OBJECTIVE: The aim of this study was to evaluate changes in the relative counts of different leukocyte subsets in peripheral and umbilical cord blood in pregnancies complicated by preterm prelabor rupture of membranes (PPROM) with respect to the presence of intraamniotic inflammation (IAI) and fetal inflammatory response syndrome (FIRS). METHODS: Fifty-two women with singleton pregnancies complicated by PPROM were included in this study. From samples of peripheral and umbilical cord blood, relative counts of these leukocyte subpopulations were determined using multicolor flow cytometry: granulocytes, monocytes, lymphocytes, T cells and their subpopulations, B cells and their subpopulations, and NK cells and their subpopulations. IAI was defined as increased concentrations of interleukin 6 in the amniotic fluid. Amniotic fluid samples were obtained by transabdominal amniocentesis. RESULTS: Women with IAI had higher relative counts of monocytes (p = 0.04) in peripheral blood. There was an increased relative number of granulocytes (p = 0.003) and a decreased number of lymphocytes (p = 0.0048), helper CD4+ T cells (p = 0.019), NK cells (p = 0.0001) within leukocytes, NK cells within lymphocytes (p = 0.003) and CD16+ NK cells within NK cells (p = 0.005) in umbilical cord blood samples of women with FIRS. However, after adjusting the results for gestational age at sampling, all differences disappeared. CONCLUSIONS: The presence of IAI or FIRS is not accompanied by significant changes in the relative counts of immune cells in peripheral blood or umbilical cord blood in pregnancies complicated by PPROM.

• MeSH
• chorioamnionitida imunologie   krev   MeSH
• dospělí MeSH
• fetální krev * imunologie   cytologie   MeSH
• interleukin-6 krev   metabolismus   MeSH
• leukocyty imunologie   MeSH
• lidé MeSH
• plodová voda imunologie   metabolismus   MeSH
• počet leukocytů MeSH
• předčasný odtok plodové vody * imunologie   krev   MeSH
• průtoková cytometrie MeSH
• syndrom systémové zánětlivé reakce imunologie   krev   MeSH
• těhotenství MeSH
• zánět imunologie   MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• těhotenství MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

BACKGROUND: This study aimed to assess variations in the absolute counts of various leukocyte subsets in the peripheral blood of women with pregnancies affected by preterm prelabour rupture of membranes (PPROM), in relation to the presence of intra-amniotic inflammation (IAI). METHODS: The study included fifty-two women with singleton pregnancies experiencing PPROM. Absolute counts of different leukocyte subpopulations, such as granulocytes, monocytes, lymphocytes, T cells and their subsets, B cells and their subsets, and NK cells and their subsets, were measured in maternal peripheral blood samples using multicolour flow cytometry. IAI was identified by elevated concentrations of interleukin 6 (IL-6) in the amniotic fluid, which was collected through transabdominal amniocentesis. RESULTS: Women with IAI exhibited higher absolute counts of leukocytes (p = 0.003), granulocytes (p = 0.008), and monocytes (p = 0.009). However, the presence of IAI did not significantly affect the absolute counts of lymphocytes or their subpopulations. CONCLUSIONS: The study found that IAI is associated with changes in the absolute counts of leukocytes from the innate immunity compartment in the peripheral blood of women with pregnancies complicated by PPROM. Conversely, it does not significantly alter the counts of cells from the adaptive immune system. The changes observed may reflect the natural, temporal, and localised characteristics of IAI.

• MeSH
• amniocentéza MeSH
• chorioamnionitida * krev   MeSH
• dospělí MeSH
• interleukin-6 krev   analýza   MeSH
• leukocyty MeSH
• lidé MeSH
• plodová voda cytologie   MeSH
• počet leukocytů MeSH
• předčasný odtok plodové vody * krev   MeSH
• přirozená imunita MeSH
• průtoková cytometrie MeSH
• těhotenství MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• těhotenství MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

