"NT14104" Dotaz Zobrazit nápovědu
Závěrečná zpráva o řešení grantu Interní grantové agentury MZ ČR
1 svazek : ilustrace ; 30 cm
Women with preterm prelabor rupture of membranes between gestational age 24 and 36 weeks will be included into the multicentre study. The intensity of inflammatory response (based on levels of cytokines and alarmins) and microbial load of Ureaplasma spp. will be determined in the cervical fluid. The placenta will be assessed for the signs of histological chorioamnionitis and funisitis after delivery. The inflammatory response in the cervical fluid will be characterized with respect to the presence of histological chorioamnionitis and funisitis with an ultimate goal to create a prediction model for these inflammatory complications. The relationship between microbial load of Ureaplasma spp. in cervical fluid and inflammatory response will be evaluated as well. Last goal will be to analyse the potential of microbial load of Ureaplasma spp. for the prediction of histological chorioamnionitis and funisitis.
Do multicentrického projektu budou zařazeny pacientky s předčasným odtokem plodové vody mezi 24. a 36. týdnem gravidity. U pacientek bude stanovena intenzita zánětové odpovědi (hladiny cytokinů a alarminů) a bakteriální nálož Ureaplasma spp. v cervikální tekutině. Po porodu bude vyšetřena placenta na přítomnost histologické chorioamnionitidy a funisitidy. Poté bude charakterizována zánětová odpověď v cervikální tekutině s ohledem na přítomnost histologické chorioamnionitidy a funisitidy a cílem vytvořit neinvazivní predikční model pro histologickou chorioamnionitidu a funisitidu na podkladě hladin specifických proteinů v cervikální tekutině. Dále bude zhodnocen vztah mezi mikrobiální náloží Ureaplasma spp. v cervikální tekutině a zánětovou odpovědí. Posledním cílem bude charakterizovat predikční potenciál mikrobiální nálože Ureaplasma spp. v cervikální tekutině pro histologickou chorioamnionitidu a funisitidu.
- MeSH
- amnion mikrobiologie MeSH
- bakteriální nálož MeSH
- cervikální hlen cytologie MeSH
- chlamydiové infekce MeSH
- chorioamnionitida diagnóza mikrobiologie MeSH
- infekční komplikace v těhotenství MeSH
- interleukin-6 analýza MeSH
- interleukin-8 analýza MeSH
- multicentrické studie jako téma MeSH
- mykoplazmové infekce MeSH
- předčasný odtok plodové vody MeSH
- předčasný porod MeSH
- pupečník patologie MeSH
- třetí trimestr těhotenství MeSH
- ureaplasmatické infekce MeSH
- zánět MeSH
- ženy MeSH
- Konspekt
- Gynekologie. Porodnictví
- NLK Obory
- gynekologie a porodnictví
- histologie
- NLK Publikační typ
- závěrečné zprávy o řešení grantu IGA MZ ČR
OBJECTIVE: To evaluate Ureaplasma species and Mycoplasma hominis DNA in the cervical fluid and their association with microbial invasion of the amniotic cavity (MIAC) and/or histological chorioamnionitis (HCA) in pregnancies complicated by preterm prelabor rupture of membranes (PPROM). STUDY DESIGN: A prospective study of 68 women with singleton pregnancies complicated by PPROM between 24(0/7) and 36(6/7) weeks was conducted. Cervical fluid and amniotic fluid were collected from all women at the time of admission. The Ureaplasma species and Mycoplasma hominis DNA in the cervical fluid were identified using specific real-time PCR. RESULTS: Ureaplasma species and Mycoplasma hominis DNA were identified in 59% (40/69) of the cervical fluid samples. Women with the presence of Ureaplasma species DNA with and without Mycoplasma hominis DNA in the cervical fluid had a higher rate of MIAC alone [35% (14/40) versus 11% (3/28); p = 0.02] and a higher rate of the presence of both MIAC and HCA [30% (12/40) versus 4% (1/28); p = 0.01] than women without Ureaplasma species and Mycoplasma hominis DNA in the cervical fluid. CONCLUSIONS: The presence of Ureaplasma species DNA with and without Mycoplasma hominis DNA in the cervical fluid is associated with a higher risk of MIAC or MIAC and HCA together in pregnancies complicated by PPROM.
