Amniotic fluid glucose and cytokines values in the early diagnosis of amniotic infection in patients with preterm labor and intact membranes

González-Bosquet, Eduardo; Cerqueira, Maria J.; Domı́nguez, Carmen; Gasser, I; Bermejo, B.; Cabero, L.

doi:10.1002/(sici)1520-6661(199907/08)8:4<155::aid-mfm3>3.0.co;2-2

Cited by 44 publications

(17 citation statements)

References 18 publications

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“…Different studies have demonstrated the value of interleukins in amniotic fl uid as markers of infection and preterm delivery [2,3,5] . The fact that amniotic fl uid can be obtained only using such invasive methods as amniocentesis has limited its use in clinical practice and as a result some researchers have opted to determine interleukin concentrations by testing cervical secretions, which can be obtained with much greater ease and comfort for the patient [12][13][14] .…”

Section: Discussionsupporting

confidence: 88%

“…The percentage of pregnant women admitted for PTL who in fact delivered preterm (38%) was similar to that observed in other studies, in which the percentage oscillates between 27 and 51.3% [3,10] . Although a history of preterm deliveries is frequent in the study group (13%), in contrast to other studies, in this study they were not found to be related to an increase in the risk of preterm delivery during hospital stay.…”

Section: Discussionmentioning

confidence: 99%

“…Elevated levels of interleukin (IL)-1 ␤ , IL-6 and IL-8 have been detected in the amniotic fl uid of pregnant women with preterm labor (PTL) with or without amniotic infections, who later delivered prematurely [2][3][4][5] . Elevated concentrations of interleukins have also been found in the amniotic fl uid of pregnant women in labor delivering full term [1] .…”

Section: Introductionmentioning

confidence: 99%

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The Value of Interleukin-8, Interleukin-6 and Interleukin-1β in Vaginal Wash as Predictors of Preterm Delivery

Bosquet

Ferrer²,

Valls³

et al. 2005

Gynecol Obstet Invest

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Aims: To study the value of interleukin (IL)-8, IL-6 and IL-1β in vaginal wash as predictors of preterm delivery. Methods: A prospective analysis of a study group of 200 pregnant women between 24 and 34 weeks of gestation with intact membranes and preterm labor and a control group of 50 pregnant women during the same period of gestation. The controls had uncomplicated pregnancies and subsequently delivered at term. Samples of vaginal secretions were collected from both groups and analyzed for IL-1β, IL-6 and IL-8 concentrations. Results: Of the women in the study group, 70 had preterm deliveries, while all women in the control group had full-term deliveries. Compared with the control group, the study group had significantly higher concentrations (p < 0.021) of IL-1β, IL-6 and IL-8. The women in the study group delivering preterm also had IL-1β, IL-6 and IL-8 concentrations significantly greater (p < 0.001) than those of the same group delivering full term. ROC curves were used to establish cut-off points for the three interleukins to predict preterm delivery. We did not find a cut-off point with an appropriate sensitivity and specificity. Conclusion: The concentrations of interleukins in vaginal wash were significantly higher both in the women with preterm labor and in those delivering preterm. While values differed between controls and those with the preterm labor, no cut-off can be obtained to use the results of IL-1β, IL-6 and IL-8 as a predictor clinically.

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Section: Discussionsupporting

confidence: 88%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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The Value of Interleukin-8, Interleukin-6 and Interleukin-1β in Vaginal Wash as Predictors of Preterm Delivery

Bosquet

Ferrer²,

Valls³

et al. 2005

Gynecol Obstet Invest

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“…Preterm birth is the leading cause of perinatal morbidity and mortality worldwide . Microbial invasion of the amniotic cavity (MIAC), determined with cultivation techniques, occurs in one of every four women who deliver preterm; yet, this may be an underestimation because the diagnosis of MIAC represents a challenge.…”

Section: Introductionmentioning

confidence: 99%

A Novel Molecular Microbiologic Technique for the Rapid Diagnosis of Microbial Invasion of the Amniotic Cavity and Intra‐Amniotic Infection in Preterm Labor with Intact Membranes

