Cervical sonoelastography is a promising technique that can complement routine diagnostic procedures to improve prediction of preterm birth. The PPV is improved by an fFN test.

Combination of FISH with broad-range PCR and sequencing permitted unambiguous identification of the causative microorganisms in chorioamnionitis. The high prevalence of Ureaplasma spp. should lead to a re-evaluation of its clinical significance and possible therapeutic consequences.

reproductive technologies and better outcomes in indicated preterm births [5]. The ability to identify women at high risk for spontaneous preterm birth is crucial yet remains difficult. In women with preterm contractions, 30 % of preterm labors resolve spontaneously, whereas 50 % of women treated for preterm labor deliver at term [6]. In addition to typical risk factors, such as low socioeconomic status, multiple pregnancies, or a history of cervical surgery, the primary methods used for the detection of preterm birth are transvaginal ultrasound and the presence of fetal fibronectin (fFN) in cervicovaginal fluid. These methods allow clinicians to perform targeted interventions such as referral to a tertiary care center, antenatal corticosteroid administration, and tocolysis. The relationship between cervical length and the incidence of preterm birth is well-known [7]. Introduction ▼Preterm birth is defined as delivery before a gestational age of 37 weeks. Annually, more than 15 million children are affected worldwide. It is the main cause of perinatal morbidity and mortality, and almost one-half of long-term neurologic morbidity cases and approximately 3-quarters of neonatal mortality are associated with preterm birth [1,2]. Furthermore, approximately one-third of neonatal deaths are caused by prematurity leading to more than 1 million newborn deaths per year [3]. Despite advancing knowledge of the risk factors and mechanisms associated with preterm labor and delivery, the preterm birth rate has risen in most industrialized countries [4]. This increase has been partially attributed to a rise in multiple pregnancies that occurred as a result of assisted Purpose: Worldwide, preterm birth annually affects more than 15 million infants. Despite increasing knowledge of the risk factors and mechanisms associated with preterm labor, the preterm birth rate has risen in most industrialized countries. The ability to identify women at high risk for spontaneous preterm birth is crucial yet remains difficult. The aim of the present study was to assess the value of cervical length measurements in combination with sonoelastography and interleukin 6 (IL-6) concentrations in cervicovaginal secretions to identify women at risk for preterm birth. Materials and Methods: 36 pregnant women with signs of threatened preterm birth were enrolled in our prospective cohort study. Cervical length measurement, sonoelastography, and IL-6 levels from cervicovaginal swab samples were measured. Results:The preterm birth rate was found to be 33.3 % in our study cohort. Maternal age did not differ between the preterm and term birth groups. Measurement of the cervical length alone was found to have a sensitivity of 0.7 and a specificity of 0.8, whereas cervical sonoelastography had a sensitivity of 0.66 and a specificity of 0.82. By using a combination of both methods, the sensitivity and specificity were found to be 0.9 and 0.7, respectively. IL-6 levels were not found to differ between women with term deliveries and women with preterm births. Conc...

Background The causative microbial etiology of prosthetic valve infective endocarditis (PVE) can be difficult to identify. Our aim was to investigate the benefit of the molecular imaging technique fluorescence in situ hybridization (FISH) combined with 16S rRNA-gene PCR and sequencing (FISHseq) for the analysis of infected prosthetic heart valves. Methods We retrospectively evaluated the diagnostic outcome of 113 prosthetic valves from 105 patients with suspected PVE, treated in the years 2003-2013 in the Department of Cardiac Surgery, Charité University Medicine Berlin. Each prosthetic valve underwent cultural diagnostics and was routinely examined by FISH combined with 16S rRNA-gene PCR and sequencing. We compared classical microbiological culture outcomes (blood and valve cultures) with FISHseq results and evaluated the diagnostic impact of the molecular imaging technique. Results Conventional microbiological diagnostic alone turned out to be insufficient, as 67% of preoperative blood cultures were non-informative (negative, inconclusive or not obtained) and 67% valve cultures remained negative. FISHseq improved the conventional cultural diagnostic methods in PVE in 30% of the cases and increased diagnostic accuracy. Out of the valve culture-negative PVE cases, FISHseq succeeded to identify the causative pathogen in 35%. Conclusions FISHseq improves PVE diagnostics, complementing the conventional cultural methods. In addition to species identification, FISH provides information about the severity of PVE and state of the pathogens, e.g. stage of biofilm formation, activity and localization on and within the prosthetic material. As a molecular imaging technique, FISHseq enables the unambiguous discrimination of skin flora as contaminant or infectious agent.