Gastric fluid used to assess changes during the latency period in preterm prelabor rupture of membranes

Musilová, Ivana; Andrýs, Ctirad; Hornychová, Helena; Plíšková, Lenka; Drahosova, Marcela; Zednikova, Barbora; Bolehovská, Radka; Faist, Tomáš; Jacobsson, Bo; Kacerovský, Marian

doi:10.1038/s41390-018-0073-1

Cited by 10 publications

(7 citation statements)

References 32 publications

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“…We have found that the earlier the gestational week of the PPROM is, the longer the latency period is, which is consistent with the results of previous reports [21,22] , and the pregnant women whose membrane rupture occurs before 32 weeks have a greater probability of latency period > 168h. It's been reported [23] that expecting a time longer than 1 week does not increase the risk of HCA, so pregnant women who have ruptured membranes before 32 weeks should keep the latency period more than one week.…”

Section: Discussionsupporting

confidence: 92%

The role of latency period on the preterm premature rupture of membranes: implication for treatment

Lü

Gan

et al. 2021

Arch Med Sci

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IntroductionConservative treatments with latency period have been used for the treatment of preterm premature rupture of membranes (PPROM) in clinical practice, we aimed to evaluate the role and potential influencing factors of latency period, to provide insights to the clinical treatment of PPROM.Material and methodsPPROM pregnant women treated in our hospital from January 1, 2015 to September 30, 2020 were included. PPROM patients were divided into 48～168h group and the >168h latency group, the characteristics and prognosis of this two groups were compared and analyzed. Logistic regression analyses were conducted to analyze the relevant influencing factors of latency period.ResultsA total of 131 PPROM patients were included. There were significant differences on the age, BMI, gestational age on admission, amniotic fluid volume before childbirth, and positive rate of cervical secretion culture between two groups (all p<0.05). Logistic regression analyses indicated that the latency period was shorter in the PPROM patients with age≥30y(OR0.048, 95%CI0.121~0.863) and gestational age≥32w on admission(OR0.463, 95%CI0.069~0.811), and the latency period was prolonged in the PPROM patients with BMI≥23kg/㎡(OR1.591, 95%CI1.134~1.944) and amniotic fluid volume≥6cm(OR2.129, 95%CI1.093~3.042) (all p<0.05). There were significant differences in the incidence of low birth weight and NRDS between 48~168h group and >168h group (all p<0.05).ConclusionsLatency period plays an important role in the PPROM, which is associated with the pregnant women's age, BMI, gestational week of rupture and amniotic fluid index.

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Section: Discussionsupporting

confidence: 92%

The role of latency period on the preterm premature rupture of membranes: implication for treatment

Lü

Gan

et al. 2021

Arch Med Sci

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“…Preterm prelabor rupture of membranes (PROM) is widely used as an inclusion criterion for predictions of other conditions. [1][2][3][4][5][6][7][8] The disease precedes 40%~50% of all preterm deliveries and arises from multiple disease pathways. 9 Yet, the antecedent remains unclear, and prognostic predictions lack proper sample sizes and external validation.…”

Section: Introductionmentioning

confidence: 99%

Prognostication for prelabor rupture of membranes and the time of delivery in nationwide insured women: development, validation, and deployment

Sufriyana

Wu²,

Ec³

2021

Preprint

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Prognostic prediction of prelabor rupture of membrane (PROM) lacks of sample size and external validation. We compared a statistical model, machine learning algorithms, and a deep-insight visible neural network (DI-VNN) for PROM and estimating the time of delivery. We selected visits, including PROM (n=23,791/170,730), retrospectively from a nationwide health insurance dataset. DI-VNN achieved the best prediction (area under receiver operating characteristics curve [AUROC] 0.73, 95% CI 0.72 to 0.75). Meanwhile, random forest using principal components achieved the best estimation with root mean squared errors ± 2.2 and 2.6 weeks respectively for the predicted event and nonevent. DI-VNN outperformed previous models by an external validation set, including one using a biomarker (AUROC 0.641; n=1,177). We deployed our models as a web application requiring diagnosis/procedure codes and dates. In conclusion, our models may be used solely in low-resource settings or as a preliminary model to reduce a specific test requiring high-resource setting.

