP8 labeling was observed in intracellular vesicular structures throughout the cytosol and plasma membrane.Conclusion:The study demonstrates the expression of aquaporin 8 in human WISH cells.These results suggest that aquaporin 8 may be a channel that mediates amniotic fluid resorption by way of intramembranous pathway.