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The amniotic sac, also called the bag of waters or the membranes, is the sac in which the embryo and later fetus develops in
amniote Amniotes are a clade of tetrapod vertebrates that comprises sauropsids (including all reptiles and birds, and extinct parareptiles and non-avian dinosaurs) and synapsids (including pelycosaurs and therapsids such as mammals). They are distin ...
s. It is a thin but tough transparent pair of
membranes A membrane is a selective barrier; it allows some things to pass through but stops others. Such things may be molecules, ions, or other small particles. Membranes can be generally classified into synthetic membranes and biological membranes. Bi ...
that hold a developing embryo (and later fetus) until shortly before
birth Birth is the act or process of bearing or bringing forth offspring, also referred to in technical contexts as parturition. In mammals, the process is initiated by hormones which cause the muscular walls of the uterus to contract, expelling the f ...
. The inner of these membranes, the
amnion The amnion is a membrane that closely covers the human and various other embryos when first formed. It fills with amniotic fluid, which causes the amnion to expand and become the amniotic sac that provides a protective environment for the develo ...
, encloses the amniotic cavity, containing the
amniotic fluid The amniotic fluid is the protective liquid contained by the amniotic sac of a gravid amniote. This fluid serves as a cushion for the growing fetus, but also serves to facilitate the exchange of nutrients, water, and biochemical products betwee ...
and the embryo. The outer membrane, the
chorion The chorion is the outermost fetal membrane around the embryo in mammals, birds and reptiles (amniotes). It develops from an outer fold on the surface of the yolk sac, which lies outside the zona pellucida (in mammals), known as the vitelline me ...
, contains the amnion and is part of the placenta. On the outer side, the amniotic sac is connected to the
yolk sac The yolk sac is a membranous wikt:sac, sac attached to an embryo, formed by cells of the hypoblast layer of the bilaminar embryonic disc. This is alternatively called the umbilical vesicle by the Terminologia Embryologica (TE), though ''yolk sac' ...
, the
allantois The allantois (plural ''allantoides'' or ''allantoises'') is a hollow sac-like structure filled with clear fluid that forms part of a developing amniote's conceptus (which consists of all embryonic and extraembryonic tissues). It helps the embryo ...
, and via the
umbilical cord In placental mammals, the umbilical cord (also called the navel string, birth cord or ''funiculus umbilicalis'') is a conduit between the developing embryo or fetus and the placenta. During prenatal development, the umbilical cord is physiologi ...
, the placenta. The yolk sac, amnion, chorion, and allantois are the four
extraembryonic membrane The extraembryonic membranes are four membranes which assist in the development of an animal's embryo. Such membranes occur in a range of animals from humans to insects. They originate from the embryo, but are not considered part of it. They typ ...
s that lie outside of the embryo and are involved in providing nutrients and protection to the developing embryo. They form from the
inner cell mass The inner cell mass (ICM) or embryoblast (known as the pluriblast in marsupials) is a structure in the early development of an embryo. It is the mass of cells inside the blastocyst that will eventually give rise to the definitive structures of t ...
; the first to form is the yolk sac followed by the amnion which grows over the developing embryo. The amnion remains an important extraembryonic membrane throughout prenatal development. The third membrane is the allantois, and the fourth is the chorion which surrounds the embryo after about a month and eventually fuses with the amnion.
Amniocentesis Amniocentesis is a medical procedure used primarily in the prenatal diagnosis of genetic conditions. It has other uses such as in the assessment of infection and fetal lung maturity. Prenatal diagnostic testing, which includes amniocentesis, is ne ...
is a medical procedure where fluid from the sac is sampled during
fetal development Prenatal development () includes the development of the embryo and of the fetus during a viviparous animal's gestation. Prenatal development starts with fertilization, in the germinal stage of embryonic development, and continues in fetal devel ...
, between 15 and 20 weeks of pregnancy, to be used in prenatal diagnosis of
chromosomal abnormalities A chromosomal abnormality, chromosomal anomaly, chromosomal aberration, chromosomal mutation, or chromosomal disorder, is a missing, extra, or irregular portion of chromosomal DNA. These can occur in the form of numerical abnormalities, where the ...
and fetal infections.


