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In the first trimester, the main sources of amniotic fluid are fetal lung secretions, transportation of maternal plasma across the fetal membranes, and the surface of the placenta. By the second trimester, the fetal kidneys start to produce urine which becomes the main source of the amniotic fluid for the remainder of the pregnancy. [4]
Leaking or rupture of membranes: Leaking or rupture of membranes may be caused by a gush of fluid or a slow constant trickle of fluid. This is due to a tear in the membrane. Premature rupture of membranes can also result in low amniotic fluid levels. Placental problems: Placental problems may cause low amniotic fluid. If the placenta is not ...
Twin-to-twin transfusion syndrome (TTTS), also known as feto-fetal transfusion syndrome (FFTS), twin oligohydramnios-polyhydramnios sequence (TOPS) and stuck twin syndrome, is a complication of monochorionic multiple pregnancies (the most common form of identical twin pregnancy) in which there is disproportionate blood supply between the fetuses.
It is characterized by changes in fetal movement, growth, heart rate, and presence of meconium stained fluid. [4] Risk factors for fetal distress/non-reassuring fetal status include anemia, restriction of fetal growth, maternal hypertension or cardiovascular disease, low amniotic fluid or meconium in the amniotic fluid, or a post-term pregnancy.
Fetal urine production begins in early gestation and comprises the majority of the amniotic fluid in the second and third trimesters of pregnancy. The fetus continuously swallows amniotic fluid, which is reabsorbed by the gastrointestinal tract and then reintroduced into the amniotic cavity by the kidneys via urination.
PUBS is also indicated in the cases of twins with accumulation of amniotic fluid and substantially different growth rates (at least 10%), if the fetus is expected to be breaking down red blood cells improperly, and in the alleviation of hydrops fetalis, a build-up of fluid in at least 2 parts of the fetus. [28]
Amniotic fluid embolism, a condition in which amniotic fluid or other fetal debris enters the maternal circulation, is an extremely rare and catastrophic complication of amniocentesis. [1] Amniotic fluid embolism can result in cardiovascular collapse and has a poor maternal prognosis. [43]
Amniotic fluid is mildly basic (pH 7.1–7.3) compared to normal vaginal secretions which are acidic (pH 4.5–6). [10] Basic fluid, like amniotic fluid, will turn the nitrazine paper from orange to dark blue. [9] Fern test: A sterile cotton swab is used to collect fluid from the vagina and place it on a microscope slide.