Amniotic
Amniotic
Amniotic
RESEARCH Paper
Abstract
Amniotic fluid is defined as a transparent liquid that is present in the uterus during
pregnancy. In this study obtain 100 sample of vaginal swaps(50 from normal birth and 50 from
caesarean), 100 samples of amniotic fluid (50 samples from normal birth and 50 samples from
caesarean) from pregnant women revision born lounge in Hilla teaching hospital, and 50
samples of amniotic sac from the caesarean women to made histological section. The result
showed the number of positive swaps of bacteria was 81 (81%) , while positive samples from
amniotic fluid was 74 (74%) from the total 100 sample and present relationships between
vaginal infection and the present of bacteria in the amniotic fluid .The type of aerobic
bacteria isolated was Escherichia coli ,Pseudomonas aeruginosa, Bacillus subtilis, Klebsiella
pneumonia, Staphylococcus epidermidis, Staphylococcus aureus, Streptococcus mutans,
Proteus mirabilis and anaerobic bacteria was Peptostreptococcus sp. Neisseria gonorrhoeae,
Lactobacillus sp. and Actinomyces sp. were isolated from amniotic fluids and vaginal swabs.
then injection the same bacteria isolated in mice and made histological section from mice
amniotic sac. Cross section of amniotic tissues in both of women and mice showed infiltration of
lymphocyte, hemorrhage and elongation of epithelial cell as a result of bacterial infection.
Keywords: Amniotic fluid, Amniotic sac, Caesarean, Vaginal infection. In vitro, In vivo.
Introduction
Amniotic fluid is defined as a transparent Help the fetus to move freely without any
liquid that is present in the uterus during difficulty (3).
pregnancy. The fetus grows within this sac
for 9 months and surrounding with the The amount of fluid in often reaches one liter,
amniotic fluid (1). but this amount increased (Polyhydramnios)
or decreased (Oligohydramnios)belong to the
The important of amniotic fluid during the number of reasons, In both cases you should
pregnancy period is: make sure to see the doctor routinely to make
sure your pregnancy is well and the fetus is
Protects the fetus from exposure to growing without any abnormal problems (1).
microbial infection.
Protects the fetus from any trauma. In both cases, high or low amniotic fluid may
Helps to complete the growth of the fetal be a sign of fetal suffering from certain
lungs(2). congenital malformations, a rupture of fetal
Helps to grow fetal muscles and bones. membranes or certain problems in the
Maintains a normal temperature so that placenta and other causes (3). The amniotic
the fetus does not feel hot or cold. fluid is free from microorganisms, but it is
exposed to contamination when the pregnant
mother suffers of repeated vaginal infections Obtain 50 samples from the amniotic sac from
during pregnancy lead to the present caesarean of the fetus in the tube contain
microorganism in the amniotic fluid (2). formal saline and then made the histological
section to study the histological change (3).
The Aim of this Study was
Experimental Mice
Isolated and identification of bacteria from Eight female and three male mice were selected
amniotic fluids and vagina. at the age of 2-3 months and each two females
were crossed with one male and two female
Study the relationships between vaginal mice as control. Visible of vaginal plug
infection and the present of bacteria in the designated as indicator on mating, which was
amniotic fluids in vivo and in vitro. considered the first day of pregnancy. After one
week, the female mice were injection by intra-
Study the patho-histological change of the vaginal with bacterial suspension (E.coli & N.
fetus amniotic sac of women and mice gonorrhoeae) contain about 105 cell ∕ ml , in
Material and Method addition to control mice injected with normal
saline solution, after about 7 days of injection,
Vaginal Swaps the pregnant mice were dissected and re-
Obtain 100 vaginal swaps from pregnant isolated of bacteria from amniotic fluid, then a
women (50 from normal birth and 50 from part of the amniotic sac was placed in the
caesarean) and taken to the microbiology formal saline solution until tissue sections
laboratory to identification the isolated bacteria were made to study tissue changes due to
(4). bacterial infection compared with control
mice(5).
Amniotic Fluids
Obtain 100 samples of amniotic fluid from Statistical Analysis
pregnant women revision born lounge in Hilla
teaching hospital by using sanitizer and clean Statistical analysis was performed by using
container (50 from normal birth and 50 from SPSS statistical computer software.
caesarean) and taken to the microbiology Result and Discussion
laboratory to identification the isolated bacteria
(1). The result showed the number of positive
swaps of bacteria was 81 (81%) from the total
Identification of Bacteria 100 sample (5) Statistical analysis showed
The sample cultured on the different media significant difference between positive and
(MacConkey`s agar, Blood agar , Eosin m negative samples figure (1).The similar result
ethylene blue agar, chocolate agar and Brain- obtain by Jabuk, et al., (6). The result showed
Heart Infusion agar plates) under aerobic and the number of positive samples of bacteria
anaerobic condition, then investigations the isolated from amniotic fluid was 74(74%) from
bacteria isolated by using different biochemical the total 100 sample and present the number of
test and gram's stain(4). positive sample in age 21-25 was 20 (20%) from
total 32 (32%) more than anther age figure (2)
Amniotic Sac Collection Statistical analysis showed significant
difference between positive and negative
samples.
