BACKGROUND: Excisional treatment of cervical intraepithelial neoplasia or very early stages of cervical cancer increases the risk of preterm prelabor rupture of membranes in subsequent pregnancies. The risk increases with the length of the excised cone. The subset of cases with preterm prelabor rupture of membranes and a history of cervical excisional treatment could also be at higher risk of intraamniotic infection/inflammation. However, there is a paucity of relevant information on this subject. OBJECTIVE: This study aimed to assess the differences in the rates of intraamniotic infection/inflammation and early-onset neonatal sepsis between singleton preterm prelabor rupture of membranes pregnancies without and with a history of cervical excisional treatment, and to investigate the association between these complications of preterm prelabor rupture of membranes and the excised cone length. STUDY DESIGN: This retrospective cohort study included 770 preterm prelabor rupture of membranes pregnancies in which transabdominal amniocentesis was performed as part of standard clinical management to assess the intraamniotic environment. The maternal and perinatal medical records of all included women were reviewed to obtain information on the absence or presence of history of cervical excisional treatment and neonatal outcomes. Women whose records contained any information on history of cervical excisional treatment were contacted by phone and in writing to inform them of the study and request permission to collect relevant information from their medical records. Women were divided into 4 subgroups according to the presence of microorganisms and/or their nucleic acids (through culturing and molecular biology methods) in amniotic fluid and/or intraamniotic inflammation (through amniotic fluid interleukin-6 concentration evaluation): intraamniotic infection (presence of both), sterile intraamniotic inflammation (intraamniotic inflammation alone), microbial invasion of the amniotic cavity without inflammation (presence of microorganisms and/or their nucleic acids in amniotic fluid alone), and negative amniotic fluid for infection/inflammation (absence of both). RESULTS: A history of cervical excisional treatment was found in 10% (76/765) of the women. Of these, 82% (62/76) had a history of only 1 treatment, and information on cone length was available for 97% (60/62) of them. Women with a history of cervical excisional treatment had higher rates of intraamniotic infection (with, 25% [19/76] vs without, 12% [85/689]; adjusted odds ratio, 2.5; adjusted P=.004), microbial invasion of the amniotic cavity without inflammation (with, 25% [19/76] vs without, 11% [74/689]; adjusted odds ratio, 3.1; adjusted P<.0001), and early-onset neonatal sepsis (with, 8% [11/76] vs without, 3% [23/689]; adjusted odds ratio, 2.9; adjusted P=.02) compared with those without such history. Quartiles of cone length (range: 3-32 mm) were used to categorize the women into 4 quartile subgroups (first: 3-8 mm; second: 9-12 mm; third: 13-17 mm; and fourth: 18-32 mm). Cone length of ≥18 mm was associated with higher rates of intraamniotic infection (with, 29% [5/15] vs without, 12% [85/689]; adjusted odds ratio, 3.0; adjusted P=.05), microbial invasion of the amniotic cavity without inflammation (with, 40% [6/15] vs without, 11% [74/689]; adjusted odds ratio, 6.1; adjusted P=.003), and early-onset neonatal sepsis (with, 20% [3/15] vs without, 3% [23/689]; adjusted odds ratio, 5.7; adjusted P=.02). CONCLUSION: History of cervical excisional treatment increases risks of intraamniotic infection, microbial invasion of the amniotic cavity without inflammation, and development of early-onset neonatal sepsis in a subsequent pregnancy complicated by preterm prelabor rupture of membranes.

• MeSH
• chorioamnionitida * epidemiologie   etiologie   MeSH
• lidé MeSH
• novorozenec MeSH
• novorozenecká sepse * MeSH
• plodová voda MeSH
• předčasný odtok plodové vody * epidemiologie   MeSH
• retrospektivní studie MeSH
• těhotenství MeSH
• zánět komplikace   MeSH
• Check Tag
• lidé MeSH
• novorozenec MeSH
• těhotenství MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

