Premature rupture of membranes: The role of C-reactive protein in the prediction of chorioamnionitis

Hawrylyshyn, P.; Bernstein, Paul S.; Milligan, John; Soldin, Steven J.; Pollard, Alan; Papsin, F.R.

doi:10.1016/0002-9378(83)91104-3

Cited by 90 publications

(57 citation statements)

References 10 publications

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“…Clinical studies have indicated that elevation of maternal serum C-reactive protein (CRP) often precedes the development of clinical chorioamnionitis and the onset of premature labor in women with preterm premature rupture of membranes (28)(29)(30). Furthermore, patients in PTL with elevated levels of CRP are more likely to be unresponsive to tocolytic therapy than those with nondetectable CRP (30)(31)(32).…”

Section: Introductionmentioning

confidence: 99%

Amniotic fluid interleukin 6 in preterm labor. Association with infection.

Romero¹,

Avila²,

Santhanam³

et al. 1990

J. Clin. Invest.

549

250

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To evaluate whether IL-6 participates in the host response to intrauterine infection, we studied IL-6 bioactivity and isoforms in amniotic fluid (AF). Two different assays for IL-6 were used: the hepatocyte stimulating factor assay (in Hep3B2 cells) and the SDS-PAGE/immunoblot assay. IL-6 determinations were performed in 205 AF samples. Samples were obtained from patients in the midtrimester of pregnancy (n = 25), at term with no labor (n = 31), at term in active labor (n = 40), and from patients in preterm labor (n = 109). Higher AF IL-6 levels were observed in women in preterm labor with intraamniotic infection than in women in preterm labor without intraamniotic infection (median = 375 ng/ml, range = 30-5000 ng/ml vs. median = 1.5 ng/ml, range = 0-500, respectively, P < 0.0001). The 23-25-and 28-30-kD IL-6 species could be readily detected in SDS-PAGE immunoblots performed directly on 10-,ul aliquots of AF from patients with intraamniotic infection. Among women in preterm labor with culture-negative AF, those who failed to respond to subsequent tocolytic treatment had higher AF IL-6 concentrations than those who responded to therapy (median = 50 ng/ml vs. median = 1.2 ng/ml, respectively, P < 0.05). Only low levels of IL-6 were detected in AF obtained from normal women in the midtrimester and third trimester of pregnancy. Decidual tissue explants obtained from the placentas of women undergoing elective cesarean section at term without labor (n = 11) produced IL-6 in response to bacterial endotoxin. In a pilot study, AF IL-6 was determined in 56 consecutive women admitted with preterm labor. All patients (n = 10) with elevated AF IL-6 (cutoff = 46 ng/ml) delivered a premature neonate. 4 of these 10 patients had positive AF cultures for microorganisms. These studies implicate IL-6 in the host response to intrauterine infection and suggest that evaluation of AF IL-6 levels may have diagnostic and prognostic value in the management of women in preterm labor. (J. Clin. Invest. 1990Invest. . 85:1392Invest. -1400.) prematurity -parturition-decidua * cytokines -bacterial endotoxins

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Section: Introductionmentioning

confidence: 99%

Amniotic fluid interleukin 6 in preterm labor. Association with infection.

Romero¹,

Avila²,

Santhanam³

et al. 1990

J. Clin. Invest.

549

250

View full text Add to dashboard Cite

show abstract

“…Hawrylyshyn et al 56 showed that serum CRP was the best laboratory test for the diagnosis of chorioamnionitis, with a serum CRP concentration of greater than 12' 5 mg/L having a positive predictive value of 960/0 and a negative predictive value of 89%. Because of the difficulty, cost and risks of amniocentesis it was concluded; that serum CRP measurement was the more useful diagnostic test.…”

Section: Premature Rupture Of Membranesmentioning

confidence: 99%

The Value of Acute Phase Protein Measurements in Clinical Practice

1992

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“…When compared with the literature, our rate of chorioamnionitis seems rather high: 18% before 37 weeks versus 12% [11], 5.2% [38], 5.3% [6] and 27% before 35 weeks versus 16% [15], 27% [27], 18% [17], 25% [16]. However, when comparing the neonatal outcome, which is the most important criteria, our PROM management is substantially more encouraging than the traditional management (table V).…”

Section: Discussionmentioning

confidence: 71%