Figure 1: The number of positive vaginal swabs sample according to the age
©2009-2017, JGPT. All Rights Reserved 148
Sura I. A. Jabuk et. al., Journal of Global Pharma Technology. 2017; 08(9):147-152
Figure 2: The number of positive amniotic fluid sample according to the age
When taken the sample of amniotic fluid significant difference between them . The
present that 56 % normal amniotic fluid, 28 same result obtain from Tasneem et al., (7)
% polyhydramnios and 16 % oligohydramnios when present the percentage of normal
from the total 100 samples table (1) amniotic fluid was 59 more than another type
Statistical analysis showed (oligohydramnios 20% and polyhydramnios
21%).
No. of positive
37(37) 23(23) 14(14) 74(74)
samples (%)
No. of negative
19(19) 5(5) 2(2) 26(26)
samples (%)
2
P value=0.0018P<0.05 significant difference χ =49.04
When observed the nature of amniotic fluid difference between the nature type of
present that 22% clear ,36 thick and 48 % amniotic fluid while Tasnee metal. (7)
thin from the total number Table (2). present the percentage of clear type more
Statistical analysis showed significant anther type.
Table 2: The number and percentage of positive and negative samples according to the nature
of amniotic fluid
Nature of
Amniotic fluid Thin Thick Clear Total No. (%)
The culture ,microscopic and biochemical isolated and number of genus N. gonorrhoeae
test diagnosis number of aerobic and more than another type of anaerobic bacteria
anaerobic type of bacteria isolated from (9).Georgeet al., (10) also present the number
vaginal swap and amniotic fluid of the of isolated E. coli more than another type.
pregnant women list in table (3) similar the The result showed the women under go
result obtain by jabuk, S.I. (8) . repeating vaginal infection by bacteria
contain the same bacteria in the amniotic
The result showed the number of genus E.coli fluid surrounding the fetus during the
more than another type of aerobic bacteria pregnancy.
©2009-2017, JGPT. All Rights Reserved 149
Sura I. A. Jabuk et. al., Journal of Global Pharma Technology. 2017; 08(9):147-152
Table 3: The type and number of bacteria isolated from vaginal swap and amniotic fluid of the pregnant women
NO. of bacteria isolated NO. of bacteria isolated from
Type of bacteria
from vagina amniotic fluid
Aerobic
Escherichia coli 30 25
Pseudomonas aeruginosa 7 0
Bacillus subtilis 10 8
Klebsiella pneumoniae 14 10
Staphylococcusepidermidis 15 12
Staphylococcus aureus 24 18
Streptococcus mutans 10 0
Proteusmirabilis 11 8
Anaerobic
Peptpstreptococcus sp. 9 5
Neisseria gonorrhoeae 11 8
Lactobacillus sp. 5 0
Actinomyces sp. 7 1
The histological section of amniotic sac result of different virulence factor produced
showed the present many pathological from the isolated bacteria such as toxin
change such as infiltration of lymphocyte, (enter toxin & exotoxin), hemolysis,
hemorrhage and elongation of epithelial cell adherence compare with the amniotic tissue
(Figure 1,2). This pathological change as a prepared from non-infected women (12).
Figure 1: Cross section of women amniotic Figure 2: Cross section of women amniotic
tissue showed infiltration of lymphocyte tissue showed hemorrhage staining
staining with hematoxylin and eosin with hematoxylin and eosin
.
Figure 3: cross section of women amniotic tissues showed elongation of epithelial cell
staining with hematoxylin and eosin.
Figure 4: Cross section of mice amniotic Figure 5: Cross section of mice amniotic
tissues showed hemorrhage and staining tissues showed infiltration of lymphocyte
with hematoxylin and eosin. staining with hematoxylin and eosin.
Figure 6: cross section of normal mice amniotic tissues (normal) staining with hematoxylin
and eosin.
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Appendix
Table 1: The number and percentage of bacterial isolated from vaginal swabs according to
the age
Total
Age No of Negative (%) No of positive (%)
No. (%)
21-25 9(9) 25(25) 34 (34)
26-30 5(5) 18(18) 33(33)
31-35 3(3) 15(15) 18(18)
36-40 1(1) 13(13) 14(14)
41-45 1(1) 10(10) 11(11)
Total
19(19) 81(81) 100 (100)
No.(%)
P value=0.000078 P<0.05 significant difference
χ2=56
Table 2: The number and percentage of bacterial infection in amniotic fluid samples according to the age
Total
Age No of Negative samples (%) No of positive samples (%)
No.(%)
21-25 12(12) 20(20) 32 (32)
26-30 8(8) 18(18) 26(26)
31-35 4(4) 16(16) 20(20)
36-40 2(2) 12(12) 14(14)
41-45 0(0) 8(8) 8(8)
Total
26(26) 74(74) 100 (100)
No.(%)
P value=0.000021 P<0.05 significant difference
2
χ =27.44