Cíl: Stanovit hladiny solubilní formy CD93 (sCD93) v plodové vodě u pacientek s předčasným odtokem plodové vody (PPROM – preterm prelabor rupture of membranes) s ohledem na přítomnost mikrobiální invaze do amniální dutiny (MIAC – microbial invasion of the amniotic cavity) a/nebo intraamniálního zánětu. Metody: Do studie bylo zahrnuto celkem144 žen s jednočetným těhotenstvím komplikovaným PPROM. Plodová voda byla získána amniocentézou. MIAC byla stanovena kultivačními a nekultivačními technikami. Intraamniální zánět byl stanoven hladinou interleukinu 6 ≥ 3 000 pg/ml v plodové vodě. Ženy byly rozděleny do následujících skupin: i) intraamniální infekce, ii) sterilní intraamniální zánět, iii) kolonizace a iv) negativní plodová voda. Hladiny sCD93 v plodové vodě byly stanoveny pomocí testu ELISA. Výsledky: Hladiny sCD93 v plodové vodě se lišily mezi skupinami žen s PPROM s intraamniální infekcí, sterilním intraamniálním zánětem, kolonizací a negativní plodovou vodou (intraamniální infekce: medián 22,3 ng/ml, sterilní intraamniální zánět: medián 21,0 ng/ml, kolonizace amniové dutiny: 8,7 ng/ml, negativní plodová voda: medián 8,7 ng/ml; p < 0,0001). Závěr: Intraamniální zánět u PPROM, bez ohledu na přítomnost, či chybení MIAC, je spojen se zvýšením hladin sCD93 v plodové vodě.

Objective: To determine the soluble form of CD93 (sCD93) concentration in amniotic fluid from pregnancies complicated by preterm prelabor rupture of membranes (PPROM) based on the presence of microbial invasion of the amniotic cavity (MIAC) and/or intra-amniotic inflammation. Methods: A total of 144 women with a singleton pregnancy complicated by PPROM were included in this study. Amniotic fluid samples were obtained by transabdominal amniocentesis. MIAC was determined by the combination of cultivation and non-cultivation techniques. Intra-amniotic inflammation was characterized as a concentration of interleukin-6 ≥ 3,000 pg/mL in amniotic fluid. Women were categorized in the following groups: i) intra-amniotic infection (both MIAC and intra-amniotic inflammation), ii) sterile intra-amniotic inflammation (intra-amniotic inflammation per se), iii) colonization of the amniotic cavity (MIAC per se), and iv) negative amniotic fluid (without both MIAC and intra-amniotic inflammation). Levels of sCD93 in amniotic fluid were assessed by ELISA. Results: A difference in the levels of sCD93 in amniotic fluid was found among the groups of women with intra-amniotic infection, sterile intra-amniotic inflammation, colonization of the amniotic cavity, and negative amniotic fluid (intra-amniotic infection: median 22.3 ng/mL, sterile intra-amniotic inflammation: median 21.0 ng/mL, colonization of the amniotic cavity: 8.7 ng/mL, negative: median 8.7 ng/mL; P < 0.0001). Conclusions: Intra-amniotic inflammation in PPROM, irrespectively of the presence or absence of MIAC, is associated with the elevation of the level of sCD93 in amniotic fluid.

• MeSH
• biologické markery MeSH
• chorioamnionitida etiologie   MeSH
• extraembryonální obaly chemie   MeSH
• lidé MeSH
• novorozenec MeSH
• plodová voda MeSH
• předčasný odtok plodové vody * MeSH
• retrospektivní studie MeSH
• těhotenství MeSH
• zánět komplikace   MeSH
• Check Tag
• lidé MeSH
• novorozenec MeSH
• těhotenství MeSH
• ženské pohlaví MeSH

OBJECTIVE: To assess the association between the birth weight of newborns and microbial invasion of the amniotic cavity (MIAC) and/or intra-amniotic inflammation in pregnancies with preterm prelabor rupture of membranes. METHODS: A total of 528 pregnancies with preterm prelabor rupture of membranes were included in this retrospective cohort study. Transabdominal amniocentesis to determine the presence of MIAC (through culturing and molecular biology methods) and intra-amniotic inflammation (according to amniotic fluid interleukin-6 level) was performed as part of standard clinical management. Based on the presence of MIAC and/or intra-amniotic inflammation, the participants were divided into four subgroups: with intra-amniotic infection (presence of both), with sterile IAI (intra-amniotic inflammation alone), with colonization (MIAC alone), and with negative amniotic fluid (absence of both). Birth weights of newborns are expressed as percentiles derived from INTERGROWTH-21st standards for (i) newborn birth weight and (ii) estimated fetal weight. RESULTS: No differences in birth weights, expressed as percentiles derived from newborn weight standards (infection: median 52; sterile: median 54; colonization: median 50; negative amniotic fluid: median 51; p = .93) and estimated fetal weight standards (infection: median 47; sterile: median 51; colonization: median 47; negative amniotic fluid: median 53; p = .48) were found among the four subgroups. No differences in percentiles (derived from both standards) were found in the subset of participants who delivered within 72 h after rupture of membranes (newborn weight standard, p = .99; estimated fetal weight standard, p = .81). CONCLUSIONS: No association was identified between the birth weight of newborns and the presence of intra-amniotic inflammatory and infection-related complications in pregnancies with preterm prelabor rupture of membranes.

