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Related Experiment Videos

Amniotic fluid activates complement. A role in amniotic fluid embolism syndrome?

D E Hammerschmidt, P L Ogburn, J E Williams

    The Journal of Laboratory and Clinical Medicine
    |December 1, 1984
    PubMed
    Summary

    Amniotic fluid embolization can activate the complement system, leading to pulmonary leukostasis. This immune response, particularly in distressed pregnancies, may contribute to post-cesarean pulmonary collapse.

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    Area of Science:

    • Immunology
    • Obstetrics
    • Pulmonary Medicine

    Background:

    • Amniotic fluid embolization (AFE) is a rare but catastrophic obstetric emergency.
    • Pulmonary microvascular leukostasis has been observed in fatal AFE cases.
    • The precise mechanisms triggering AFE-induced pulmonary complications remain under investigation.

    Purpose of the Study:

    • To investigate the in vitro capacity of amniotic fluid to activate granulocytes and the complement system.
    • To identify components within amniotic fluid responsible for immune activation.
    • To explore the potential role of maternal plasma variability in AFE pathogenesis.

    Main Methods:

    • Incubation of human amniotic fluid with normal plasma and granulocytes.
    • Assays for granulocyte aggregation, respiratory burst, and chemotaxis.

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  • Complement activation assays, including assessment of the alternative pathway.
  • Analysis of amniotic fluid lipid content and its role in complement activation.

    • Main Results:

    • Normal amniotic fluid did not directly activate granulocytes but activated the complement system in normal plasma.
    • Complement activation was primarily mediated by lipid-rich particulate matter in amniotic fluid, predominantly via the alternative pathway.
    • Significant variability was observed in the complement-activating potential of amniotic fluids and the activatability of plasma, with potent activators often associated with distressed pregnancies or gravid donors.

    Conclusions:

    • Amniotic fluid embolization can initiate a potent inflammatory cascade involving complement and granulocyte activation.
    • This immune activation may contribute to the pulmonary leukostasis and collapse seen in AFE.
    • The severity of AFE complications may be influenced by the interaction between potent amniotic fluid activators and highly activatable maternal plasma.