1. Presanted by
Reshma Suzen

2. • Amniotic fluid is found in the membranous sac that
surrounds the fetus and provides a cushion to protect the
fetus

3. Transudation from maternal circulation
Secretion from amniotic epithelium
Transudation from fetal plasma
Contribution from the fetus

4. Amniotic fluid volume :
• About 500 mls enter and leave the amniotic sac each hour.
• gradual ↑ up to 36 weeks to around 600 to 1000 ml then↓ after
that.
• The normal range is wide but the approximate volumes are:
- 50 ml at 12 weeks
- 400 ml at 20 weeks
- 800 ml at 34 weeks.
- 1L at 36-38 week.
- 600 - 800 ml at term.

5. a) Organic @ non organic
 Protein : .3gm %
 Glucose : 20mg%
 Urea : 30mg%
 NPN : 30mg%
 Uric acid : 4mg%
 Creatine : 2mg
 Total lipids : 50mg%
 hormones

6. b) Non organic
Sodium
Sodium chloride
c) Suspended particles
Lanugo
Exfoliate squamous cell
Vernix caseosa

7. Alkaline
Low specific gravity – 1.010
Hypotonic to maternal serum at term
Osmolarity – 250 Osmol
Colour
– in early pregnancy colourless
- at term it become pale straw
colored

8. Green : meconium stained
Golden : Rh incompactability
Greenish yellow : post maturity
Dark colured : concealed accidental
haemorrhage
Dark brown : IUD

9. Amniotic fluid function:
During pregnancy
• Allow room for fetal growth, movement and
development.
• Ingestion into GIT→ growth and maturation.
• Fetal pulmonary development (20 weeks).
• Protects the fetus from trauma.
• Maintains temperature.
• Contains antibacterial activity.

10. Dilatation of cervix
Flushes the birth canal by its antiseptic
and bactericidal action

11. Clinical importance of AF:
• Screening for fetal malformation (serum α-
fetoprotien).
• Assessment of fetal well-being (amniotic fluid
index).
• Assessment of fetal lung maturity (L/S ratio).
• Diagnosis and follow up of labour.
• Diagnosis of PROM

13. Tests for the Well-being and Maturity
____________________________________________ ______________
Test Normal values at term Significance
__________________________________________________________
Bilirubin scan 0.025 mg/dl Hemolytic disease
of the newborn
L/S ratio 2.0 Fetal lung maturity
Phosphatidyl- Present Fetal lung maturity
Glycerol
Creatinine 1.3 – 4.0 mg/dl Fetal age
Alpha fetal protein 4.0 mg/dl Neural tube disorders
__________________________________________________________

14. Amniotic fluid abnormalities
 Oligohydramnios:
Defined as reduced amniotic fluid i.e. amniotic
fluid index of 8 cm
 Polyhydramnios:
Defined as excessive amount of amniotic fluid of
2000 ml or more (AFI of > 20 cm