• MeSH
• chorioamnionitida * etiologie   MeSH
• gestační stáří MeSH
• hmotnost plodu MeSH
• lidé MeSH
• novorozenec MeSH
• plodová voda MeSH
• porodní hmotnost MeSH
• předčasný odtok plodové vody * etiologie   MeSH
• retrospektivní studie MeSH
• těhotenství MeSH
• zánět komplikace   MeSH
• Check Tag
• lidé MeSH
• novorozenec MeSH
• těhotenství MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

INTRODUCTION: To determine the amniotic fluid glucose levels in pregnancies complicated by preterm prelabor rupture of membranes (PPROM) based on the presence of microbial invasion of the amniotic cavity and/or intra-amniotic inflammation. METHODS OF STUDY: A total of 142 women with singleton pregnancies complicated by PPROM between gestational ages 24 + 0 and 36 + 6 weeks were included. Amniocentesis was performed at the time of admission. The assessments of microbial invasion of the amniotic cavity (using both cultivation and non-cultivation techniques) and intra-amniotic inflammation (amniotic fluid interleukin-6 levels ≥ 3000 pg/mL) were performed on all the women. Based on the presence of microbial invasion of the amniotic cavity and/or intra-amniotic inflammation, the women were further categorized into the subgroups: (i) intra-amniotic infection (the presence of both microbial invasion of the amniotic cavity and intra-amniotic inflammation); (ii) sterile intra-amniotic inflammation (the presence of intra-amniotic inflammation without microbial invasion of the amniotic cavity); (iii) colonization (the presence of microbial invasion of the amniotic cavity without intra-amniotic inflammation); and (iv) negative amniotic fluid (the absence of either microbial invasion of the amniotic cavity or intra-amniotic inflammation). Amniotic fluid glucose levels were assessed using enzymatic reference method with hexokinase. RESULTS: There was a difference in the amniotic fluid glucose levels among the women with intra-amniotic infection, sterile intra-amniotic inflammation, colonization, and those with negative amniotic fluid (p < .0001). No difference was found in the amniotic fluid glucose levels between women with intra-amniotic infection and those with sterile intra-amniotic inflammation [infection: median 11.6 mg/dL (0.7 mmol/L) vs. sterile: median 6.3 mg/dL (0.4 mmol/L); p = .41] and between women with colonization and negative amniotic fluid [colonization: median 21.6 mg/dL (1.2 mmol/L) vs. negative: median 23.4 mg/dL (1.3 mmol/L; p = .67]. Women with intra-amniotic infection and sterile intra-amniotic inflammation had lower amniotic fluid glucose levels than women with colonization and with negative amniotic fluid in crude analysis as well as after adjustment for gestational age at sampling. Amniotic fluid glucose level of 10 mg/dL (0.56 mmol/L) was the optimal concentration for the identification of intra-amniotic inflammation in women with PPROM. CONCLUSIONS: The presence of intra-amniotic inflammation was associated with lower amniotic fluid glucose levels in singleton pregnancies complicated with PPROM. An amniotic fluid glucose level of 10 mg/dL (0.56 mmol/L) was the optimal concentration for the identification of intra-amniotic inflammation in PPROM pregnancies. In the absence of better amniotic fluid markers, amniotic glucose could be used as a marker of intra-amniotic inflammation, with very good specificity in PPROM pregnancies.

• MeSH
• biologické markery analýza   MeSH
• chorioamnionitida * epidemiologie   etiologie   MeSH
• gestační stáří MeSH
• glukosa MeSH
• kojenec MeSH
• lidé MeSH
• novorozenec MeSH
• plodová voda chemie   MeSH
• přátelé MeSH
• předčasný odtok plodové vody * etiologie   MeSH
• těhotenství MeSH
• zánět komplikace   MeSH
• Check Tag
• kojenec MeSH
• lidé MeSH
• mužské pohlaví MeSH
• novorozenec MeSH
• těhotenství MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

