Dr.

Anisha Mathew
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Amniotic fluid analysis &

Other body fluids Analysis
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Body Fluids

 Includes Urine, fluid in body

cavities, sweat, joint fluids etc.
 Generally involved in process
of transportation, excretion and
lubrication
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Various Body Fluids

 Amniotic fluid
 Pericardial, Parietal, peritoneal fluids
 Synovial Fluid
 Gastric fluid
 Semen
 Other body fluids: Sweat, Saliva, Tears
 Body Fluid Analysis
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Amniotic Fluid
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Amniotic Fluid
 Liquid produced by membranes and
fetus
 Surrounds fetus during pregnancy

 Volume increases with gestational

age (2 weeks- 30ml-350ml),
thereafter 500-1000ml
 Clear with desquamates fetal cells &
little lipids
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Functions of Amniotic Fluids

 Provides protective cushion for foetus

 Allows fetal movements

 Stabilize temperature to protect fetus from extreme

temperature change
 Permit proper lung development
 Properties of Amniotic fluid
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 Composition

 Same as maternal plasma

 Small amount of sloughed fetal cells

 Portion from fetal respiratory tract,

urine, amniotic membrane, &
umbilical cord
 Utility of analysis
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 Diagnostic
 Early months of pregnancy
 Neural Tube defects

 Inborn errors of metabolism

 Karyotyping

 Later months of Pregnancy

 Foetal Maturation

 Foetal Distress

 Rh incompatibility

 Lung development in fetus

Gross Examination of Amniotic
Fluid z

 Normally colorless to pale

yellow
 Slight moderate turbidity

 Cellular debris, especially

in late fetal development
period
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Examination of amniotic fluid

Properties
Specific Gravity 1.01
Colour Colourless/Straw
Bilirubin <0.04 mg/dL
Creatinine ~2.2 mg/dL
L/S ratio >2
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Examination of Amniotic fluid

a. Gross Appearance
Colour Condition
Pale Straw Normal
Green Fetal Distress
Golden Rh incompatibilty
Dark Brown Intrauterine foetal
death
Red colour Fresh Heamorrhage
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Examination of Amniotic Fluid

2. Cytogenetic and biochemical studies

Test Significance
Karyotyping Chromosomal disorders
Bilirubin Hemolytic disease
Phospholipids Lung maturity
Foam Stability test Lung Maturity
Hormones Hormonal disorders
Creatinine Concentration Maturity of fetus
Alpha fetoprotein Neural Tube defects
Determination of Fetal Lung
Maturity
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Hemolytic disease
assessment

 Liley’s chart
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Specimen Collection

 Amniocentesis
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Amniocentesis: karyotyping
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Serous Fluids
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Pleural Fluid

 Thoracentesis

 Sample to be collected in Heparin vials and EDTA vials

 Check if fluid is exudate or transudate

z Causes of Pleural Effusion
 Transudate Vs. Exudate
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 Light’s criteria
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Series of fluid/plasma (F/P) ratios

 F/P for total protein is greater than 0.5

 Ratio for lactate dehydrogenase (LDH) is greater than 0.6

 Pleural fluid LDH/upper limit serum LDH ratio reference

interval is greater than 0.67
Causes of transudative and Exudative effusions
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 Gross Appearance of Pleural Fluid
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Appearance Condition
Bloody Malignancy, Asbestosis,
Pulmonary infarction
White-milky Chylothorax,
Psuedochlyothorax
Black Aspergillus Niger
Yellow Green Test Glucose
Anchovy Sauce Amoebic Liver Abscess
Pus (Fetid odor) Empyema
Clear Central Line
Amber Colour Urinothorax (Check Urea &
Creatinine of pleural fluid)
 Chemical Analysis of Pleural Fluid
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Biochemical Parameter Significance
Protein Little Value

Glucose Decreased fluid/serum glucose

ratio- rheumatoid pleuritis
Lactate Infectious pleuritis
Amylase Elevated in oesophageal
rupture or pancreatitic rupture
LDH Inflammation
ADD TB pleuritis
Interferon gamma “
pH Identifies type of effusion
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Peritoneal Fluid

 Peritoneal cavity is space between abdomen organ (such as

stomach, spleen, liver and Gall bladder)
 Liquid in abdominal cavity to lubricate tissue that lines
abdominal wall, pelvic cavity and cover
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Peritoneal
Fluid
Analysis
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 z Serum Ascites albumin gradient (SAAG)
• Method for determining transudates and exudates

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Other tests

 Cytology: Malignant cells

 Amylase: Exclude pancreatic ascites

 ALP: Hollow visceral injuries

 ADA: TB peritonitis

 Lactate: TB peritonities
 z Pericardial Fluid

 Obtained by Pericardiotomy

 Normal Pericardial Fluid:

Pale yellow & clear
 Large effusion (>350ml)
most often caused by
malignancy/uremia/idiopathic
 Other fluids
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Synovial and Sweat
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Synovial Fluid

 Movable joint contains a cavity that is enclosed by a capsule;

the inner lining of the capsule is synovial membrane
containing synovial fluid
 Mucoprotein rich in hyaluronic acid, making it viscous

 Functions as a lubricant for the joints and as a transport

medium for delivery of nutrients and removal of cell wastes
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Collection of sample

 Arthrocentesis
of the joint
under aseptic
conditions
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Tests of Synovial fluid

 Ratio of synovial fluid

to plasma glucose
(0.9:1)
 Microscopic
examination
(Polarized light
Microscopy)
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Sweat Analysis

 Analysis of sweat for chloride levels in the diagnosis of cystic

fibrosis (CF)
 For CF: abnormal sweat electrolytes, pancreatic or bronchial
abnormalities, and family history
 Under research for molecular and diagnostic prediction of
diseases
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Thank You