OBJECTIVETo detect the change of nerve growth factor (NGF) level in human amniotic fluid during gestation, and to explore the relationship between this change and fetal ventriculomegaly (VM).

METHODSThe studied subjects (collected from 2004 to 2007) were divided into four groups, including the second-trimester pregnancy group (n=113), third-trimester pregnancy group (n=110), fetal cerebral VM group (n=12), and healthy control group (n=12) which matched with the VM group in gestational weeks. The amniotic fluid specimens were obtained during amniocentesis or cesarean section. The NGF levels in amniotic fluid were detected with enzyme-linked immunosorbent assay.

RESULTSA significantly negative correlation was found between gestational age and the NGF level in amniotic fluid (r=−0.6149, P<0.0001). The NGF level in patients with fetal VM was significantly lower than that in healthy controls (33.95±29.24 pg/mL vs. 64.73±16.21 pg/mL, P=0.024).

CONCLUSIONNGF levels in amniotic fluid may be a sensitive marker for fetal VM.

Adult ; Amniotic Fluid ; chemistry ; Female ; Humans ; Hydrocephalus ; metabolism ; Nerve Growth Factor ; analysis ; Pregnancy

OBJECTIVE: The purpose of this study is to assess the relationship between the oligohydramnios and umbilical venous blood EPO levels and nRBC counts, and to investigate the significance of oligohydramnios as intrauterine hypoxic marker in AGA and SGA fetuses. METHODS: EPO and nRBC were measured in 217 singletons with a gestational age of 32 to 42 weeks at delivery. The subjects were divided into 4 groups: group 1 (AGA with normal amniotic fluid volume, n=129), group 2 (AGA with oligohydramnios, n=15), group 3 (SGA with normal amniotic fluid volume, n=57) and group 4 (SGA with oligohydramnios, n=11). EPO levels and nRBC counts in group 2, 3 and 4 were compared to those in group 1 using Mann-Whitney U-test. Relationship between EPO and nRBC was assessed using linear regression analysis. In addition, relationship between results of umbilical venous blood gas analysis and EPO/nRBC was assessed using the same method. P-values less than 0.05 were considered statistically significant. RESULTS: EPO levels and nRBC counts in AGA with oligohydramnios (group 2) were not significantly different from those in AGA with normal amniotic fluid volume (group 1). EPO levels in SGA with normal amniotic fluid volume (group 3) were significantly higher than those in AGA with normal amniotic fluid volume (group 1). EPO levels and nRBC counts in SGA with oligohydramnios (group 4) were significantly higher than those in AGA with normal amniotic fluid volume (group 1). There was significant positive correlation between EPO and nRBC. Parameters obtained from the umbilical venous blood gas analysis were more related with nRBC than EPO. CONCLUSION: Oligohydramnios was significant intrauterine hypoxic marker in SGA fetuses. However, the results of this study suggested that the influence of oligohydramnios on antenatal fetal condition might be less severe in AGA fetuses than in SGA fetuses. Moreover, it was likely that nRBC had stronger association with pathologic hypoxia than EPO did.
Amniotic Fluid ; Anoxia ; Blood Gas Analysis ; Erythroblasts* ; Erythropoietin* ; Female ; Fetus* ; Gestational Age* ; Linear Models ; Oligohydramnios ; Parturition* ; Pregnancy

Diagnostic amniocentesis is one of the most useful technique for the prenatal detection of genetic disorders. Traditionally standard amniocentesis has been most commonly performed during the 2nd trimester from 16 to 20 weeks` gestation. Our laboratory has received 1,284 midtrimester amniotic fluid specimens during the past 5 year period for cytogenetic analysis and 1,274 were successfully cultured and yielded results. This study was based on data from 1,274 genetic amniocentesis performed at CHA General Hospital from Jan. 1991 to Dec. 1995. Chromosomal abnormalities were found in 61(4.8%) of the cases. There were 23 cases of aneuploidy, 37 cases of chromosomal rearrangemen t and 1 case of mosaicism.
Amniocentesis ; Amniotic Fluid ; Aneuploidy ; Chromosome Aberrations ; Cytogenetic Analysis ; Female ; Hospitals, General ; Humans ; Mosaicism ; Pregnancy ; Pregnancy Trimester, Second* ; Prenatal Diagnosis