Romero

Miranda

Chaiworapongsa

et al. 2014

American J Rep Immunol

183

197

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Objective The major challenges in using amniotic fluid (AF) cultivation techniques to diagnose microbial invasion of the amniotic cavity (MIAC) are: 1) several days are typically required to obtain results, and 2) many organisms implicated in the pathogenesis of human disease are difficult to culture. Here, we compare the performance of AF culture with a novel technique for the diagnosis of MIAC that can provide results within eight hours by combining broad-range real-time polymerase chain reaction with electrospray ionization mass spectrometry (PCR/ESI-MS) to identify and quantify genomic material from bacteria and viruses in AF. Methods AF samples obtained by transabdominal amniocentesis from 142 women with preterm labor (PTL) and intact membranes were analyzed using cultivation techniques (aerobic, anaerobic and genital mycoplasmas) as well as PCR/ESI-MS. The prevalence and relative magnitude of intra-amniotic inflammation [AF Interleukin 6 (IL-6) concentration ≥ 2.6 ng/mL], acute histologic chorioamnionitis, spontaneous preterm delivery, and perinatal mortality were examined according to the results of these two tests. Results 1) The prevalence of MIAC in patients with preterm labor and intact membranes was 7% using standard cultivation techniques and 12% using PCR/ESI-MS; 2) seven of ten patients with positive AF culture also had positive PCR/ESI-MS [≥17 genome equivalents per PCR reaction well (GE/well)] 3) patients with positive PCR/ESI-MS (≥17 GE/well) and negative AF cultures had significantly higher rates of intra-amniotic inflammation and histologic acute chorioamnionitis, shorter intervals to delivery [median (interquartile range-IQR)], and offspring at higher risk of perinatal mortality, than women with both tests negative [90% (9/10) vs. 32% (39/122); (p<0.001); 70% (7/10) vs. 35% (39/112); (p=0.04); 1 (IQR: <1 – 2) days vs. 25 (IQR: 5 – 51) days; (p=0.002); OR: 5.6; 95% CI: 1.4 – 22, respectively]; 5) there were no significant differences in these factors between patients with positive PCR/ESI-MS (≥17 GE/well) who had negative AF cultures compared to those with positive AF cultures; and 6) PCR/ESI-MS detected genomic material from viruses in two patients (1.4%). Conclusion 1) Rapid diagnosis of intra-amniotic infection is possible using PCR/ESI-MS, which can provide results within 8 hours; 2) the combined use of biomarkers of inflammation and PCR/ESI-MS allows for the rapid identification of specific bacteria and viruses in women with preterm labor and intra-amniotic infection; and 3) this approach may allow for administration of timely and specific interventions to reduce morbidity attributed to infection-induced preterm birth.

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“…Although preterm labor is a heterogenous condition, a large number of such cases particularly at <28 weeks gestation are associated with either overt or subclinical inflammation. [7][8][9][10][11][12][13][14][15][16][17][18] Intrauterine infection or inflammation from other causes activates the innate immune system involving the release of several cytokines and chemokines that, in turn, may trigger preterm contractions, cervical ripening and rupture of the membranes. [19][20][21][22] Several cytokines and chemokines including interleukin (IL)-1a, tumor necrosis factor (TNF)-a, 23 IL-6, 24-28 IL-10, 29,30 IL-1b, 30 IL-16, 31 IL-18, 32 colonystimulating factor, 9,33 macrophage migration inhibitory factor, 34 IL-8, 35,36 monocyte chemotactic protein-1, 37 regulated upon activation, normal T cell expressed, and secreted (RANTES), 38 and epithelial cell-derived neutrophil-activating peptide-78 39 have been examined in human biological fluids and implicated in the pathogenesis of preterm labor.…”

mentioning

confidence: 99%

Second-Trimester Serum Cytokines in Women Who Develop Spontaneous Preterm Labor at Less than 28 Weeks' Gestation versus Term Labor

Yang¹,

Sayed²,

Shaw³

et al. 2009

Amer J Perinatol

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We sought to determine if there is a relationship between serum concentrations of cytokines and the development of preterm labor. A panel of 28 cytokines was measured using the multiplex assay in serum samples collected between 15 and 18 weeks' gestation from women who developed spontaneous preterm labor and delivered between 24 and 28 weeks' gestation (N = 25) and from women who delivered at term (>or=37 weeks; N = 25). Sixteen of the 28 cytokines measured were detected. Except for vascular endothelial growth factor, which showed a trend toward a significant increase in patients who developed preterm labor, there was no difference in cytokine levels between groups in preterm labor and in term labor. Serum cytokine changes in women who develop spontaneous preterm labor possibly occur in the period between 18 weeks' gestation and the onset of labor.

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Amniotic fluid glucose and cytokines values in the early diagnosis of amniotic infection in patients with preterm labor and intact membranes

Cited by 44 publications

References 18 publications

The Value of Interleukin-8, Interleukin-6 and Interleukin-1β in Vaginal Wash as Predictors of Preterm Delivery

The Value of Interleukin-8, Interleukin-6 and Interleukin-1β in Vaginal Wash as Predictors of Preterm Delivery

A Novel Molecular Microbiologic Technique for the Rapid Diagnosis of Microbial Invasion of the Amniotic Cavity and Intra‐Amniotic Infection in Preterm Labor with Intact Membranes

Second-Trimester Serum Cytokines in Women Who Develop Spontaneous Preterm Labor at Less than 28 Weeks' Gestation versus Term Labor

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