Amniotic fluid matrix metalloproteinase-9 and interleukin-6 in predicting intra-amniotic infection

Harirah, Hassan; Donia, Sahar E.; Hsu, Chaur Dong

doi:10.1016/s0029-7844(01)01632-5

Cited by 38 publications

(14 citation statements)

References 14 publications

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“…The noninvasive tests that are used in the detection of intrauterine infection are maternal serum C-reactive protein (CRP), white blood cell (WBC) count, and IL-6 measurements. These tests have relatively low sensitivity rates between 67 and 81% [5,6]. Therefore, a highly sensitive and specific noninvasive prenatal test is needed to predict fetal infection in PPROM pregnancies.…”

Section: Introductionmentioning

confidence: 99%

Serial Ultrasonographic Examination of the Fetal Thymus in the Prediction of Early Neonatal Sepsis in Preterm Premature Rupture of Membranes

Çetin

Cetin

Uludağ

et al. 2014

Gynecol Obstet Invest

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Background/Aims: To evaluate the diagnostic accuracy of fetal thymus transverse diameter (FTTD) in predicting fetal infection in preterm premature rupture of membranes (PPROM) and compare its accuracy with cord blood tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6). Methods: Forty consecutive pregnancies complicated with PPROM between 26^1/7 and 36^6/7 gestational weeks were evaluated prospectively. Serial fetal ultrasonography follow-ups with 3-day intervals were performed beginning on the admission day. The FTTD was recorded on every ultrasonographic examination. Cord blood TNF-α and IL-6 values were measured after delivery. Results: FTTD was decreased below 5% according to nomograms compared to the initial measurement in 45% of all PPROM cases. Decreased FTTD had a sensitivity of 100%, specificity of 73%, positive predictive value of 55%, and negative predictive value of 100% in predicting early neonatal sepsis. Cord blood TNF-α had a sensitivity of 80% and specificity of 90%, whereas IL-6 had a sensitivity of 90% and specificity of 63.3% in predicting early neonatal sepsis. Conclusions: Assessment of the decrease in FTTD by serial ultrasonographic examinations is a promising ‘prenatal' method for the early detection of early neonatal sepsis.

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Section: Introductionmentioning

confidence: 99%

Serial Ultrasonographic Examination of the Fetal Thymus in the Prediction of Early Neonatal Sepsis in Preterm Premature Rupture of Membranes

Çetin

Cetin

Uludağ

et al. 2014

Gynecol Obstet Invest

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“…However, the risk of adverse pregnancy outcome after emergency cerclage seems to be increased also among those with no detectable amniotic fluid infection but with a latent intra-amniotic inflammatory process. Several markers of intra-amniotic inflammation have been shown to predict early cerclage failure and impending delivery including IL-6, metalloproteinase-8, glucose concentration, CRP, white blood cell, LDH and neutrophil counts [4,5,8,10,11]. …”

Section: Discussionmentioning

confidence: 99%

“…On the contrary, the IL-6 levels, despite being increased and compatible with inflammation [12] as well as impending delivery [7], were below the threshold value which has shown a high positive predictive value for intra-amniotic infection [10]. Unfortunately, further rapid tests to assess more accurately the presence of intra-amniotic inflammation were not available in the laboratory of our institution, as well as molecular microbiologic techniques (i.e.…”