To assess the influence of different sampling methods on Human Amniotic Fluid (HAF) during metabonomics analysis, and to establish a metabolite profile database for normal human amniotic fluid, four experimental groups (the group of freeze-drying, of freeze-thawing, of storage at -20 degrees C, and of keeping in room temperature) and a control group were investigated by use of 1H-NMR spectroscopy, respectively; the data of H-NMR spectroscopy was treated by principal components analysis (PCA). The results showed that, by comparison with the control, there were distinct differences in the experimental groups except the group of storage at -20 degrees C. Therefore, It is possible to use 1H-NMR-based metabonomics technique for analysis of HAF; moreover, during the tests, careful treatments of HAF should be institued to minimize the influence on the samples.
Amniotic Fluid ; metabolism ; Female ; Humans ; Magnetic Resonance Spectroscopy ; methods ; Metabolome ; Metabolomics ; methods ; Pregnancy ; Principal Component Analysis ; Specimen Handling ; methods ; standards

OBJECTIVE: To assess the value of chromosomal microarray analysis (CMA) for fetuses with choroid plexus cysts (CPC) detected by prenatal ultrasonography. METHODS: Amniotic fluid chromosomal karyotype was analyzed in 104 fetuses with CPC, and copy number variations (CNVs) among the fetuses were detected by using CMA. RESULTS: Ten fetuses (9.62%) were found to have an abnormal karyotype, and 14 additional CNVs were detected in those with a normal karyotype. The fetuses were divided into isolated CPC group (n = 87) and non-isolated CPC group (n = 17) based on the presence of additional ultrasonographic abnormalities. The detection rates for karyotypic abnormalities of the two groups were 4.6% and 35.3%, respectively, whilst those for the CMA were 4.6% and 47.1%, respectively. The detection rates for karyotypic abnormalities and CMA of the non-isolated CPC group were significantly higher than those of the isolated CPC group (P < 0.05). The detection rate for CMA in the non-isolated group was significantly higher than chromosomal karyotype abnormalities (P < 0.05). Among the 8 fetuses with abnormal CMA, 4 had single umbilical artery, 3 had abnormal cardiac structure, and 2 had enhanced intestinal echo. CONCLUSION CPC is closely associated with chromosomal abnormalities. Chromosome karyotype analysis in combination with CMA can effectively detect fetal chromosomal abnormalities and provide a basis for genetic counseling.
Humans ; Female ; Pregnancy ; DNA Copy Number Variations ; Choroid Plexus/diagnostic imaging* ; Microarray Analysis ; Karyotype ; Chromosome Aberrations ; Amniotic Fluid ; Cysts

