Amniotic fluid

• Circulation: replaced in every 3 hours.

• Volume: 50ml at 12 weeks, 400ml at 20 weeks, 1lt at 36-38weeks,
600-800ml at term, 200ml at 43 weeks i.e post-term.
• Faintly alkaline, low specific gravity of 1.010, highly hypotonic to
maternal serum at term.
• An osmolarity of 250mmol/L is suggestive of fetal maturity.
• Colorless in early pregnancy, pale straw at term, may look turbid.
• Abnormal color:
 Meconium stained(green): fetal distress
 Golden : Rh incompatibility
 Greenish yellow(saffron): postmaturity.
 Dark: concealed accidental haemorrhage
 Dark brown(tobacco juice): IUD
• Composition: in 1st half, identical to transudate of plasma. In late pregnancy, very much altered, d/t
fetal urinary metabolites, includes water(98-99%) and solid(1-2%).
• Function: protect the fetus.
 During pregnancy:
1. Act as shock absorber, protects the fetus from extraneous injury.
2. Maintains an even temperature
3. Distends the amniotic sac and allows for growth and free movement of fetus and prevents
adhesion.
4. Nutrition
 During labor:
1. Amnion and chorion are combined to form a hydrostatic wedge which helps in dilatation of cervix.
2. During uterine contraction, it prevents marked interference with placental circulation so long as
the membranes remain intact.
3. Guards against umbilical cord compression.
4. Flushes the birth canal at the end of 1st stage of labor and by its aseptic and bactericidal action
protects fetus and prevents ascending infection to the uterine cavity.
• Clinical importance:
1. Provides information about well being and maturity of fetus.
2. Intra amniotic instillation of chemicals is used as method of
induction of abortion.
3. AFI: maternal abdomen is divided into quadrants taking
umbilicus, pubic symphysis and fundus as the refernce points.
With ultrasound, largest vertical pocket in each quadrant is
measured. The sum of four measurements(cm) is the AFI. It is
measured to diagnose polyhydromnios or oligohydromnios.
4. Rupture of membranes with drainage of liquor is helpful
method in induction of labor.