Section: Discussionmentioning

confidence: 99%

Occurrence of Septic Shock in a Patient Submitted to Emergency Cerclage following a Negative Amniocentesis: Report of a Case

et al. 2012

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Background: Second trimester emergency cerclage is an option for pregnant women presenting bulging fetal membranes. Despite a significant prolongation of pregnancy might be achieved, serious fetal and maternal events have been reported. Exclusion of infections through preprocedure amniocentesis has been proposed. Methods: A 37-year-old woman, gravida 4 para 1, was admitted at 21 weeks of gestation to our University Hospital due to bulging fetal membranes. An amniocentesis was performed in order to exclude an actual amniotic infection. Our Microbiology Department found a negative amniotic culture for bacteria and Mycoplasma and a normal glucose and interleukin-6 level, so a cervical cerclage was performed. The patient was discharged home on oral erythromycin. Results: After 48 h, the patient complained of hyperpyrexia, shivers and reduced fetal movements. Ultrasound at admission showed absent cardiac activity and after cerclage removal a non-viable fetus was delivered vaginally. Piperacillin and tazobactam were started, but the clinical course of the patient deteriorated and she developed a cold septic shock and was submitted to hysterectomy and transferred to the ICU of our hospital. Conclusion: This report heralds that even after negative amniocentesis, a life-threatening infection may not be excluded in women candidate for emergency cerclage due to bulging fetal membranes.

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“…Rupturing of the membranes is believed to be the result of the effects of physical forces which are localized in areas surrounding the membranes that are made weaker by the degradation of structural collagens [38]. The matrix metalloproteinases (MMPs) are a family of enzymes (with more than 20 members identified) that use zinc-dependant catalysis to break down the components of the ECM [39], allowing for the movement of cells and tissue reorganization in order to support the growing fetus [40]. Several MMPs are constitutively generated by reproductive tissues, and a fluctuation in the gene expression level of certain MMPs has been observed during the various stages of parturition [41].…”

Section: Matrix Metalloproteinasesmentioning

confidence: 99%

“…MMP-9 is considered to be an enzyme which plays a role in the latter part of ECM remodeling and, unlike other MMPs, is produced and activated under certain conditions such as infection, active labor, and premature rupture of the membranes (PROM) [46, 47]. In the setting of intraamniotic infection, the concentrations of AF MMP-9 and the inflammatory cytokine IL-6 have been found to be significantly elevated [39]. A study conducted by Harirah et al [39] reported that 22 out of 26 women with positive AF cultures had detectable levels of MMP-9, ranging from 30.1 to 541.9 ng/mL, while MMP-9 was nearly undetectable in women with negative AF cultures.…”

Section: Matrix Metalloproteinasesmentioning

confidence: 99%

The Matrix Metalloproteases and Endothelin‐1 in Infection‐Associated Preterm Birth

Olgun

Reznik

2010

Obstetrics and Gynecology International

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Preterm birth (PTB) is clinically defined as any delivery which occurs before the completion of 37 weeks of gestation, and is currently the most important problem in obstetrics. In the United States, PTB accounts for 12-13% of all live births, and, with the exception of fetuses suffering from anomalies, is the primary cause of perinatal mortality. While the risk factors for PTB are numerous, the single most common cause is intrauterine infection. As there is currently no FDA-approved therapy for infection-associated PTB, understanding the pathogenesis of preterm labor (PTL) and delivery should be given high priority. The matrix metalloproteinases (MMPs) are a family of enzymes that have been implicated in normal parturition as well as infection-triggered rupture of membranes and preterm birth. Several lines of evidence also suggest a role for endothelin-1 (ET-1) in infection-associated preterm delivery. This paper focuses on the evidence that the MMPs and ET-1 act in the same molecular pathway in preterm birth.

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Amniotic fluid matrix metalloproteinase-9 and interleukin-6 in predicting intra-amniotic infection

Cited by 38 publications

References 14 publications

Serial Ultrasonographic Examination of the Fetal Thymus in the Prediction of Early Neonatal Sepsis in Preterm Premature Rupture of Membranes

Serial Ultrasonographic Examination of the Fetal Thymus in the Prediction of Early Neonatal Sepsis in Preterm Premature Rupture of Membranes

Occurrence of Septic Shock in a Patient Submitted to Emergency Cerclage following a Negative Amniocentesis: Report of a Case

The Matrix Metalloproteases and Endothelin‐1 in Infection‐Associated Preterm Birth

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