OBJECTIVE: Disseminated intravascular coagulation (DIC) is a serious and life-threatening complication of amniotic fluid embolism and chorioamnionitis. DIC results from excessive thrombin activity leading to a consumptive coagulopathy. The mechanisms responsible for the increased availability of thrombin in intrauterine infection remain to be elucidated. The purpose of this study was to determine if thrombin activation in amniotic fluid, as measured by thrombin-antithrombin III (TAT) concentration, was associated with intrauterine infection and preterm delivery. METHODS: A cross-sectional study included women who underwent transabdominal amniocentesis (n=129) in the following group: (1) mid-trimester (n=10) (2) preterm labor and intact membranes in the presence (n=17) or absence (n=72) of microbial invasion of the amniotic cavity, (3) term, not in labor and absence (n=30) of microbial invasion of the amniotic cavity. Intrauterine infection was defined as a positive amniotic fluid culture for microorganism. Thrombin was detected by assaying the thrombin-antithrombin III complex in amniotic fluid by means of sensitive and specific immunoassay (Enzygnost TAT micro; Behring Diagnostics Inc Westwood MA). RESULTS: 1) TAT complex was detected in all amniotic fluid samples and its concentration did not have a relation with gestational age. 2) The women with a positive amniotic fluid culture had a significantly higher median TAT complex concentration than those with a negative cultures (median, 168 micro gram/l; range, 23.1-288 vs median 80 micro gram/l; range, 10.7-507; p<0.05). 3) Multivariate analysis showed that amniotic fluid TAT complex was an independent predictor for preterm delivery (odd ratio 4.72, p<0.05) after correction for known confounding variables (i.e. gestational age, cervical dilatation at amniocentesis and positive amniotic fluid culture). CONCLUSION: This study showed that TAT complex in amniotic fluid was elevated in women with preterm labor and intact membranes who had a intrauterine infection or were destined to deliver before term. Our findings support the hypothesis that the excess thrombin released during the course of intrauterine infection may play a role in the genesis of DIC in this condition.
Amniocentesis ; Amniotic Fluid* ; Chorioamnionitis ; Confounding Factors (Epidemiology) ; Cross-Sectional Studies ; Dacarbazine ; Disseminated Intravascular Coagulation ; Embolism, Amniotic Fluid ; Female ; Gestational Age ; Humans ; Immunoassay ; Labor Stage, First ; Membranes ; Multivariate Analysis ; Obstetric Labor, Premature ; Parturition* ; Pregnancy ; Thrombin*

Prenatal alpha-fetoprotein screening may serve as an index of suspicion of many congenital anomalies of the fetus including neural tube defect and aneuploid fetus. This study was undertaken to determine the normal ranges of AFP in maternal serum and amniotic fluid at 9 to 41 weeks gestation which thus far had not been established in Korea. Normal ranges of maternal serum and amniotic fluid AFP from 9 to 34 weeks and from 16 to 41 weeks gestation were obtained respectively from 198 uncomplicated pregnant women delivered of normal singleton baby. Maternal serum AFP values showed an increasing trend from 12 weeks gestation reaching a peak level at 29 to 34 weeks gestation and after which there was a gradual decline. Amniotic fluid AFP values was the highest at 17 weeks gestation and declined as pregnancy approached term. The correlation of a median value between AF AFP and MS AFP was 100 to 1 in ratio in each week. The authors conclude that this initial experience in Korea with maternal serum AFP values could efficiently detect genetic disorders, perhaps with high sensitivity and provide a proper management scheme of pregnant women with abnormal high and low AFP values during the midtrimester of pregnancy.
Abnormalities/diagnosis* ; Adult ; Amniocentesis ; Amniotic Fluid/analysis* ; Female ; Human ; Infant, Newborn ; Male ; Pregnancy ; Pregnancy Outcome ; Prenatal Diagnosis* ; Reference Values ; alpha-Fetoproteins/analysis*

BACKGROUNDBioactive proteins, such as cytokines and chemokines, have not been systematically evaluated in healthy and preeclamptic pregnancies. We aimed to investigate the difference of these proteins between healthy and preeclamptic pregnancies in order to help clarify their potential roles in the pathogenesis of hypertension and proteinuria in preeclampsia.

METHODSSamples of amniotic fluid and maternal/umbilical cord blood were collected from normal pregnancies and women with preeclampsia for examination of bioactive proteins. Fifty-three pregnant women were enrolled in this study. Of them, 30 pregnant women were recruited as healthy controls, and 23 pregnant women were diagnosed with preeclampsia. An antibody array was used to screen for higher levels of cytokines and related proteins in amniotic fluid than in the blood samples, and these proteins were then selected for quantification by immunoassay.

RESULTSInterleukin-1 receptor 4, hepatocyte growth factor, and urokinase plasminogen activator receptor were significantly elevated in the blood of preeclampsia patients. In particular, interleukin-1 receptor 4 was 8-fold higher in preeclampsia patients than in the healthy pregnancies. Moreover, in cord blood samples hepatocyte growth factor and interleukin-8 were significantly higher in preeclampsia patients.

