The amniotic membrane and the amniotic fluid are one of life's most complex and delicate tissues and fluids, respectively. What was known about this tissue and fluid prior to the 20th century was extremely limited scientifically, but was significantly defined by beliefs entrenched in mysticism, folklore, and superstitions. A comprehensive literature review of the amniotic membrane tissue and amniotic fluid reveals the many unique and complex characteristics and biological properties that been heavily investigated since the turn of the 20th century and continues to surge into the 21st century. The historical perspectives, evolution, derivation, histology, structure, and composition of the amniotic membrane; and historical perspectives, volume and regulation, and cellular and non-cellular composition of the amniotic fluid are discussed here and are coalesced for an easy and comprehensible resource. Lastly, future perspectives regarding research and application of the amniotic membrane and amniotic fluid, including stem cells are discussed.

Stem cell synthesized extracellular matrix (ECM) may serve as a replacement for current bone grafting techniques. The overall goal of this thesis is to quantify the osteoinductivity of the ECM produced by human amniotic fluid stem cells (AFS cells), compare it to that of human mesenchymal stem cells (MSC), and assess its potential for use in bone tissue engineering therapies. Each stem cell type was cultured in osteogenic media to produce the ECM, which was then decellularized via freeze/thaw cycling and DNase treatment. The success of the decellularization was confirmed with live/dead staining and DNA quantification. A series of in vitro studies were performed to evaluate the characteristics of the ECM relevant to a bone tissue engineering therapy. Reseeded MSCs were able to attach to and proliferate on both ECM types in both 2D and 3D culture. In 2D, cells cultured on both ECM types showed increased levels of calcium deposition. Additionally, cells cultured on the MSC ECM showed increased alkaline phosphatase activity. A synergistic effect on osteogenic differentiation was observed when the osteoinductive factor dexamethasone was added to the culture. In 3D, both ECM types increased the mineralized matrix production of reseeded MSCs. The AFS ECM had a greater effect than the MSC ECM. When ECM was used to treat a rat femoral segmental defect in vivo, it was found that each ECM type increased the rate of bridging of the defect when compared to collagen coated scaffolds. However the ECM did not have a significant effect on the volume of mineralized matrix within the defect site in this study.