Complement factors in fetal and maternal blood and amniotic fluid during the second trimester of normal pregnancy

ABSTRACT Prenatal diagnosis is the branch of medicine and in particular of obstetrics, that studies and applies the techniques that reveal the normality or the presence of diseases of various kinds, in the fetus. All the techniques of prenatal diagnosis are performed during pregnancy and may be invasive or less. Among the best known, amniocentesis is the most exploited technique nowadays to highlight the possible presence of chromosomal disorders in the fetus, but also infections and genetic diseases such as thalassemia, cystic fibrosis, hemophilia, spina bifida, albinism. Amniocentesis consists of taking an amniotic fluid sample which is then analyzed. Fetal cells suspended in the withdrawn liquid allow us to reconstruct the chromosome map of the fetus and then to confirm or not its normality. Genetic testing, however, are not able to recognize the physical or mental characteristics of the unborn child which are the result of the interaction between multiple genes and the environment. Amniotic fluid makes possible to perform other types of analysis, more or less complex, and it is also possible to store the amniotic stem cells. Similar to amniocentesis as a principle but different as a technique, is chorionic villus sampling (CVS), in which the cells can be put in culture to show their normality, but they are cells taken outside from the gestational chamber (chorionic villi). These are invasive techniques (the fluid is taken by puncture in both cases), but there are also noninvasive techniques. The development of ultrasound, for example, has made it possible to develop some highly sensitive diagnostic techniques, such as the first trimester combined test [bitest and nuchal translucency (NT)], the ‘quadruple’ test, and lately the SCA test in the second trimester, all based on the ultrasound measurement of anatomical and functional parameters of the fetus and on the results of blood tests. These are all screening tests, then they do not give a definite answer but they have a statistical value (very accurate) that can direct toward diagnostic tests. Recently, an extremely sensitive test for the most common aneuploidies and in particular Down syndrome has been proposed to be performed on maternal blood. This test (called fetal DNA testing) is based on the count of fragments of specific chromosomes (21 in the case of Down syndrome) in maternal blood. Although not belonging to diagnostic tests but to probabilistic ones, this test is absolutely the most accurate so far available, with values around 99.99% sensitivity and 0.2% false positives. Also ultrasound in the second trimester of pregnancy (also called morphological ultrasound) that can detect any malformation or fetal abnormality and fetal echocardiography, which analyzes sonographically the fetal heart not only anatomically but also from the dynamic-functional point of view, may be considered methods of prenatal diagnosis. This technique cannot identify genetic diseases. How to cite this article Borruto F, Treisser A, Comparetto C. Prenatal Diagnosis, Where and How: No Way Out? Donald School J Ultrasound Obstet Gynecol 2014;8(3):293-310.

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Determination of prolactin, growth hormone, β-endorphin, and cortisol in both maternal plasma and amniotic fluid during human gestation

Acta Endocrinologica ◽

10.1530/acta.0.1210297 ◽

1989 ◽

Vol 121 (2) ◽

pp. 297-303 ◽

Cited By ~ 5

Author(s):

Toshiro Kubota ◽

Hiroo Tsuzuki ◽

Motoi Saito

Keyword(s):

Cesarean Section ◽

Amniotic Fluid ◽

Maternal Blood ◽

Maternal Plasma ◽

Full Term ◽

Elective Cesarean Section ◽

Second Trimester ◽

Elective Cesarean ◽

Cortisol Levels ◽

Plasma Prl

Abstract. This study focuses on PRL, GH, β-endorphin and cortisol in maternal blood and amniotic fluid during human pregnancy. Maternal blood and amniotic fluid samples were obtained from 18 normal pregnant women in the second trimester, 12 full-term gravidas having spontaneous delivery, and 10 full-term gravidas having elective cesarean section. Two gravidas bearing anencephalic fetuses in the third trimester were also studied. In the second trimester women, levels of PRL (3215.9 ± 458.9 μg/l), GH (19.1 ± 1.7 μg/l) and β-endorphin (11.1 ± 0.9 pmol/l) were significantly higher in the amniotic fluid than in maternal plasma. In addition, PRL was significantly correlated with β-endorphin (r = 0.670) and with GH (r = 0.547) in the amniotic fluid. However, amniotic fluid cortisol levels (0.27 ± 0.18 nmol/l) were significantly lower than plasma cortisol levels. The amniotic fluid of the women with anencephalic fetuses had normal levels of PRL, GH and β-endorphin. In full-term gravidas, plasma PRL levels were significantly lower in women with vaginal delivery than in those with elective cesarean section, and there was a significant negative correlation between plasma PRL and β-endorphin, and between plasma PRL and cortisol levels. Plasma GH levels in women with vaginal delivery showed no signficant difference from those in women with cesarean section. Examination of amniotic fluid yielded no significant differences in the levels of PRL, β-endorphin and GH between these two groups. The authors conclude that the hormone releasing system in amniotic fluid seems to be independent of that in maternal plasma during pregnancy, and that the stress of labour has a significant effect on plasma PRL, β-endorphin and cortisol levels in maternal plasma but not on those in amniotic fluid.