INTRODUCTION: The aim of the study was to identify predictive values of the soluble fms-like tyrosine kinase/placental growth factor (sFlt-1/PlGF) ratio and interleukin (IL)-6, assessed with a clinically available method in a large-volume biochemistry laboratory, in maternal blood, amniotic fluid, and umbilical cord blood for the presence of the placental lesions consistent with maternal vascular malperfusion (MVM) and acute histological chorioamnionitis (HCA), respectively. METHODS: This retrospective study included 92 women with preterm labor with intact membranes (PTL) delivered within 7 days of admission with gestational ages between 22+0 and 34+6 weeks. The sFlt-1/PlGF ratio and IL-6 were assessed in stored samples of maternal serum, amniotic fluid, and umbilical cord serum using Elecsys® sFlt-1, PlGF, and IL-6 immunoassays. RESULTS: Women with MVM had a higher sFlt-1/PlGF ratio in the maternal serum, compared to those without MVM (19.9 vs. 4.6; p < 0.0001), but not in the amniotic fluid or umbilical cord blood. A cut-off value of 8 for the sFlt-1/PlGF ratio in maternal serum was identified as optimal for predicting MVM in patients with PTL. Women with HCA had higher concentrations of IL-6 in maternal serum, compared to those without HCA (11.1 pg/mL vs. 8.4 pg/mL; p = 0.03), amniotic fluid (9,216 pg/mL vs. 1,423 pg/mL; p < 0.0001), and umbilical cord blood (20.7 pg/mL vs. 10.7 pg/mL, p = 0.002). Amniotic-fluid IL-6 showed the highest predictive value. A cut-off value of IL-6 concentration in the amniotic fluid of 5,000 pg/mL was found to be optimal for predicting HCA in PTL. CONCLUSION: Maternal serum sFlt-1/PlGF and amniotic fluid IL-6 concentrations can be used for liquid biopsy to predict placental lesions in women with PTL who deliver within 7 days.

• MeSH
• biologické markery krev   MeSH
• chorioamnionitida krev   diagnóza   MeSH
• dospělí MeSH
• fetální krev metabolismus   MeSH
• interleukin-6 * krev   MeSH
• lidé MeSH
• placenta metabolismus   MeSH
• placentární růstový faktor * krev   MeSH
• plodová voda metabolismus   MeSH
• předčasná porodní činnost * krev   MeSH
• prediktivní hodnota testů * MeSH
• receptor 1 pro vaskulární endoteliální růstový faktor * krev   MeSH
• retrospektivní studie MeSH
• těhotenství MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• těhotenství MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

INTRODUCTION: This study aimed to identify whether microbial invasion of the amniotic cavity and/or intra-amniotic inflammation in women with late preterm prelabor rupture of membranes (PPROM) was associated with changes in concentrations of soluble fms-like tyrosine kinase-1 (sFlt-1), placental growth factor (PlGF) and its ratio in maternal serum, and whether placental features consistent with maternal vascular malperfusion further affect their concentrations. MATERIAL AND METHODS: This historical study included 154 women with singleton pregnancies complicated by PPROM between gestational ages 34+0 and 36+6 weeks. Transabdominal amniocentesis was performed as part of standard clinical management to evaluate the intra-amniotic environment. Women were categorized into two subgroups based on the presence of microorganisms and/or their nucleic acids in amniotic fluid (determined by culturing and molecular biology method) and intra-amniotic inflammation (by amniotic fluid interleukin-6 concentration evaluation): (1) those with the presence of microorganisms and/or inflammation (at least one present) and (2) those with negative amniotic fluid for infection/inflammation (absence of both). Concentrations of sFlt-1 and PlGF were assessed using the Elecsys® sFlt-1 and Elecsys® PlGF immunoassays and converted into multiples of medians. RESULTS: Women with the presence of microorganisms and/or inflammation in amniotic fluid had lower serum concentrations of sFlt-1 and sFlt-1/PlGF ratios and higher concentrations of PlGF compared with those with negative amniotic fluid. (sFlt-1: presence: median 1.0 multiples of the median (MoM), vs negative: median: 1.5 MoM, P = 0.003; PlGF: presence: median 0.7 MoM, vs negative: median 0.4 MoM, P = 0.02; sFlt-1/PlGF: presence: median 8.9 vs negative 25.0, P = 0.001). Higher serum concentrations of sFlt-1 and sFlt-1/PlGF ratios as well as lower concentrations of PlGF were found in the subsets of women with maternal vascular malperfusion than in those without maternal vascular malperfusion. CONCLUSIONS: Among women experiencing late PPROM, angiogenic imbalance in maternal serum is primarily observed in those without both microbial invasion of the amniotic cavity and intra-amniotic inflammation. Additionally, there is an association between angiogenic imbalance and the presence of maternal vascular malperfusion.

