Effect of an oxytocin receptor antagonist (atosiban) on uterine electrical activity

Hadar, Eran; Melamed, Nir; Aviram, Amir; Raban, Oded; Saltzer, Liat; Hiersch, Liran; Yogev, Yariv

doi:10.1016/j.ajog.2013.05.053

Cited by 22 publications

(12 citation statements)

References 34 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Therapy to reduce the rate of preterm birth in patients with symptoms of preterm labor has focused almost exclusively on tocolytic agents . However, these efforts have had limited success .…”

Section: Resultsmentioning

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

View full text Add to dashboard Cite

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.

show abstract

Section: Resultsmentioning

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

View full text Add to dashboard Cite

show abstract

“…Thus, these findings suggest that clinical decision-making should take into consideration other predictors for preterm delivery such as historical factors, fetal fibronectin testing, 19 and possibly new modalities such as uterine electrical activity measurement. 20,21 More efforts should be directed at developing additional diagnostic tools that will improve our ability to distinguish between true and false labor and to predict the risk of early preterm delivery. Receiver operator characteristic (ROC) curve describing the accuracy of cervical length in predicting preterm delivery at less than 37 weeks of gestation.…”

Section: Discussionmentioning

confidence: 99%

Predictive Value of Cervical Length in Women With Threatened Preterm Labor

Melamed

Hiersch

Domniz

et al. 2013

Obstetrics & Gynecology

Self Cite

View full text Add to dashboard Cite

show abstract

“…As has been mentioned, labor is preceded by two physiological phenomena: increased excitability and increased connectivity among the myometrial cells, changes which are reflected in the EHG. Various ways of characterizing the EHG have been proposed for different aims, mainly predicting preterm and term delivery (Fele-Zorz et al, 2008), but also to study the uterine electrophysiological response to tocolytic agents such as atosiban (Hadar et al, 2013) or nifepidine (Vinken et al, 2010) or to labor induction drugs (Aviram et al, 2014;Benalcazar Parra et al, 2017), to predict the possible need for labor induction in late term pregnancies (Alberola-Rubio et al, 2017), or labor arrest (Euliano et al, 2009;Vasak et al, 2013), among others. Section 2.1 provides a structured review of the use of EHG for predicting PTB according to the different types of parameter used: temporal and spectral, non-linear and bivariate analysis.…”

Section: Electrohysterography For Diagnosis Of Preterm Labormentioning

confidence: 99%