Clinical and inflammatory markers in amniotic fluid as predictors of adverse outcomes in preterm premature rupture of membranes

Cobo, Teresa; Palacio, Montse; Martínez-Terrón, Mònica; Navarro-Sastre, Aleix; Bosch, Jordi; Filella, Xavier; Gratacós, E.

doi:10.1016/j.ajog.2011.03.050

Cited by 71 publications

(48 citation statements)

References 15 publications

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“…Increase in the proinflammatory cytokines has been reported in the etiology of PPROM (28). Increased levels of IL-6 and IL-8 in patients with PPROM have further supported these findings (9,29). In our study, comparison of the TNF-α and hs-CRP levels in both the groups as well as in the chorioamnionitis (+) and (-) groups revealed no significant differences.…”

Section: Discussionsupporting

confidence: 70%

“…Therefore, it is important to detect subclinical intrauterine infection before the development of clinical chorioamnionitis. Although culture of fluid obtained by amniocentesis is a safe method for diagnosing intrauterine infection, due to its invasive nature several studies have aimed to develop noninvasive diagnostic tests (9). In this study, our aim was to determine the importance of plasma markers in the prediction of PPROM and chorioamnionitis in pregnant women.…”

Section: Introductionmentioning

confidence: 99%

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Maternal plasma prolidase, matrix metalloproteinases 1 and 13, and oxidative stress levels in pregnancies complicated by preterm premature rupture of the membranes and chorioamnionitis

Soydinç

Sak

Evliyaoğlu

et al. 2012

J Turkish German Gynecol Assoc

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Maternal plasma prolidase, matrix metalloproteinases 1 and 13, and oxidative stress levels in pregnancies complicated by preterm premature rupture of the membranes and chorioamnionitis Objective: This study aimed to investigate the role of various biochemical markers in preterm premature rupture of membranes (PPROM) and in prediction of chorioamnionitis in patients with PPROM. Material and Methods:This case-control study included a total of 100 pregnant women at 26-34 gestational weeks. Of these women, 50 were healthy and 50 had PPROM. The biochemical markers in the maternal plasma including prolidase, matrix metalloproteinase (MMP) 1 and 13, total oxidative status (TOS), total antioxidant capacity (TAC), glutathione peroxidase (GPx), catalase (CAT), paraoxonase-1 (PON-1), tumor necrosis factor alpha (TNF-α), and high sensitive C-reactive protein (hs-CRP) were assayed. These levels were compared between the PPROM and control groups and between women with or without chorioamnionitis in the PPROM group.Results: Compared to the control group, the levels of prolidase, MMP-13, and TOS were significantly higher (p values <0.001, 0.020, and 0.035, respectively) and those of TAC and PON-1 were significantly lower in the maternal plasma of the PPROM group (p values=0.012 and <0.001, respectively). The plasma prolidase and TOS levels were significantly higher (p values=0.033 and 0.005, respectively) and the plasma TAC and PON-1 levels were significantly lower in women with chorioamnionitis as compared with the corresponding values in women without chorioamnionitis in the PPROM group (p values =0.041 and 0.048, respectively). The multivariate logistic regression analysis observed that prolidase, TAC, and PON-1 were important markers for the presence of PPROM and prolidase and TOS were important markers for predicting chorioamnionitis. Conclusion:This study suggested that maternal plasma prolidase, TAC, and PON-1 may be useful for the diagnosis of PPROM, and prolidase and TOS may be used to predict chorioamnionitis in patients with PPROM. (J Turkish-German Gynecol Assoc 2012; 13: 172-7)Key words: Preterm premature rupture of membranes, maternal plasma, prolidase, matrix metalloproteinase, oxidative stress Received: 13 June, 2012 Accepted: 21 July, 2012 Amaç: Bu çalışmanın amacı çeşitli biokimyasal belirteçlerin preterm erken membran rüptürü (PEMR) ve PEMR olan hastalarda koryoamnioniti predikte etmedeki rollerini araştırmaktır.

