Premature Rupture of the Fetal Membranes

Parry, Samuel; Strauss, Jerome F.

doi:10.1056/nejm199803053381006

Cited by 684 publications

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“…The observation that the risk of preterm delivery was 12.5% in the affected women with a healthy fetus, but 40% in the control group of healthy mothers with an affected fetus, and was usually caused by spontaneous rupture of membranes, suggests that the fetal connective tissue disorder may affect the fetal membranes, rather than the maternal disorder the uterine tissues. It has been shown that the membranes of fetuses with connective tissue disorders have an abnormal collagen content and structure (16) and are weaker than normal membranes, which may be an explanation for the elevated preterm delivery rate. The results of this study do not suggest a role of the cervix as a causal factor of preterm delivery, as no clear cases of cervical incompetence were found.…”

Section: Discussionmentioning

confidence: 99%

Pregnancy and the Ehlers-Danlos syndrome: a retrospective study in a Dutch population

Lind¹,

Wallenburg²

2002

Acta Obstet Gynecol Scand

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Background. The study was carried out to assess the course and outcome of pregnancies in women with the Ehlers-Danlos syndrome, with the aim of developing guidelines for assessment of risk and counseling, and for providing optimum medical and obstetric care. Methods. A retrospective study based on data collected from members of the Dutch Association of Ehlers-Danlos patients. Pregnancies and neonatal outcomes of the affected mothers were compared with those of the nonaffected mothers who delivered an infant with Ehlers-Danlos syndrome.Results. In a group of 46 women with Ehlers-Danlos syndrome, 128 pregnancies beyond 24 weeks gestation were evaluated and compared with 43 pregnancies of 33 nonaffected women. The main maternal complications consisted of pelvic pain and instability (26% vs. 7%). One bowel rupture was reported in a woman with Ehlers-Danlos syndrome type IV. Preterm delivery occurred in 21% of the affected mothers compared with 40% of the nonaffected women with an affected infant; the women with Ehlers-Danlos syndrome experienced postpartum hemorrhage (19% vs. 7%) and complicated perineal wounds (8% vs. 0%) more often than the unaffected women. The floppy infant syndrome was diagnosed in 13% of the affected infants and did not occur in the nonaffected neonates. Conclusion. Pregnancy is generally well-tolerated in women with Ehlers-Danlos syndrome, with favorable maternal and neonatal outcomes. In Ehlers-Danlos syndrome type IV it may be associated with severe maternal complications. Preconceptional counseling concerning specific possible complications and a multidisciplinary approach are recommended.

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Section: Discussionmentioning

confidence: 99%

Pregnancy and the Ehlers-Danlos syndrome: a retrospective study in a Dutch population

Lind¹,

Wallenburg²

2002

Acta Obstet Gynecol Scand

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“…5 This is the reason why PPROM and chorioamnionitis frequently coexist. 6,7 Preterm premature rupture of membranes (PPROM), defined as spontaneous rupture of the membranes before 37 weeks of gestation, is the major identifiable cause of preterm delivery, 8,9 occurring approximately in one-third of all preterm births. 8 Multifactorial in nature, 5 PPROM, however, is most strongly associated with the presence of intrauterine infection/inflammation.…”

Section: Introductionmentioning

confidence: 99%

“…6,7 Preterm premature rupture of membranes (PPROM), defined as spontaneous rupture of the membranes before 37 weeks of gestation, is the major identifiable cause of preterm delivery, 8,9 occurring approximately in one-third of all preterm births. 8 Multifactorial in nature, 5 PPROM, however, is most strongly associated with the presence of intrauterine infection/inflammation. 10 This is relevant, considering that a fetal inflammatory response syndrome, with a complex series of events, which include an inflammatory cascade, increased surfactant production and alterations to lung structure 11,12 are present in nearly one-half of fetuses with PPROM or preterm labour and intact membranes.…”

Section: Introductionmentioning

confidence: 99%

Preterm premature rupture of membranes, chorioamnion inflammatory scores and neonatal respiratory outcome