Structure

The amniotic cavity is the closed sac between the embryo and the amnion, containing the amniotic fluid. The amniotic cavity is formed by the fusion of the parts of the amniotic fold, which first makes its appearance at the
cephalic A head is the part of an organism which usually includes the ears, brain, forehead, cheeks, chin, eyes, nose, and mouth, each of which aid in various sensory functions such as sight, hearing, smell, and taste. Some very simple animals may not ...
extremity and subsequently at the
caudal Caudal may refer to: Anatomy * Caudal (anatomical term) (from Latin ''cauda''; tail), used to describe how close something is to the trailing end of an organism * Caudal artery, the portion of the dorsal aorta of a vertebrate that passes into the ...
end and sides of the embryo. As the amniotic fold rises and fuses over the dorsal aspect of the embryo, the amniotic cavity is formed.


Development

At the beginning of the second week, a cavity appears within the
inner cell mass The inner cell mass (ICM) or embryoblast (known as the pluriblast in marsupials) is a structure in the early development of an embryo. It is the mass of cells inside the blastocyst that will eventually give rise to the definitive structures of t ...
, and when it enlarges, it becomes the amniotic cavity. The floor of the amniotic cavity is formed by the
epiblast In amniote embryonic development, the epiblast (also known as the primitive ectoderm) is one of two distinct cell layers arising from the inner cell mass in the mammalian blastocyst, or from the blastula in reptiles and birds, the other layer is ...
. Epiblast migrates between the epiblastic disc and trophoblast. In this way the epiblastic cells migrate between the embryoblast and trophoblast. The floor is formed by the epiblast which later on transforms to ectoderm while the remaining cells which are present between the embryoblast and trophoblast are called amnioblasts (flattened cells). These cells are also derived from epiblast which is transformed into ectoderm. The amniotic cavity is surrounded by an
extraembryonic membrane The extraembryonic membranes are four membranes which assist in the development of an animal's embryo. Such membranes occur in a range of animals from humans to insects. They originate from the embryo, but are not considered part of it. They typ ...
, called the amnion. As the implantation of the blastocyst progresses, a small space appears in the embryoblast, which is the primordium of the amniotic cavity. Soon, amniogenic (amnion-forming cells) called amnioblasts separate from the epiblast and line the amnion, which encloses the amniotic cavity. The epiblast forms the floor of the amniotic cavity and is continuous peripherally with the amnion. The hypoblast forms the roof of the exocoelomic cavity and is continuous with the thin exocoelomic membrane. This membrane along with hypoblast forms the primary yolk sac. The embryonic disc now lies between the amniotic cavity and the primary yolk sac. Cells from the yolk sac
endoderm Endoderm is the innermost of the three primary germ layers in the very early embryo. The other two layers are the ectoderm (outside layer) and mesoderm (middle layer). Cells migrating inward along the archenteron form the inner layer of the gastru ...
form a layer of connective tissue, the extraembryonic mesoderm, which surrounds the amnion and yolk sac.


Birth

If, after birth, the complete amniotic sac or big parts of the membrane remain coating the newborn, this is called a
caul A caul or cowl ( la, Caput galeatum, literally, "helmeted head") is a piece of membrane that can cover a newborn's head and face. Birth with a caul is rare, occurring in fewer than 1 in 80,000 births. The caul is harmless and is immediately remov ...
. When seen in the light, the amniotic sac is shiny and very smooth, but tough. Once the baby is pushed out of the mother's uterus, the
umbilical cord In placental mammals, the umbilical cord (also called the navel string, birth cord or ''funiculus umbilicalis'') is a conduit between the developing embryo or fetus and the placenta. During prenatal development, the umbilical cord is physiologi ...
, placenta, and amniotic sac are pushed out in the after birth. File:Amnion.jpg, The amniotic sac opened during afterbirth examination File:Placenta with fetal membranes.jpg, Placenta with attached
fetal membranes The fetal membranes are the four extraembryonic membranes, associated with the developing embryo, and fetus in humans and other mammals.. They are the amnion, chorion, allantois, and yolk sac. The amnion and the chorion are the chorioamniotic memb ...
(ruptured at the margin at the left in the image).