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Section: Discussionsupporting

confidence: 70%

Section: Introductionmentioning

confidence: 99%

Maternal plasma prolidase, matrix metalloproteinases 1 and 13, and oxidative stress levels in pregnancies complicated by preterm premature rupture of the membranes and chorioamnionitis

Soydinç

Sak

Evliyaoğlu

et al. 2012

J Turkish German Gynecol Assoc

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“…Azithromycin was introduced after 2012 as targeted prophylactic treatment of the most common microorganism isolated in women with MIAC [23], Ureaplasma spp., based on its efficacy reported in animal models and its pharmacokinetics in pregnant women [24][25][26].…”

Section: Clinical Managementmentioning

confidence: 99%

Contribution of Amniotic Fluid along Gestation to the Prediction of Perinatal Mortality in Women with Early Preterm Premature Rupture of Membranes

et al. 2017

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Introduction: To evaluate the largest vertical pocket (LVP) of amniotic fluid as a time-dependent factor to predict perinatal mortality in women with early preterm premature rupture of membranes (EPPROM). Material and Methods: Observational cohort studyof singleton pregnancies with EPPROM <24 weeks. Termination of pregnancy (TOP) was considered if the LVP was <2 cm at 7 days. The maternal and neonatal characteristics of ongoing pregnancies were recorded. Prediction of perinatal mortality was estimated based on the influence of the LVP as a time-dependent factor after adjustment for maternal age, prior invasive procedure, and gestational age at EPPROM. Results: Of 104 women, 39 requested TOP. Neonatal survival to discharge was 40%, increasing to 74% if pregnancies achieved 24 weeks. LVP at admission <1 cm, latency to delivery, and gestational age at delivery were independent predictors of perinatal mortality. When evaluating the LVP at different time points of gestation, the highest perinatal mortality risk was established at 2 weeks (odds ratio 14.67, p < 0.001) after membrane rupture, being 5.75 (p = 0.05) the week after and 10.93 (p = 0.037) beyond 2 weeks of EPPROM. Discussion: When LVP measurement, gestational age at EPPROM, maternal age, and prior invasive procedure were considered, we found that the worst prognosis related to perinatal mortality was at 2 weeks after EPPROM.

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“…There is convincing evidence that infections in pregnant women may alter normal cytokine and hormone-regulated gestation, which could result in preterm labor, premature rupture of membranes and preterm birth 4 . Periodontitis has been associated with pregnancy outcomes such as preterm birth, low birth weight deliveries and premature rupture of membranes 4 .…”

Section: Introductionmentioning

confidence: 99%

“…Periodontitis has been associated with pregnancy outcomes such as preterm birth, low birth weight deliveries and premature rupture of membranes 4 . The development of periodontitis involves the invasion of primarily Gram-negative bacteria through the periodontium, stimulating a chronic inflamma-tory response and forming pockets that become infected 5,6 .…”

Section: Introductionmentioning

confidence: 99%

Periodontal disease treatment and risk of preterm birth: a systematic review and meta-analysis

et al. 2012

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The events leading to preterm birth are still not completely understood. A quantitative systematic review was performed to estimate the effects of periodontal care during pregnancy on preventing preterm birth and low birth weight. The meta-analysis included randomized trials with pregnant women with a diagnosis of periodontal disease before 20 weeks of gestation. Relative risk (RR) with 95% confidence intervals (95%CI) was calculated. We evaluated the reduction in preterm and low birth weight. Thirteen trials were included, comparing 3,576 women in intervention groups with 3,412 women receiving usual care. The meta-analysis of the effects of periodontal disease treatment during pregnancy indicated a non-significant reduction in preterm births (RR = 0.90; 95%CI: 0.68-1.19) and low birth weights (RR = 0.92; 95%CI: 0.71-1.20). The creation and examination of a funnel plot revealed clear evidence of publication bias. In summary, primary periodontal care during pregnancy cannot be considered an efficient way of reducing the incidence of preterm birth.

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Clinical and inflammatory markers in amniotic fluid as predictors of adverse outcomes in preterm premature rupture of membranes

Cited by 71 publications

References 15 publications

Maternal plasma prolidase, matrix metalloproteinases 1 and 13, and oxidative stress levels in pregnancies complicated by preterm premature rupture of the membranes and chorioamnionitis

Maternal plasma prolidase, matrix metalloproteinases 1 and 13, and oxidative stress levels in pregnancies complicated by preterm premature rupture of the membranes and chorioamnionitis

Contribution of Amniotic Fluid along Gestation to the Prediction of Perinatal Mortality in Women with Early Preterm Premature Rupture of Membranes

Periodontal disease treatment and risk of preterm birth: a systematic review and meta-analysis

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