CONCLUSIONSBecause of the biologic activities, Interleukin-1 receptor 4, hepatocyte growth factor, urokinase plasminogen activator receptor and interleukin-8 in maternal and/or cord blood could play a role in the pathogenesis of hypertension and proteinuria in preeclampsia.

Adult ; Amniotic Fluid ; metabolism ; Chemokines ; analysis ; physiology ; Cytokines ; analysis ; physiology ; Female ; Humans ; Hypertension ; etiology ; L-Lactate Dehydrogenase ; blood ; Pre-Eclampsia ; metabolism ; Pregnancy ; Proteinuria ; etiology

We present two fetuses who were prenatally diagnosed by amniocentesis as having chromosomal mosaicism but who had a normal karyotype in the fetal blood by cordocentesis. One of the both fetuses had Turner and the other had trisomy 20 mosaicism. The prognosis for Turner mosaicism and trisomy 20 mosaicism diagnosed prenatally has yet to be established. The pregnancy with 45,X/46,XX mosaicism was terminated at 23+3 weeks' gestation. Autopsy findings showed no features of Turner's syndrome. Postnatal cytogenetic analysis revealed 45,X[4]/46,XX[52] mosaicism in skin and 46,XX in the lung tissue. The other fetus had amniocytes with trisomy 20 mosaicism and fetal cord blood cells with a normal karyotype. The baby was delivered at 38+2 weeks' gestation. At birth and 3 months after birth, no apparent abnormal findings were found. These cases with chromosomal discrepancy among various fetal tissues are rare. Two cases were discussed with the review of literature.
Amniocentesis ; Amniotic Fluid ; Autopsy ; Chromosomes, Human, Pair 20 ; Cordocentesis ; Cytogenetic Analysis ; Cytogenetics ; Female ; Fetal Blood ; Fetus ; Karyotype ; Lung ; Mosaicism ; Parturition ; Pregnancy ; Prognosis ; Skin ; Trisomy ; Turner Syndrome

This study was conducted to investigate the potential embryo-fetal toxicity and toxicokinetics of the antimalarial agent artesunate (ARTS) in Sprague-Dawley rats. Pregnant rats were administered ARTS daily from gestational day 6~15 via oral gavage, at test doses of 0, 2, 4, or 8 mg/kg (22 females per group). The fetuses were examined for external, visceral, and skeletal abnormalities on gestational day 20. With regard to the dams, there were no deaths, treatment-related clinical signs, changes in body weight, or food intake in any of the treatment groups. There were no treatment-related gross findings at necropsy in any treatment group. In the 8 mg/kg group, there was a decrease in gravid uterine weight and in the weight of female fetuses. There was also an increase in fetal deaths (primarily late resorptions) and an increase in post-implantation losses (37%) at 8 mg/kg. An increase in the incidence of visceral and skeletal variations at 4 and 8 mg/kg was observed. These defects included minor changes in the appearance of the kidney and thymus, as well as absent ribs or thoracic vertebrae. Toxicokinetics were assessed in a parallel study, using 4 mated females per group. Using liquid chromatography-mass spectrometry (LC-MS) analysis, the concentration of ARTS and its metabolite dihydroartemisinin (DHA) were quantified in plasma from rats on gestational days 5, 6, 10, and 15. Amniotic fluid was assayed for ARTS and DHA on gestational day 15. There was evidence of rapid conversion of ARTS to the metabolite DHA in maternal plasma, since ARTS could not be consistently detected in plasma at the three doses tested. ARTS and DHA were not detected in amniotic fluid at gestational day 15, indicating limited placental transfer of the two agents. The embryo-fetal no-observable-adverse-effect level (NOAEL) of the test item was considered to be 8 mg/kg/day for dams, and 2 mg/kg/day for embryo-fetal development.
Amniotic Fluid ; Animals ; Artemisinins ; Body Weight ; Eating ; Female ; Fetal Death ; Fetus ; Humans ; Incidence ; Kidney ; Plasma ; Rats ; Rats, Sprague-Dawley ; Ribs ; Spectrum Analysis ; Thoracic Vertebrae ; Thymus Gland