OBJECTIVE: To perform a systematic review of the literature available on the association between the presence of microbial invasion of the amniotic cavity (MIAC) and/or intra-amniotic inflammation and long-term neurodevelopmental outcomes of infants from pregnancies complicated by preterm prelabor rupture of membranes (PPROM). METHODS: A literature search, from their earliest entries to May 2020, was performed by employing three electronic databases (Web of Science, PubMed, and Scopus). The selection criteria were as follows: (1) singleton pregnancies with PPROM; (2) available information regarding MIAC and/or intra-amniotic inflammation; (3) long-term (at least one year of the corrected age) neurodevelopmental outcomes of respective infants. RESULTS: The initial search identified 10,953 articles, of which 8 were selected for full-text reading; however, none were included in the review owing to the following reasons: (i) spontaneous preterm labor with intact membranes and/or indicated (iatrogenic) preterm delivery were included in the studies without providing separate data for PPROM (n = 5); (ii) long-term, at least one year of the corrected age, neurodevelopmental outcomes of infants were not assessed (n = 1); (iii) the presence of both the abovementioned reasons (n = 1); (iv) amniotic fluid was not assessed, and a long-term neurodevelopmental outcome was not evaluated (n = 1). CONCLUSION: The literature search provides evidence of a knowledge gap in the association between the presence of MIAC and/or intra-amniotic inflammation and long-term neurodevelopmental outcomes in infants with PPROM.

• MeSH
• chorioamnionitida * etiologie   MeSH
• gestační stáří MeSH
• lidé MeSH
• novorozenec MeSH
• plodová voda MeSH
• předčasný odtok plodové vody * MeSH
• těhotenství MeSH
• zánět komplikace   MeSH
• Check Tag
• lidé MeSH
• novorozenec MeSH
• těhotenství MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• systematický přehled MeSH

The most common cause of preterm birth is chorioamnionitis which often leads to the development of fetal inflammatory response syndrome (FIRS). FIRS is a major risk factor for perinatal mortality, but also for early ad long-term neonatal morditidy, such as impaired cardiac function, bronchopulmonary dysplasia and brain injury. FIRS is defined by increased systemic inflammatory cytokine concentrations. Recently it became clear that blood platelets and platelet microparticles play an important role in many inflammatory conditions. Our project is aimed on a study of platelet status and presence of platelet microparticles in cord blood of preterm infants with and without chorioamnionitis. We plan to utilize quantitative flow cytometry for gathering representative data and correlate the results with the clinical outcome of the enrolled preterm birth infants. The goal of our project is to develop new diagnostic method of FIRS which would allow better prediction of clinical complications and individualization of the clinical care for preterm born infants.

Chorioamnionitida je jednou z nejčastějších příčin předčasného porodu, která velmi často vede k rozvoji syndromu systémové zánětlivé odpovědi plodu (fetal inflammatory response syndrome - FIRS). FIRS je vysoce rizikovým faktorem perinatální mortality a dlouhodobé neonatální morbidity (myokardiální dysfunkce, bronchopulmonální dysplázie a poškození mozku). FIRS je definován zvýšenou systémovou koncentrací cytokinů plodu. Nedávno publikované práce prokazují, že krevní destičky a destičkové mikropartikule mají důležitou úlohu při zánětové odpovědi organismu. Náš projekt je zaměřen na zjištění stavu destiček a přítomnosti destičkových mikropartikulí v pupečníkové krvi u nedonošených dětí ve vztahu k chorioamnionitidě pomocí kvantitativní průtokové cytometrie. Výsledky dostatečně reprezentativního vzorku u nezralých novorozenců budou analyzovány ve vztahu k závažným klinickým komplikacím. Cílem našeho projektu je vývoj nové diagnostické metody FIRS, která by umožňovala lepší predikci závažných klinických komplikací a vedla k individualizaci péče u předčasně narozených dětí.

• MeSH
• chorioamnionitida diagnóza   etiologie   MeSH
• fetální krev MeSH
• infekční komplikace v těhotenství MeSH
• lidé MeSH
• mikropartikule patologie   MeSH
• morbidita MeSH
• novorozenec nedonošený MeSH
• plod cytologie   patologie   MeSH
• předčasný porod MeSH
• průtoková cytometrie MeSH
• syndrom systémové zánětlivé reakce diagnóza   etiologie   MeSH
• vyšetření funkce trombocytů MeSH
• Check Tag
• lidé MeSH

• Konspekt
• Pediatrie
• NLK Obory
• perinatologie a neonatologie
• infekční lékařství
• cytologie, klinická cytologie
• NLK Publikační typ
• závěrečné zprávy o řešení grantu AZV MZ ČR