- MeSH
- chorioamnionitida mikrobiologie MeSH
- dospělí MeSH
- lidé MeSH
- mladý dospělý MeSH
- Mycoplasma hominis izolace a purifikace MeSH
- plodová voda mikrobiologie MeSH
- předčasný odtok plodové vody mikrobiologie MeSH
- těhotenství MeSH
- Ureaplasma izolace a purifikace MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- mladý dospělý MeSH
- těhotenství MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
OBJECTIVE: To determine the cervical and vaginal fluid soluble Toll-like receptor-2 (sTLR2) levels in pregnancies complicated by preterm prelabor rupture of membranes (PPROM) and their correlation to microbial invasion of the amniotic cavity (MIAC) and/or histological chorioamnionitis (HCA). METHODS: Sixty-eight women with singleton pregnancies complicated by PPROM were included in this study. Cervical and vaginal fluid was collected at the time of admission, and levels of sTLR2 in the cervical and vaginal fluid were determined using enzyme-linked immunosorbent assay. RESULT: Women with MIAC and both MIAC and HCA did not have different cervical and vaginal fluid sTLR2 levels compared to those without MIAC and without both MIAC and HCA. Women with HCA had higher cervical fluid sTLR2 levels in crude analysis (with HCA: median 11.6 pg/mL versus without HCA: median 5.5 pg/mL; p = 0.04) but not after adjustment for gestational age at sampling (p = 0.19). No difference in vaginal fluid sTLR2 levels between women with and without HCA was found. A positive correlation between cervical and vaginal fluid sTLR2 levels was identified (rho = 0.54; p < 0.0001). CONCLUSIONS: Cervical and vaginal fluid sTLR2 levels did not reflect the presence of MIAC and/or HCA.
- MeSH
- cervix uteri metabolismus MeSH
- chorioamnionitida metabolismus MeSH
- dospělí MeSH
- ELISA MeSH
- lidé MeSH
- novorozenec MeSH
- plodová voda mikrobiologie MeSH
- předčasný odtok plodové vody metabolismus patologie MeSH
- těhotenství MeSH
- tělesné tekutiny metabolismus MeSH
- toll-like receptor 2 metabolismus MeSH
- vagina metabolismus MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- novorozenec MeSH
- těhotenství MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
OBJECTIVE: To determine the vaginal fluid interleukin (IL)-6 and IL-8 concentrations in pregnancies complicated by preterm prelabor rupture of membranes and their correlation to microbial invasion of the amniotic cavity (MIAC) as well as histological chorioamnionitis (HCA). METHODS: Sixty-eight women with singleton pregnancies were included in this study. Vaginal fluid was collected at the time of admission. IL-6 and IL-8 concentrations in the vaginal fluid were determined using ELISA. RESULT: Women with MIAC had higher vaginal fluid IL-6 levels compared to those without MIAC (with MIAC: median 374 pg/mL versus without MIAC: median 174 pg/mL; p = 0.03). IL-8 levels were higher in women with MIAC only in the crude analysis but not after adjustment for gestational age. There was no difference in the IL-6 and IL-8 concentrations between those with and without HCA. Women with both MIAC and HCA had higher IL-6 vaginal fluid levels than those without both MIAC and HCA (with MIAC and HCA: median 466 pg/mL versus without MIAC and HCA: median 178 pg/mL; p = 0.02). IL-8 levels were higher in women with MIAC and HCA only in the crude analysis but not after adjustment for gestational age. CONCLUSIONS: Vaginal fluid IL-6 but not IL-8 levels reflect the presence of MIAC and both MIAC and HCA.