Zanardo¹,

Vedovato²,

Cosmi

et al. 2009

BJOG

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Objective To evaluate whether histological chorioamnionitis (HCA), in the setting of preterm premature rupture of membranes (PPROM), affects infant respiratory outcome.Design A prospective histological study on 287 consecutive placentas was performed in preterm infants (£32 +6 weeks gestation), categorised into four groups: according to the presence or absence of HCA, in the setting or in absence of PPROM. Results Among the 287 NICU admitted preterm infants, 68/287 (23.6%) presented with HCA, 16/68 (23.5%) with a coexisting fetal inflammatory response, and 74/287 (25.7%) with PPROM. HCA was associated with a greater frequency of vaginal delivery (P < 0.0001), lower gestational age (P < 0.0001) and lower birth weight (P < 0.01). HCA had no effect on fetal lung maturation, however, it was a significant risk factor for CLD (RR; 95% CI 2.08; 1.30-3.33). HCA and the fetal inflammatory response were also significant risk factors for PPROM (RR; 95% CI 2.07; 1.42-3.03 and 2.64; 1.71-4.09 respectively). Conversely, HCA in the setting of PPROM failed to reveal any RDS protection or subtype CLD risk. Multivariate analysis demonstrated significant independent effects of presence of maternal HCA (P = 0.04), gestational age (P < 0.0001) and interaction HCA-gestational age (P = 0.04) on CLD development, regardless of the presence of fetal HCA or fetal HCA-gestational age interaction, PPROM or PPROM-gestational age interaction.Conclusions Histological chorioamnionitis is a significant PPROM and CLD risk factor, but it fails to provide any protection from RDS. HCA in the setting of PPROM also failed to reveal any RDS protection or subtype CLD risk.Keywords Chronic lung disease, fetal inflammatory response syndrome, histological chorioamnionitis, preterm premature rupture of membranes, respiratory distress syndrome.Please cite this paper as: Zanardo V, Vedovato S, Cosmi E, Litta P, Cavallin F, Trevisanuto D, Chiarelli S. Preterm premature rupture of membranes, chorioamnion inflammatory scores and neonatal respiratory outcome. BJOG 2010;117:94-98.

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“…The advantage of our procedure is that MSC were loaded directly on the stromal side of intact AM without any treatment technique. The stromal layer is composed of materials of the extracellular matrix (ECM) such as collagen, fibronectin, and proteoglycans 38 and, therefore, represents a natural scaffold compared with synthetic scaffolds. 26 Walker et al 26 recently reported that 85% of MSC from a synthetic scaffold (silicone) were capable to migrate to a reepithelialized human dermis.…”

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confidence: 99%

In VitroCharacterization of Patches of Human Mesenchymal Stromal Cells

Roux

Bodivit

Bartis

et al. 2015

Tissue Engineering Part A

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Stem cells may represent an excellent strategy to improve the healing of skin ulcers. Today the administration mode of stem cells to skin defects remains unsatisfactory. Delivering stem cells with topical treatments represents a new strategy and answering the patients' need. Mesenchymal stromal cells (MSC) have been shown to improve wound healing of cutaneous lesions and amniotic membrane (AM) is known to represent a natural scaffold for cells. The aim of this study is to develop a tissue-engineered product combining MSC and AM for clinical use. In this work we investigated whether the stromal matrix of intact human AM could constitute a scaffold for human MSC derived from either bone marrow (BM) or adipose tissue (AT). For this purpose, clinical-grade AM, MSC, and culture medium were used. We performed experiments of short-term adherence and proliferation for 15 days after the seeding of the cells. Morphological aspects and secretion profiles of MSC onto AM were studied, respectively, by scanning electron microscopy and Luminex analysis. Results demonstrated that the stromal matrix allow the adherence in much greater amount of MSC from BM or AT compared to 2D material. Experiments of proliferation showed that both kinds of MSC could proliferate on the stromal matrix and remain viable 15 days after the seeding of the cells. The 3D analysis of MSC culture demonstrated that both types of MSC invaded the stromal matrix and grew in multiple layers while retaining their fibroblastic morphology. By studying the secretion profile of MSC onto the stromal matrix, we found that both kinds of MSC secrete important cytokines and growth factors for wound healing of cutaneous lesions, such as vascular endothelial growth factor, hepatocyte growth factor, and basic fibroblast growth factor. In conclusion, these results suggest that the stromal matrix of AM seeded with MSC represents a bioactive scaffold that should be evaluated in patients with a nonhealing cutaneous wound.

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Premature Rupture of the Fetal Membranes

Cited by 684 publications

References 40 publications

Pregnancy and the Ehlers-Danlos syndrome: a retrospective study in a Dutch population

Pregnancy and the Ehlers-Danlos syndrome: a retrospective study in a Dutch population

Preterm premature rupture of membranes, chorioamnion inflammatory scores and neonatal respiratory outcome

In VitroCharacterization of Patches of Human Mesenchymal Stromal Cells

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