Introduction: We aimed to compare the amniotic fluid interleukin (IL)-6 concentrations measured using the automated electrochemiluminescence immunoassay method and ELISA, and to establish an IL-6 concentration cut-off value for intra-amniotic inflammation (IAI) in preterm prelabor rupture of membranes (PPROM), which can be used in the automated electrochemiluminescence immunoassay method.Materials and methods: A total of 120 women with PPROM were included in this study. Amniotic fluid samples were obtained through transabdominal amniocentesis. IL-6 concentrations were assessed using both the automated electrochemiluminescence immunoassay method and ELISA, the current gold standard. IAI was defined as an amniotic fluid IL-6 concentration of ≥2600 pg/mL measured using ELISA.Results: A correlation between both assays was found (Spearman's rho = 0.97; p < .0001). Based on the receiver-operating characteristic curve for the identification of IAI (area under the curve = 0.99), a cut-off value of ≥3000 pg/mL was selected for the automated electrochemiluminescence immunoassay method with a sensitivity of 88%, specificity of 99%, positive predictive value of 97%, negative predictive value of 96%, and likelihood ratio of 76.Conclusions: For amniotic fluid IL-6 concentrations assessed using the automated electrochemiluminescence immunoassay method, a cut-off value of 3000 pg/mL was indicated for diagnosing IAI in women with PPROM.

• MeSH
• biologické markery metabolismus   MeSH
• chorioamnionitida diagnóza   etiologie   metabolismus   MeSH
• dospělí MeSH
• elektrochemické techniky metody   MeSH
• ELISA MeSH
• imunoanalýza metody   MeSH
• interleukin-6 metabolismus   MeSH
• lidé MeSH
• plodová voda metabolismus   MeSH
• předčasný odtok plodové vody patofyziologie   MeSH
• retrospektivní studie MeSH
• senzitivita a specificita MeSH
• těhotenství MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• těhotenství MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• srovnávací studie MeSH

BACKGROUND: Preterm prelabor rupture of the membranes (PPROM) is frequently complicated by intraamniotic inflammatory processes such as intraamniotic infection and sterile intraamniotic inflammation. Antibiotic therapy is recommended to patients with PPROM to prolong the interval between this complication and delivery (latency period), reduce the risk of clinical chorioamnionitis, and improve neonatal outcome. However, there is a lack of information regarding whether the administration of antibiotics can reduce the intensity of the intraamniotic inflammatory response or eradicate microorganisms in patients with PPROM. OBJECTIVE: The first aim of the study was to determine whether antimicrobial agents can reduce the magnitude of the intraamniotic inflammatory response in patients with PPROM by assessing the concentrations of interleukin-6 in amniotic fluid before and after antibiotic treatment. The second aim was to determine whether treatment with intravenous clarithromycin changes the microbial load of Ureaplasma spp DNA in amniotic fluid. STUDY DESIGN: A retrospective cohort study included patients who had (1) a singleton gestation, (2) PPROM between 24+0 and 33+6 weeks, (3) a transabdominal amniocentesis at the time of admission, and (4) intravenous antibiotic treatment (clarithromycin for patients with intraamniotic inflammation and benzylpenicillin/clindamycin in the cases of allergy in patients without intraamniotic inflammation) for 7 days. Follow-up amniocenteses (7th day after admission) were performed in the subset of patients with a latency period lasting longer than 7 days. Concentrations of interleukin-6 were measured in the samples of amniotic fluid with a bedside test, and the presence of microbial invasion of the amniotic cavity was assessed with culture and molecular microbiological methods. Intraamniotic inflammation was defined as a bedside interleukin-6 concentration ≥745 pg/mL in the samples of amniotic fluid. Intraamniotic infection was defined as the presence of both microbial invasion of the amniotic cavity and intraamniotic inflammation; sterile intraamniotic inflammation was defined as the presence of intraamniotic inflammation without microbial invasion of the amniotic cavity. RESULTS: A total of 270 patients with PPROM were included in this study: 207 patients delivered within 7 days and 63 patients delivered after 7 days of admission. Of the 63 patients who delivered after 7 days following the initial amniocentesis, 40 underwent a follow-up amniocentesis. Patients with intraamniotic infection (n = 7) and sterile intraamniotic inflammation (n = 7) were treated with intravenous clarithromycin. Patients without either microbial invasion of the amniotic cavity or intraamniotic inflammation (n = 26) were treated with benzylpenicillin or clindamycin. Treatment with clarithromycin decreased the interleukin-6 concentration in amniotic fluid at the follow-up amniocentesis compared to the initial amniocentesis in patients with intraamniotic infection (follow-up: median, 295 pg/mL, interquartile range [IQR], 72-673 vs initial: median, 2973 pg/mL, IQR, 1750-6296; P = .02) and in those with sterile intraamniotic inflammation (follow-up: median, 221 pg/mL, IQR 118-366 pg/mL vs initial: median, 1446 pg/mL, IQR, 1300-2941; P = .02). Samples of amniotic fluid with Ureaplasma spp DNA had a lower microbial load at the time of follow-up amniocentesis compared to the initial amniocentesis (follow-up: median, 1.8 × 104 copies DNA/mL, 2.9 × 104 to 6.7 × 108 vs initial: median, 4.7 × 107 copies DNA/mL, interquartile range, 2.9 × 103 to 3.6 × 107; P = .03). CONCLUSION: Intravenous therapy with clarithromycin was associated with a reduction in the intensity of the intraamniotic inflammatory response in patients with PPROM with either intraamniotic infection or sterile intraamniotic inflammation. Moreover, treatment with clarithromycin was related to a reduction in the load of Ureaplasma spp DNA in the amniotic fluid of patients with PPROM <34 weeks of gestation.