• MeSH
• amniocentéza MeSH
• biologické markery krev   MeSH
• chorioamnionitida krev   MeSH
• dospělí MeSH
• gestační stáří MeSH
• lidé MeSH
• placentární růstový faktor * krev   MeSH
• plodová voda * mikrobiologie   metabolismus   MeSH
• předčasný odtok plodové vody * krev   MeSH
• receptor 1 pro vaskulární endoteliální růstový faktor * krev   MeSH
• těhotenství MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• těhotenství MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

• MeSH
• chorioamnionitida diagnostické zobrazování   imunologie   krev   patofyziologie   MeSH
• interleukin-6 krev   MeSH
• ledviny diagnostické zobrazování   MeSH
• lidé MeSH
• nadledviny diagnostické zobrazování   MeSH
• nemoci nedonošenců epidemiologie   klasifikace   MeSH
• novorozenec MeSH
• periventrikulární leukomalacie epidemiologie   patofyziologie   patologie   MeSH
• plíce diagnostické zobrazování   MeSH
• plod patofyziologie   patologie   MeSH
• slezina diagnostické zobrazování   MeSH
• srdce diagnostické zobrazování   MeSH
• syndrom systémové zánětlivé reakce * imunologie   krev   patofyziologie   terapie   MeSH
• těhotenství MeSH
• thymus diagnostické zobrazování   MeSH
• ultrasonografie prenatální MeSH
• Check Tag
• lidé MeSH
• novorozenec MeSH
• těhotenství MeSH
• ženské pohlaví MeSH
• Publikační typ
• práce podpořená grantem MeSH

OBJECTIVE: To evaluate maternal serum C-reactive protein (CRP) concentrations in pregnancies complicated by preterm prelabor rupture of membranes (PPROM) in relation to the presence of microbial invasion of the amniotic cavity (MIAC) and/or intra-amniotic inflammation (IAI). METHODS: Two hundred and eighty-seven women with singleton pregnancies complicated by PPROM between 2014 and 2016 were included in this study. Maternal blood and amniotic fluid samples were collected at the time of admission. Maternal serum CRP concentration was measured using a high-sensitivity immunoturbidimetric assay. Interleukin-6 (IL-6) concentration was measured using a point-of-care test. MIAC was diagnosed based on a positive polymerase chain reaction result for Ureaplasma species, Mycoplasma hominis, and/or Chlamydia trachomatis and for the 16S rRNA gene. IAI was characterized by an amniotic fluid IL-6 concentration of ≥ 745 pg/mL. RESULT: Women with MIAC and IAI had higher maternal serum CRP concentrations than did women without (with MIAC: median 6.9 mg/L vs. without MIAC: median 4.9 mg/L; p = 0.02; with IAI: median 8.6 mg/L vs. without IAI: median 4.7 mg/L; p < 0.0001). When women were split into four subgroups based on the presence of MIAC and/or IAI, women with the presence of both MIAC and IAI had higher maternal serum CRP than did women with IAI alone, with MIAC alone, and women without MIAC and IAI (both MIAC and IAI: median: 13.1 mg/L; IAI alone: 6.0 mg/L; MIAC alone: 3.9 mg/L; and without MIAC and IAI: median 4.8 mg/L; p < 0.0001). The maternal serum CRP cutoff value of 17.5 mg/L was the best level to identify the presence of both MIAC and IAI, with sensitivity of 47%, specificity of 96%, positive predictive value of 42%, negative predictive value of 96%, and the positive likelihood ratio of 10.9. CONCLUSION: The presence of both MIAC and IAI was associated with the highest maternal serum CRP concentrations. Maternal serum CRP concentration in women with PPROM at the time of admission can rule out the presence of the combined condition of both MIAC and IAI, therefore, it may serve as a non-invasive screening tool to distinguish between women with PPROM who are at high or at low risk for the presence of both MIAC and IAI.

• MeSH
• biologické markery MeSH
• C-reaktivní protein * MeSH
• chorioamnionitida krev   diagnóza   mikrobiologie   MeSH
• dospělí MeSH
• gestační stáří MeSH
• interleukin-6 metabolismus   MeSH
• komplikace těhotenství MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• plodová voda metabolismus   mikrobiologie   MeSH
• předčasný odtok plodové vody krev   diagnóza   etiologie   MeSH
• ROC křivka MeSH
• těhotenství MeSH
• vedení porodu metody   MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• těhotenství MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

OBJECTIVE: To evaluate umbilical cord blood interleukin (IL)-6 concentrations and the occurrence of fetal inflammatory response syndrome (FIRS) with respect to microbial invasion of the amniotic cavity (MIAC) and/or intraamniotic inflammation (IAI) in pregnancies complicated by preterm prelabor rupture of membranes (PPROM). METHODS: One-hundred-eighty-eight women with singleton pregnancies complicated by PPROM between gestational ages of 24 + 0 and 36 + 6 weeks were included in the study. Blood samples were obtained by venipuncture from the umbilical cord after the delivery of the newborn. The umbilical cord blood IL-6 concentrations were evaluated using ELISA kits. FIRS was defined as umbilical cord blood IL-6 > 11 pg/mL. RESULT: Women with MIAC and IAI had higher IL-6 concentrations than women without these complications (with MIAC: median 18.1 pg/mL versus without MIAC: median 5.8; p < 0.0001; with IAI: median 32.9 pg/mL, versus without IAI: median 5.8; p < 0.0001). Women with IAI with MIAC and women with IAI without MIAC had the highest umbilical cord blood IL-6 concentrations (medians: 32.6 and 39.4 pg/mL) and rates of FIRS (78% and 67%). CONCLUSIONS: IAI was associated with the highest umbilical cord blood IL-6 concentrations and rate of FIRS independent of the presence or absence of MIAC.