- MeSH
- chorioamnionitida metabolismus patologie MeSH
- dospělí MeSH
- infekční komplikace v těhotenství metabolismus patologie MeSH
- interleukin-6 analýza metabolismus MeSH
- interleukin-8 analýza metabolismus MeSH
- kohortové studie MeSH
- lidé MeSH
- mladý dospělý MeSH
- novorozenec MeSH
- předčasný odtok plodové vody metabolismus patologie MeSH
- těhotenství MeSH
- tělesné tekutiny chemie metabolismus MeSH
- vagina MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- mladý dospělý MeSH
- novorozenec MeSH
- těhotenství MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
UNLABELLED: Abstract Objective: To determine the cervical fluid interleukin (IL)-6 and IL-8 levels in pregnancies complicated by preterm prelabor rupture of membranes (PPROM) and the association of these interleukins with microbial invasion of the amniotic cavity (MIAC) and histological chorioamnionitis (HCA). METHODS: Sixty women with singleton pregnancies were included in this study. Cervical fluid was sampled at the time of admission using Dacron polyester swabs, which were placed into the endocervical canal for 20 s. IL-6 and IL-8 levels were determined by ELISA. The management of PPROM was active management (except for in pregnancies <28 weeks of gestation) and occurs not later than 72 h after the rupture of membranes. RESULT: The women with MIAC had higher IL-6 and IL-8 levels than did the women without MIAC (IL-6: p=0.01; IL-8: p=0.003). There was no difference in IL-6 levels between women with and without HCA (p=0.37). The women with HCA had higher IL-8 levels only in the crude analysis (p=0.01) but not after adjustment for gestational age (p=0.06). The women with both MIAC and HCA had higher levels of IL-6 and IL-8 than did the other women (IL-6: p=0.003; IL-8: p=0.001). IL-8 level of 2653 pg/mL was found to be the best cut-off point in the identification of PPROM pregnancies complicated by both MIAC and HCA with a likelihood ratio of 24. CONCLUSIONS: The presence of MIAC is the most important factor impacting the local cervical inflammatory response, which is determined by IL-6 and IL-8 levels in the cervical fluid. IL-8 levels seem to be a promising non-invasive marker for the prediction of pregnancies complicated by the presence of both MIAC and HCA.
- MeSH
- amnion metabolismus mikrobiologie patologie MeSH
- cervix uteri chemie metabolismus MeSH
- chorioamnionitida diagnóza metabolismus mikrobiologie patologie MeSH
- dospělí MeSH
- infekční komplikace v těhotenství diagnóza metabolismus MeSH
- interleukin-6 analýza metabolismus MeSH
- interleukin-8 analýza metabolismus MeSH
- lidé MeSH
- mladý dospělý MeSH
- plodová voda chemie metabolismus MeSH
- předčasný odtok plodové vody metabolismus MeSH
- těhotenství MeSH
- tělesné tekutiny chemie metabolismus MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- mladý dospělý MeSH
- těhotenství MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem 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.
- MeSH
- chorioamnionitida krev epidemiologie patofyziologie MeSH
- dospělí MeSH
- fetální krev chemie metabolismus MeSH
- interleukin-6 analýza krev MeSH
- lidé MeSH
- mladý dospělý MeSH
- nemoci novorozenců diagnóza epidemiologie etiologie MeSH
- novorozenec MeSH
- plod krevní zásobení imunologie MeSH
- předčasný odtok plodové vody * krev diagnóza epidemiologie patofyziologie MeSH
- prognóza MeSH
- regionální krevní průtok * MeSH
- retrospektivní studie MeSH
- těhotenství MeSH
- vena lienalis fyziologie MeSH
- výsledek těhotenství epidemiologie MeSH
- zánět krev epidemiologie patofyziologie MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- mladý dospělý MeSH
- novorozenec MeSH
- těhotenství MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
OBJECTIVE: To 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). METHODS: Women 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. RESULTS: In 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). CONCLUSION: The presence of oligohydramnios is not associated with an adverse outcome in actively managed PPROM in singleton pregnancies in the absence of other complications.
- MeSH
- chorioamnionitida patofyziologie MeSH
- dospělí MeSH
- fetální krev metabolismus MeSH
- gestační stáří MeSH
- interleukin-6 metabolismus MeSH
- kojenec MeSH
- lidé MeSH
- nemoci nedonošenců diagnóza patofyziologie MeSH
- novorozenec nedonošený MeSH
- novorozenec MeSH
- oligohydramnion patofyziologie MeSH
- plodová voda metabolismus MeSH
- předčasná porodní činnost MeSH
- předčasný odtok plodové vody patofyziologie MeSH
- předčasný porod MeSH
- prospektivní studie MeSH
- těhotenství MeSH
- ultrasonografie prenatální MeSH
- výsledek těhotenství * MeSH
- Check Tag
- dospělí MeSH
- kojenec MeSH
- lidé MeSH
- novorozenec MeSH
- těhotenství MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
OBJECTIVE: To evaluate Ureaplasma species and M. hominis DNA in the umbilical cord blood and its correlation with its microbial load in the amniotic fluid, as a measure of microbial burden in fetal inflammatory response and neonatal outcome in pregnancies complicated by preterm prelabor rupture of membranes (pPROM). STUDY DESIGN: A retrospective study of 158 women with singleton pregnancies complicated by pPROM between 24(0/7) and 36(6/7) weeks was conducted. Amniotic fluid was obtained from all women by transabdominal amniocentesis, and umbilical cord blood was obtained by venipuncture from umbilical cords immediately after the delivery of the neonates. The Ureaplasma species and M. hominis DNA was quantitated using absolute quantification techniques. RESULT: Ureaplasma species and M. hominis DNA was identified in 9% of the umbilical cord blood samples. No correlation between the amniotic fluid and umbilical cord blood microbial load was observed. The presence of Ureaplasma species and M. hominis DNA in the umbilical cord blood had no impact on short-term neonatal morbidity. CONCLUSIONS: A high microbial load of genital mycoplasma Ureaplasma species DNA in the umbilical cord in pregnancies complicated by pPROM is not associated with a high fetal inflammatory response and is therefore not associated with serious neonatal morbidity.