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“…The fact that the rat animal model of intra-amniotic inflammation was not associated with the risk of labor induction within 24 h is important from a research standpoint because it provides an opportunity to collect various body fluids and tissues from gestational sacs after their exposure to intra-amniotic inflammation. This approach mimics human clinical scenarios ( Musilova et al, 2018 ; Kacerovsky et al, 2020b ).…”

Section: Discussionmentioning

confidence: 99%

Development of a Rat Model of Intra-Amniotic Inflammation via Ultrasound-Guided Administration of a Triggering Agent in the Gestational Sac to Enable Analysis of Individual Amniotic Fluid Samples

et al. 2022

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Objectives: To develop a rat model of intra-amniotic inflammation, characterized by the concentration of interleukin-6 in the amniotic fluid, induced by an ultrasound-guided transabdominal administration of lipopolysaccharide into individual gestational sacs.Methods: An ultrasound-guided transabdominal intra-amniotic administration of lipopolysaccharide or phosphate-buffered saline (PBS) as control was performed in rats on embryonic day 18. Only accessible gestational sacs with precise recording of their positions were injected. Twenty-four hours later, individual amniotic fluid samples were collected from the gestational sacs of laparotomized animals. The gestational sacs were divided into four subgroups: (i) with lipopolysaccharide: injected gestational sacs from rats undergoing lipopolysaccharide administration; (ii) without lipopolysaccharide: non-injected gestational sacs from rats undergoing lipopolysaccharide administration; (iii) with PBS: injected gestational sacs from rats undergoing PBS administration; and (iv) without PBS: non-injected gestational sacs from rats undergoing PBS administration. The concentration of interleukin-6 in individual amniotic fluid samples was assessed using ELISA.Results: In the group of five animals receiving lipopolysaccharide, 24 (33%) and 48 (77%) gestational sacs were and were not injected, respectively. The amniotic fluid was obtained from 21 (88%) injected and 46 (95%) non-injected sacs. In the control group of five animals receiving phosphate-buffered saline, 28 (35%) and 52 (75%) gestational sacs were and were not injected, respectively. The amniotic fluid was obtained from 18 (64%) injected and 50 (96%) non-injected sacs. No labor occurred, and only one fetal death was observed in a gestational sac injected with lipopolysaccharide. Differences in concentrations of interleukin-6 in the amniotic fluid were found among the subgroups of the gestational sacs (with lipopolysaccharide: median 762 pg/ml; without lipopolysaccharide: median 35.6 pg/ml; with PBS: median 35.6 pg/ml; and without PBS: median 35.6 pg/ml; p < 0.0001). Concentrations of interleukin-6 in the amniotic fluid from the gestational sacs with lipopolysaccharide were significantly higher than those in the three remaining subgroups (p < 0.0001). No differences in concentrations of interleukin-6 in the amniotic fluid were identified between the three remaining subgroups.Conclusion: The ultrasound-guided transabdominal intra-amniotic administration of lipopolysaccharide with a subsequent collection and analysis of amniotic fluid samples is feasible in rats. The intra-amniotic administration of lipopolysaccharide led to the development of intra-amniotic inflammation without leading to fetal mortality or induction of labor.

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Gastric fluid used to assess changes during the latency period in preterm prelabor rupture of membranes

Abstract: The microbial and inflammatory status of the intraamniotic compartment changes during the latency period in PPROM. Bedside IL-6 assessment of gastric fluid may be useful in the rapid diagnosis of funisitis and FIRS.

Cited by 10 publications

References 32 publications

The role of latency period on the preterm premature rupture of membranes: implication for treatment

The role of latency period on the preterm premature rupture of membranes: implication for treatment

Prognostication for prelabor rupture of membranes and the time of delivery in nationwide insured women: development, validation, and deployment

Development of a Rat Model of Intra-Amniotic Inflammation via Ultrasound-Guided Administration of a Triggering Agent in the Gestational Sac to Enable Analysis of Individual Amniotic Fluid Samples

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