Function

The amniotic sac and its filling provide a liquid that surrounds and cushions the fetus. It is a site of exchange of essential substances, such as oxygen, between the umbilical cord and the fetus. It allows the fetus to move freely within the walls of the uterus.
Buoyancy Buoyancy (), or upthrust, is an upward force exerted by a fluid that opposes the weight of a partially or fully immersed object. In a column of fluid, pressure increases with depth as a result of the weight of the overlying fluid. Thus the pr ...
is also provided.


Clinical significance

Chorioamnionitis Chorioamnionitis, also known as intra-amniotic infection (IAI), is inflammation of the fetal membranes (amnion and chorion), usually due to bacterial infection. In 2015, a National Institute of Child Health and Human Development Workshop expe ...
is inflammation of the amniotic sac ('' chorio-'' + ''amnion'' + ''
-itis Inflammation (from la, inflammatio) is part of the complex biological response of body tissues to harmful stimuli, such as pathogens, damaged cells, or irritants, and is a protective response involving immune cells, blood vessels, and molec ...
''), usually because of infection. It is a risk factor for
neonatal sepsis Neonatal sepsis is a type of neonatal infection and specifically refers to the presence in a newborn baby of a bacterial blood stream infection (BSI) (such as meningitis, pneumonia, pyelonephritis, or gastroenteritis) in the setting of fever. ...
. During
labor Labour or labor may refer to: * Childbirth, the delivery of a baby * Labour (human activity), or work ** Manual labour, physical work ** Wage labour, a socioeconomic relationship between a worker and an employer ** Organized labour and the labour ...
, the amniotic sac must break so that the child can
be born ''Marvin's Marvelous Mechanical Museum'' is the debut studio album by American rock band Tally Hall, originally released on October 24, 2005. Their previous recordings were all independently produced and distributed demos. All of the tracks on ...
. This is known as rupture of membranes (ROM). Normally, it occurs spontaneously at full term either during or at the beginning of labor. A
premature rupture of membranes Prelabor rupture of membranes (PROM), previously known as premature rupture of membranes, is breakage of the amniotic sac before the onset of labor. Women usually experience a painless gush or a steady leakage of fluid from the vagina. Complicat ...
(PROM) is a rupture of the amnion that occurs prior to the onset of labor. An
artificial rupture of membranes Artificial rupture of membranes (AROM), also known as an amniotomy, is performed by a midwife or obstetrician and was once thought to be an effective means to induce or accelerate labor. The membranes can be ruptured using a specialized tool, suc ...
(AROM), also known as an amniotomy, may be clinically performed using an amnihook or amnicot in order to induce or to accelerate labour. The amniotic sac has to be punctured to perform
amniocentesis Amniocentesis is a medical procedure used primarily in the prenatal diagnosis of genetic conditions. It has other uses such as in the assessment of infection and fetal lung maturity. Prenatal diagnostic testing, which includes amniocentesis, is ne ...
. This is fairly routine procedure, but can lead to infection of the amniotic sac in a very small number of cases. Infection more commonly arises vaginally.


References


External links

* https://www.mun.ca/biology/scarr/Amniotic_egg.html * http://staff.um.edu.mt/acus1/IMPLANTATION.htm {{DEFAULTSORT:Amniotic Sac Body fluids Embryology Obstetrics Human anatomy Midwifery