- MeSH
- biologické markery krev MeSH
- dospělí MeSH
- fetální krev mikrobiologie MeSH
- interleukin-6 krev MeSH
- lidé MeSH
- mladý dospělý MeSH
- Mycoplasma hominis izolace a purifikace MeSH
- plodová voda mikrobiologie MeSH
- předčasný odtok plodové vody mikrobiologie MeSH
- retrospektivní studie MeSH
- těhotenství MeSH
- Ureaplasma izolace a purifikace MeSH
- zánět krev MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- mladý dospělý MeSH
- těhotenství MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
OBJECTIVE: To determine the possible association between azurocidin in maternal serum in the first trimester of pregnancy and subsequent spontaneous preterm labor, preterm prelabor rupture of membranes, and iatrogenic preterm delivery. METHODS: Women who underwent first trimester screening for chromosomal abnormalities between January and November 2011 were included in the study, and a sample of maternal serum was obtained. In total, 1905 women were followed-up through the local record system, and 13 women with spontaneous preterm labor, 17 women with preterm prelabor rupture of membranes (PPROM), and 16 women with iatrogenic preterm delivery were identified. Twenty-two women with uncomplicated pregnancies who delivered at term were selected as controls. Maternal serum azurocidin levels in women were determined using ELISA. RESULT: Women with PPROM had lower azurocidin levels (median 0.91 ng/mL, range 0.2-2.07) than women who delivered at term (median 1.63 ng/mL, range 0.4-10.98; p = 0.02). No differences in azurocidin levels between women with labor at term and those with either spontaneous preterm labor (median 1.46 ng/mL, range 0.19-2.59; p = 0.42) or iatrogenic preterm delivery (median 1.60 ng/mL, range 0.66-7.96; p = 0.27) were found. CONCLUSIONS: Low levels of azurocidin in maternal serum in the first trimester were associated with subsequent PPROM.
- MeSH
- biologické markery krev MeSH
- dospělí MeSH
- kationické antimikrobiální peptidy krev MeSH
- kohortové studie MeSH
- krevní proteiny MeSH
- lidé MeSH
- matky MeSH
- mladý dospělý MeSH
- předčasná porodní činnost krev diagnóza MeSH
- předčasný odtok plodové vody krev diagnóza MeSH
- prognóza MeSH
- průřezové studie MeSH
- první trimestr těhotenství krev MeSH
- studie případů a kontrol MeSH
- těhotenství MeSH
- transportní proteiny krev MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- mladý dospělý MeSH
- těhotenství MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
BACKGROUND: The role of viral infections in preterm prelabor rupture of the membranes (PPROM) is not established. Studies on the presence of viral genomes in the amniotic fluid (AF) collected in pregnancies complicated by PPROM show contradictory outcomes. OBJECTIVES: To investigate AF samples of PPROM pregnancies for the presence of viral genomes. STUDY DESIGN: AF samples from patients with PPROM were collected during a 4-year (2008-2012) observational study. 174 women were included with selection criteria of singleton pregnancy, PPROM, and maternal age of 18 years and above. PCR was used for detection of human cytomegalovirus (HCMV), herpes simplex virus (HSV), parvovirus B19, human adenoviruses (HAdV), enteroviruses (EV) and human parechovirus (HPeV). The selection of these viral targets was based on literature regarding screening of AF for presence of viral genomes. RESULTS: Only a single sample was positive out of the 174 tested AFs, HCMV DNA was detected. CONCLUSIONS: PPROM is not associated with active viral infections.
