Amniotic liquid

Composition

Fetal urine, fetal cells (exfoliation), and amniotic. This property allows the prenatal diagnosis (DPN), thanks to the amniocentèse (sampling of amniotic liquid and analyzes cells recuellies)

Physiology

  • the volume of the amniotic liquid is constantly a balance between the structures producing or authorizing its passage in the Amniotic cavity (Chorion and membranes, skin, respiratory tree, and urinary tract) and those concerned with the reabsorption (digestive tract, breathing apparatus, interface amnion-chorion on the uterine wall.
  • the most important phenomenon intermembranaire is related to the transfer between amniotic liquid and fetal blood perfusant placental surface, the fetal skin and the umbilical cord.
  • the transmembrane phenomenon relates to the exchanges between amniotic liquid and uterine muscle.

Production of the amniotic liquid

  • In the first quarter, only a diffusion by the amnion and the coupled chorion is real, as the absence testifies some or not to an alive embryo.
  • In the medium and at the end of the first quarter the skin is determining because it contains only four cellular layers, with a keratinization towards 24-26 weeks.
  • This liquid amniotic is lost when the contractions of the Utérus and cuts it of the baby bore the amniotic bag: it is the loss of water .

Exploration of the amniotic liquid

  • This liquid, which fills the digestive Tract and the Breathing apparatus of the fetus, contains cells of the future baby, which can be used at the time of a Amniocentèse

Evaluation of the amniotic liquid in the evaluation of the good fetal being

The evaluation of the quantity of amniotic liquid is an essential component of the evaluation of the Bien to be fetal. It enters the composition of the Score of Manning

Measurement technique

  1. Patient on the back
  2. To divide the uterus into four quadrants by using the sagittal line and a line perpendicular to half of the distance between the pubis and the uterine bottom
  3. Sonde must remain parallel to the plan sagittal and perpendicular to the plan coronal
  4. the pocket of amniotic liquid must be free and measurement strictly vertical
  5. the amniotic index is the sum of the four pockets
  • If the index is lower than 8, to remake measurement three times and made the average of these three measurements
  • One speaks about Hydramnios if the amniotic Index is higher than 25.
  • One speaks about Oligoamnios if the amniotic Index is lower than 5.

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