The fetal splenic vein flow pattern and fetal inflammatory response in the preterm prelabor rupture of membranes
Language English Country Great Britain, England Media print-electronic
Document type Journal Article, Research Support, Non-U.S. Gov't
- MeSH
- Chorioamnionitis blood epidemiology physiopathology MeSH
- Adult MeSH
- Fetal Blood chemistry metabolism MeSH
- Interleukin-6 analysis blood MeSH
- Humans MeSH
- Young Adult MeSH
- Infant, Newborn, Diseases diagnosis epidemiology etiology MeSH
- Infant, Newborn MeSH
- Fetus blood supply immunology MeSH
- Fetal Membranes, Premature Rupture * blood diagnosis epidemiology physiopathology MeSH
- Prognosis MeSH
- Regional Blood Flow * MeSH
- Retrospective Studies MeSH
- Pregnancy MeSH
- Splenic Vein physiology MeSH
- Pregnancy Outcome epidemiology MeSH
- Inflammation blood epidemiology physiopathology MeSH
- Check Tag
- Adult MeSH
- Humans MeSH
- Young Adult MeSH
- Infant, Newborn MeSH
- Pregnancy MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Research Support, Non-U.S. Gov't MeSH
- Names of Substances
- Interleukin-6 MeSH
OBJECTIVE: To evaluate the intensity of the fetal inflammatory response, characterized by umbilical cord blood IL-6 levels, and neonatal outcome in the preterm prelabor rupture of membranes (PPROM) pregnancies using the pulsatile fetal splenic vein flow pattern. METHODS: Women with singleton pregnancies complicated by PPROM at a gestational age between 24 + 0 and 36 + 6 weeks were included in the study. Doppler evaluation of the fetal splenic vein flow was performed. The flow-velocity waveform pattern was evaluated qualitatively as continuous or pulsatile. The umbilical cord blood interleukin-6 (IL-6) levels were evaluated after delivery. The fetal inflammatory response was defined as IL-6 >11 pg/mL. RESULTS: In total, 129 women were included. The fetuses with pulsatile splenic vein flow exhibited higher IL-6 levels in umbilical cord blood (median: 56.7 pg/mL versus 5.6 pg/mL; p < 0.0001) and had a higher rate of fetal inflammatory response syndrome (71% versus 35%; p = 0.0005) than fetuses with continuous flow. The pulsatile flow pattern was related to a higher rate of early onset neonatal sepsis (odds ratio 4.2; 95% confidence interval: 1.3-13.5). CONCLUSION: The presence of pulsatile fetal splenic vein flow in PPROM pregnancies is associated with fetal inflammatory response and neonatal morbidity.
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