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Expression pattern of cytokines in the different compartments of the feto-maternal unit under various conditions

Reproduction Fertility and Development ◽

10.1071/rd9951573 ◽

1995 ◽

Vol 7 (6) ◽

pp. 1573 ◽

Cited By ~ 57

Author(s):

T Stallmach ◽

G Hebisch ◽

H Joller ◽

P Kolditz ◽

M Engelmann

Keyword(s):

Amniotic Fluid ◽

Uterine Contraction ◽

Venous Blood ◽

Normal Pregnancy ◽

Maternal Blood ◽

Significant Rise ◽

Gm Csf ◽

Uterine Contractions ◽

Fluid Compartment ◽

Maternal Peripheral Blood

Concentrations of five cytokines, GM-CSF, G-CSF, IL-1, IL-6 and IL-8, were determined within five compartments under four different conditions: at the time of a Caesarean section performed between 25 and 38 weeks' gestational age in normal pregnancy without uterine contraction (n = 12), in normal pregnancy with labour already established (n = 8), in pregnancy complicated by amniotic infection (n = 11), or under the conditions of preeclampsia with fetal intrauterine dystrophy (n = 13), cytokine concentrations were determined in fetal arterial and venous blood, in amniotic fluid, and in retroplacentally obtained maternal blood and peripheral maternal blood. With dystrophy, the concentrations of GM-CSF, G-CSF and IL-1 were about 20-50% lower (P < 0.01) in the amniotic fluid, and IL-6 and IL-8 were elevated in maternal peripheral blood (P < 0.01) but not within maternal retroplacental blood. Thus, preeclampsia/intrauterine dystrophy is characterized by reduction of some cytokines within the amniotic fluid compartment and concomitant reactive augmentations of other cytokines within the maternal and fetal organism. With amniotic fluid infection, concentrations of G-CSF, IL-6 and IL-8 were elevated in all compartments (P < 0.001) but GM-CSF and IL-1 showed a significant rise only within amniotic fluid and retroplacental maternal blood (P < 0.001), a rise that was apparently not transmitted to peripheral maternal or fetal blood. Care was taken to exclude the presence of uterine contractions in the group of controls, because this condition by itself causes severe elevation of cytokine concentrations, which are pronounced within amniotic fluid.

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The amniotic fluid proteome changes with gestational age in normal pregnancy: a cross-sectional study

Scientific Reports ◽

10.1038/s41598-021-04050-9 ◽

2022 ◽

Vol 12 (1) ◽

Author(s):

Gaurav Bhatti ◽

Roberto Romero ◽

Nardhy Gomez-Lopez ◽

Tinnakorn Chaiworapongsa ◽

Eunjung Jung ◽

...

Keyword(s):

Amniotic Fluid ◽

Gestational Age ◽

Fetal Liver ◽

Normal Pregnancy ◽

Maternal Blood ◽

Brain Regions ◽

Cross Sectional Study ◽

Cross Sectional ◽

Proteome Changes ◽

Gestational Tissues

AbstractThe cell-free transcriptome in amniotic fluid (AF) has been shown to be informative of physiologic and pathologic processes in pregnancy; however, the change in AF proteome with gestational age has mostly been studied by targeted approaches. The objective of this study was to describe the gestational age-dependent changes in the AF proteome during normal pregnancy by using an omics platform. The abundance of 1310 proteins was measured on a high-throughput aptamer-based proteomics platform in AF samples collected from women during midtrimester (16–24 weeks of gestation, n = 15) and at term without labor (37–42 weeks of gestation, n = 13). Only pregnancies without obstetrical complications were included in the study. Almost 25% (320) of AF proteins significantly changed in abundance between the midtrimester and term gestation. Of these, 154 (48.1%) proteins increased, and 166 (51.9%) decreased in abundance at term compared to midtrimester. Tissue-specific signatures of the trachea, salivary glands, brain regions, and immune system were increased while those of the gestational tissues (uterus, placenta, and ovary), cardiac myocytes, and fetal liver were decreased at term compared to midtrimester. The changes in AF protein abundance were correlated with those previously reported in the cell-free AF transcriptome. Intersecting gestational age-modulated AF proteins and their corresponding mRNAs previously reported in the maternal blood identified neutrophil-related protein/mRNA pairs that were modulated in the same direction. The first study to utilize an aptamer-based assay to profile the AF proteome modulation with gestational age, it reveals that almost one-quarter of the proteins are modulated as gestation advances, which is more than twice the fraction of altered plasma proteins (~ 10%). The results reported herein have implications for future studies focused on discovering biomarkers to predict, monitor, and diagnose obstetrical diseases.

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