Amniotic fluid volume regulation: basal volumes and responses to fluid infusion or withdrawal in sheep

Abstract

To better understand the mechanisms that regulate amniotic fluid (AF) volume, we measured AF volume and the rates of fetal swallowing and urination in 33 pregnant sheep at 124-142 days gestation. In four of five ewes over 9-18 days, the spontaneous changes in amniotic fluid volume correlated positively with urine flow rate and negatively with the rate of swallowing (R = 0.686, P less than 0.01), such that 47% of the AF volume changes could be attributed to changes in rates of urination and swallowing. Following infusion of one liter of isotonic amniotic saline (n = 12) or mannitol (n = 5), AF volume increased 110%, and after 24 h returned to the control value in the saline group but it remained elevated 59% above control in the mannitol group. AF sodium was unchanged following saline infusion but remained reduced following mannitol. Following withdrawal of 61% of AF over 20-40 min, AF volume averaged 51 and 71% of control at 24 and 48 h, respectively, whereas AF sodium was unchanged. Variations in rates of fetal swallowing or urine formation could not explain the entire changes in AF volume following either the volume infusion or withdrawal. These data suggest that AF volume is regulated within a relatively narrow range and fetal urine formation and swallowing together and transplacental fluid flux each appear to contribute equally to the regulation of AF volume.