The fetal inflammatory response in subgroups of women with preterm prelabor rupture of the membranes

Kacerovský, Marian; Cobo, Teresa; Andrýs, Ctirad; Musilová, Ivana; Drahosova, Marcela; Hornychová, Helena; Janků, Petr; Jacobsson, Bo

doi:10.3109/14767058.2013.765404

Cited by 56 publications

(35 citation statements)

References 29 publications

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“…These findings are in conflict with a previous study by Yoon et al, which showed an association between oligohydramnios and a higher intra-amniotic inflammatory response (determined by the amniotic fluid IL-6, IL-1β and tumor necrosis factor-α levels) and the fetal inflammatory response (characterized by the umbilical cord blood IL-6 levels) [13]. Our previous studies showed that the highest intra-amniotic and fetal inflammatory responses in pregnancies characterized by PPROM are elicited when both MIAC and HCA are present [7], [34]. In this study, we found no difference in the presence of women with both MIAC and HCA between the groups with and without oligohydramnios [with oligohydramnios 25% (10/40) vs. without oligohydramnios 21% (7/34); p = 0.78; data not shown] [7], [13], [34].…”

Section: Discussionmentioning

confidence: 95%

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Oligohydramnios in Women with Preterm Prelabor Rupture of Membranes and Adverse Pregnancy and Neonatal Outcomes

et al. 2014

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ObjectiveTo determine the association between the presence of oligohydramnios, determined as an amniotic fluid index ≤ 5 cm and the intra-amniotic inflammatory response, fetal inflammatory response and neonatal outcomes in actively managed preterm prelabor rupture of membranes (PPROM).MethodsWomen with singleton pregnancies complicated by PPROM at a gestational age of between 24+0 and 36+6 weeks were included in the study. Ultrasound assessments of the amniotic fluid index and evaluation of the amniotic fluid interleukin (IL)-6 levels were performed at admission. The umbilical cord blood IL-6 levels were evaluated after delivery.ResultsIn total, 74 women were included. The women with oligohydramnios did not have different amniotic fluid IL-6 levels [with oligohydramnios: median 342 pg/mL, interquartile range (IQR) 110-1809 vs. without oligohydramnios: median 256 pg/mL, IQR 122–748; p = 0.71] or umbilical cord blood IL-6 levels (with oligohydramnios: median 8.2 pg/mL, IQR 3.8–146.9 vs. without oligohydramnios: median 5.9 pg/mL, IQR 2.1–27.9; p = 0.14) than those without oligohydramnios. No association between oligohydramnios and neonatal morbidity was found. A correlation between the amniotic fluid index and the interval from rupture of membranes to amniocentesis was observed (rho = −0.34; p = 0.003).ConclusionThe presence of oligohydramnios is not associated with an adverse outcome in actively managed PPROM in singleton pregnancies in the absence of other complications.

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Section: Discussionmentioning

confidence: 95%

“…The presence of these conditions is followed by an intra-amniotic and fetal inflammatory response that is associated with an adverse neonatal outcome [3]–[7]. Early identification of these complications appears to be crucial for the optimal management of PPROM and improved neonatal outcomes.…”

Section: Introductionmentioning

confidence: 99%

Oligohydramnios in Women with Preterm Prelabor Rupture of Membranes and Adverse Pregnancy and Neonatal Outcomes

et al. 2014

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“…21 PPROM pregnancies complicated by both MIAC and HCA seem to comprise the worst-case scenario subgroup of PPROM because of their highest intraamniotic and fetal inflammatory response. 10,11 In this study, the highest intraamniotic inflammatory response, as determined by amniotic fluid IL-6, peaked when both MIAC and HCA were present. This subgroup of women had a higher amniotic fluid concentration of IL-6 than the remaining 3 subgroups (MIAC alone, HCA alone, and without both MIAC and HCA).…”

Section: Principal Findings Of This Studymentioning

confidence: 96%

“…[3][4][5][6][7][8][9] Our previous work has shown that the presence of both MIAC and HCA is associated with strong intraamniotic and fetal inflammatory response. 10,11 This indicates that this subgroup constitutes the worst case scenario of PPROM.…”

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Bedside assessment of amniotic fluid interleukin-6 in preterm prelabor rupture of membranes

Kacerovský

Musilová

Hornychová

et al. 2014

American Journal of Obstetrics and Gynecology

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“…The low rate of antenatal infectious complications may be attributed in part to a relative short latency between diagnosis and delivery (mean = 19 days), which averted the onset of infection in some women. It is also possible that FIRS occurred without microbial invasion of the amniotic cavity in some cases [38] . Lack of correlation between maternal IL-6 levels and a diagnosis of chorioamnionitis in the present study may be due to a combination of the relative rarity of overt antenatal chorioamnionitis and the limited number of subjects in the study.…”

Section: Discussionmentioning

confidence: 99%

Fetal Urine Production Rate in Preterm Premature Rupture of Membranes Is Associated with Adverse Neonatal Outcome: A Pilot Study

Avitan¹,

Drukker²,

Pri‐Chen³

et al. 2017

Gynecol Obstet Invest

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Aim: In this study, we evaluate the associations between fetal urinary production rate (FUPR), measured by ultrasound, and adverse neonatal outcome in women with preterm premature rupture of membranes (PPROM). Methods: We conducted a prospective pilot cohort of singleton pregnancies complicated by PPROM occurring at gestational week 24 or later managed until spontaneous labor (after 48 h of admission), chorioamnionitis, or induction by protocol at 35 + 0 weeks. FUPR was evaluated by 2D sonography at admission (corrected for gestational age). The main neonatal outcome measures were chorioamnionitis, placental inflammatory grading, first neonatal creatinine value, first neonatal dextrose value, length of neonatal intensive care unit (NICU) stay, necrotizing enterocolitis (NEC), intraventricular hemorrhage (IVH) (grades I-IV), blood transfusions, reduced neonatal urine production rate (<4 mL/kg/h), and early neonatal sepsis. Samples of maternal (at admission) and umbilical cord blood were analyzed for interleukin-6 (IL-6) level. Results: The study included 38 women. Low FUPR was associated with clinical chorioamnionitis, longer NICU hospitalization (p = 0.01), higher rates of NEC or IVH (p = 0.008), and blood transfusion (p = 0.004). Conclusions: A finding of FUPR on in utero ultrasound examination in pregnancies complicated by PPROM may be indicative of adverse neonatal outcome.

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The fetal inflammatory response in subgroups of women with preterm prelabor rupture of the membranes

Abstract: A higher fetal inflammatory response mediated by umbilical cord blood IL-6 was identified when both MIAC and HCA were detected in pregnancies complicated by PPROM.

Cited by 56 publications

References 29 publications

Oligohydramnios in Women with Preterm Prelabor Rupture of Membranes and Adverse Pregnancy and Neonatal Outcomes

Oligohydramnios in Women with Preterm Prelabor Rupture of Membranes and Adverse Pregnancy and Neonatal Outcomes

Bedside assessment of amniotic fluid interleukin-6 in preterm prelabor rupture of membranes

Fetal Urine Production Rate in Preterm Premature Rupture of Membranes Is Associated with Adverse Neonatal Outcome: A Pilot Study

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