AMNIOTIC FLUID

Class Prayer
Prayer Leader:
Let us bow our heads and remember that we are in the Holy
Presence of God.

All:
Dear God, we know You are with us in this class. Bless us with
your Grace and help us become better Laurelians constantly
engaged in scholarly pursuits and continually finding optimal
and innovative solutions to challenge concerns that confront us.
Help us to be considerate, compassionate, and mindful of each
other as we strive to accomplish our common objective of
bolstering our knowledge and sharpening our skills with the
active participation of students and with guidance of faculty. We
pray that You bless our beloved LPU Davao so it will continue to
grow and last for generations to come; will be true to Laurelian
values; and will be faithful to our credo

PRO DEO ET PATRIA, VERITAS ET FORTITUDO.

Amen.
 Objectives:
• State the importance of Amniotic fluid;

• Describe the formation and composition of

Amniotic fluid; and

• Describe the analysis of amniotic fluid for the

detection of neural tube disorders.
 AMNIOTIC FLUID
PHYSIOLOGY

 Present in the amnion, a membranous sac that surrounds the

fetus.
 FUNCTIONS :
 Provides cushion for the fetus, allows movement of the fetus,
 stabilize the temperature to protect the fetus from extreme
temperature changes,
 permit proper lung development and
 exchanges of water and chemicals
 COMPOSITION:
o Similar to maternal plasma; contains small amount of sloughed fetal
cells
o Fetal swallowing regulates the increase in fluid from the urine.
o After first trimester, FETAL URINE is major contributor to the
amniotic fluid.
 AMNIOTIC FLUID
PHYSIOLOGY

 VOLUME :
• regulated by a balance between the production of fetal urine and
lung fluid and the absorption from fetal swallowing and
intramembranous flow.
• 35 ml for the 1st trimester
• 1 liter for the 3rd trimester
• POLYHDRAMNIOS – excessive accumulation of amniotic fluid-
volume > 1200ml
- failure of swallowing
• OLIGOHYDRAMNIOS – decrease to failure of swallowing
 COLOR AND APPEARANCE
 Normal color may exhibit slight turbidity
 Blood streak may due to Traumatic tap, abdominal trauma,
intra-amniotic hemorrhage
 AMNIOTIC FLUID
SPECIMEN COLLECTION and SPECIMEN HANDLING
 Needle aspiration into the amniotic sac called AMNIOCENTESIS
• Transabdominal amniocentesis
• Vaginal amniocentesis
• Performed after 14th week of gestation
 Fluid for chromosomes analysis is collected at 16th
week of gestation
 Maximum of 30 ml is collected
 Fluid for fetal lung maturity test should be placed in Ice for
delivery to the laboratory and refrigerated prior to testing.
 Specimen for cytogenic studies are maintained at room or body temperature
prior to analysis
 All Fluid for chemical tests should be separated from cellular elements and
debris as soon as possible.
 AMNIOTIC FLUID
SPECIMEN COLLECTION and SPECIMEN HANDLING
 Needle aspiration into the amniotic sac called AMNIOCENTESIS
• Transabdominal amniocentesis
• Vaginal amniocentesis
• Performed after 14th week of gestation
 Fluid for chromosomes analysis is collected at 16th
week of gestation
 Maximum of 30 ml is collected
 Fluid for fetal lung maturity test should be placed in Ice for
delivery to the laboratory and refrigerated prior to testing.
 Specimen for cytogenic studies are maintained at room or body temperature
prior to analysis
 All Fluid for chemical tests should be separated from cellular elements and
debris as soon as possible.
 AMNIOTIC FLUID
TEST FOR FETAL DISTRESS
 Hemolytic disease of the Newborn
• Measurement of amniotic fluid performed by
spectrophotometric analysis
• The optical density of the fluid is measured in intervals
between 365 nm and 550 nm and the readings are
plotted on semilogarithmic graph
 Neutral Tube Defects
• Indicated by an increase of the protein AFP in both maternal
circulation and amniotic fluid.
• Indicative of fetal neutral tube detect such as Anencephaly and
Spina Bifida.
• Both serum and amniotic fluid AFP levels are reported in terms of
multiples of the median. (MoM)
 AMNIOTIC FLUID
TEST FOR FETAL MATURITY
 RESPIRATROY DISTRESS SYNDROME
o is the most frequent complication of early delivery
o 7th most common cause of morbidity and mortality in the
premature infant
 LECITHIN-SPHINGOMYELIN RATIO
o Lecithin - primary component of the surfactants that make up the
alveolar lining and account for alveolar stability
o Sphingomyelin – serves as a control on which to base the rise of
lecithin
Up to 26th week of gestation: On the 36th week of gestation:
ratio ratio
Lecithin < sphingomyelin Lecithin = sphingomyelin

After 36th week of gestation

Lecithin is markedly increased, while
sphingomyelin levels remain constant