• MeSH
• antibakteriální látky terapeutické užití   MeSH
• bakteriální infekce etiologie   prevence a kontrola   MeSH
• chorioamnionitida etiologie   prevence a kontrola   MeSH
• DNA bakterií analýza   MeSH
• dospělí MeSH
• interleukin-6 analýza   MeSH
• klarithromycin terapeutické užití   MeSH
• klindamycin terapeutické užití   MeSH
• kohortové studie MeSH
• lidé MeSH
• penicilin G terapeutické užití   MeSH
• plodová voda chemie   MeSH
• předčasný odtok plodové vody * MeSH
• retrospektivní studie MeSH
• těhotenství MeSH
• Ureaplasma genetika   MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• těhotenství MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Research Support, N.I.H., Extramural MeSH

• MeSH
• chorioamnionitida etiologie   MeSH
• diferenciální diagnóza MeSH
• dospělí MeSH
• genetická predispozice k nemoci MeSH
• habituální potrat * etiologie   MeSH
• lektin vázající mannosu * fyziologie   genetika   nedostatek   MeSH
• lektinová dráha komplementu fyziologie   MeSH
• lidé MeSH
• samovolný potrat etiologie   MeSH
• těhotenství MeSH
• výsledek těhotenství MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• těhotenství MeSH
• ženské pohlaví MeSH
• Publikační typ
• kazuistiky MeSH

OBJECTIVES: To determine the pulsatility index (PI) in the fetal splenic vein, the main portal vein, the left portal vein, and the ductus venosus with respect to the presence or absence of intra-amniotic inflammation (IAI) in preterm prelabor rupture of membranes (PPROM). METHOD: Women with singleton pregnancies and PPROM, ranging in gestational age from 22+0 to 36+6 weeks, were included. Amniotic fluid samples were obtained by transabdominal amniocentesis and the amniotic fluid level of interleukin-6 (IL-6) was assessed by a point-of-care test. Doppler examination of the selected veins was performed, and the PI was assessed. IAI was defined as amniotic fluid levels of IL-6 ≥745 pg/mL. RESULTS: In total, 42 women were included. Fetuses with IAI compared with those without IAI exhibited a higher PI in the splenic vein (p = 0.005) and the main portal vein (p = 0.05). No differences were observed in the left portal vein PI (p = 0.36) and the ductus venosus PI (p = 0.98). CONCLUSION: IAI was associated with increased fetal splenic vein PI and main portal vein PI in PPROM. The absence of changes in the left portal vein PI and ductus venosus PI supports the local cause of the finding.

• MeSH
• chorioamnionitida diagnostické zobrazování   etiologie   metabolismus   patofyziologie   MeSH
• dospělí MeSH
• gestační stáří MeSH
• interleukin-6 analýza   MeSH
• jaterní oběh * MeSH
• lidé MeSH
• plodová voda chemie   MeSH
• předčasná porodní činnost diagnostické zobrazování   etiologie   metabolismus   patofyziologie   MeSH
• prospektivní studie MeSH
• pulzatilní průtok * MeSH
• rychlost toku krve MeSH
• těhotenství MeSH
• ultrasonografie dopplerovská barevná MeSH
• ultrasonografie prenatální metody   MeSH
• vena lienalis diagnostické zobrazování   patofyziologie   MeSH
• vena portae diagnostické zobrazování   patofyziologie   MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• těhotenství MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH