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The perinatal prognosis in cases of eclampsia could be improved if it were possible to predict its onset so that appropriate treatment could be given as early as possible. The investigators performed cerebral magnetic resonance imaging (MRI) in 41 women with severe preeclampsia in an attempt to identify ways in which this imaging procedure can be most effective. Six patients had systemic seizures and 14 had visual symptoms apart from retinal detachment. Urinary protein exceeding 2.5 g daily was noted in 12 cases. All patients received magnesium sulfate prophylactically, and some also received alpha methyldopa, labetalol hydrochloride, or calcium channel blockers such as nicardipine. All participants had MRI studies regardless of whether headaches or visual symptoms were part of the picture.Abnormal MR images were obtained in 11 patients, 9 with vasogenic edema and 3 with minor cerebral embolism. Vasoconstriction was observed in 4 cases. Six of the 11 patients with abnormal MRI findings had seizures. Abnormal cerebral MRI findings had a predictive accuracy of 85%. Only 14% of patients had been diagnosed by radiologic imaging. Diastolic blood pressure and elevated serum levels of liver enzymes predicted abnormal MRI findings with 83% accuracy. Thirty-three women underwent emergency cesarean section. Labor was induced in 5 cases, leading to vaginal delivery. Three women delivered spontaneously. The neonatal prognosis was consistently good, and all women recovered without sequelae.Although MRI may not be clinically cost-effective when done routinely in women with preeclampsia, it is recommended when delivery is delayed in those with severe preeclampsia. This is especially the case when diastolic blood pressure and liver enzymes are elevated. In women with eclampsia, MRI should be repeated until cerebral edema no longer is present. ABSTRACTPreterm birth (PTB) remains the leading cause of perinatal morbidity and mortality and also is associated with cerebral palsy and suboptimal performance at school. Adverse outcomes are especially likely if there is intrauterine infection and inflammation. Because of its subclinical nature, however, the diagnosis depends on examining amniotic fluid, a relatively invasive procedure. In this study, amniotic fluid and cervical fluid were evaluated, and the presence in the latter of interleukin (IL)-6 and IL-8 was related to microbial invasion of amniotic fluid, intraamniotic inflammation, and PTB in women with singleton pregnancies who were in preterm labor before 34 weeks gestation and whose membranes were intact. Cervical fluid was sampled from the external cervical os within 12 hours of admission in 91 women and amniotic fluid in 56. The polymerase chain reaction technique was used to detect Ureaplasma urealyticum and Mycoplasma hominis. Interleukins 6 and 8 were estimated by enzyme-linked immunosorbent assay.Women had a median gestational age of 30 weeks at the time of the study; 38% delivered before 34 weeks gestation. No woman had clinical chorioamnionitis. Although the presence o...

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