• MeSH
• chorioamnionitida krev   MeSH
• dospělí MeSH
• fetální krev chemie   MeSH
• gestační stáří MeSH
• infekční komplikace v těhotenství krev   MeSH
• interleukin-6 analýza   krev   MeSH
• lidé MeSH
• novorozenec MeSH
• plodová voda chemie   metabolismus   MeSH
• předčasný odtok plodové vody krev   MeSH
• retrospektivní studie MeSH
• těhotenství MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• novorozenec MeSH
• těhotenství MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

OBJECTIVE: To determine umbilical cord blood total antioxidant capacity (TAC), ferric reducing antioxidant power (FRAP), thiobarbituric acid-reacting substances (TBARS), advanced glycation end products (AGEs) and markers of oxidative stress in pregnancies complicated by preterm prelabor rupture of membranes (PPROM) and their associations with microbial invasion of the amniotic cavity (MIAC) and/or histological chorioamnionitis (HCA), funisitis and selected aspects of short-term neonatal morbidity. MATERIALS AND METHODS: One hundred and sixty-five women with singleton pregnancies complicated by PPROM were included in this study. Blood samples were obtained by venipuncture from the umbilical cord vein after the delivery of the newborn. The umbilical cord blood concentrations of TAC, FRAP, TBARS and AGEs were measured. RESULTS: The presence of MIAC, HCA and funisitis did not show differences in the umbilical cord blood TAC, FRAP, TBARS and AGEs concentrations. Positive correlations were found between the gestational age at sampling and umbilical cord blood TAC and AGEs concentrations (TAC: rho = 0.26; p = 0.001; AGEs: rho = 0.35; p < 0.0001). There was no association between umbilical cord blood TAC, FRAP, TBARS and AGEs concentrations and selected aspects of short-term neonatal morbidity. CONCLUSIONS: Oxidative stress is associated with PPROM, as indicated by the presence of markers tested in the umbilical cord blood; however, the evaluated oxidative stress markers are not influenced by the presence of MIAC and/or HCA, and funisitis or subsequent development of selected aspects of short-term neonatal morbidity.

• MeSH
• antioxidancia metabolismus   MeSH
• biologické markery krev   MeSH
• chorioamnionitida krev   MeSH
• dospělí MeSH
• fetální krev chemie   MeSH
• gestační stáří MeSH
• látky reagující s kyselinou thiobarbiturovou metabolismus   MeSH
• lidé MeSH
• mladý dospělý MeSH
• novorozenec MeSH
• oxidační stres * MeSH
• předčasný odtok plodové vody krev   MeSH
• produkty pokročilé glykace krev   MeSH
• prospektivní studie MeSH
• těhotenství 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: This study evaluated maternal C-reactive protein (CRP) as a predictor of microbial invasion of the amniotic cavity (MIAC) and histological chorioamnionitis (HCA) in women with preterm prelabor rupture of the membranes (PPROM) before and after 32 weeks of gestation. METHODS: This study was a prospective observational cohort study of 386 women. Maternal serum CRP concentrations were evaluated, and amniotic fluid samples were obtained via transabdominal amniocentesis at the time of admission. Placentas underwent histopathological examination after delivery. MIAC was defined based on a positive PCR for Ureaplasma species, Mycoplasma hominis and Chlamydia trachomatis and/or positive 16S rRNA gene amplification. HCA was defined based on the Salafia classification. RESULTS: Maternal CRP was significantly higher in women with MIAC and HCA (median 9.0 mg/l) than in women with HCA alone (median 6.9 mg/l), MIAC alone (median 7.4 mg/l) and without MIAC or HCA (median 4.5 mg/l) (p<0.0001). CRP was a weak predictor of the occurrence of MIAC and HCA before and after 32 weeks of gestation. Only the 95th percentile of CRP and PPROM before 32 weeks exhibited a false-positive rate of 1%, a positive predictive value of 90% and a positive likelihood ratio of 13.2 to predict MIAC and HCA. However, the low sensitivity of 15% limits the clinical utility of this detection. CONCLUSION: CRP is a poor predictor of the occurrence of MIAC and HCA, even at early gestational ages.

• MeSH
• bakteriální nálož MeSH
• biologické modely MeSH
• C-reaktivní protein metabolismus   MeSH
• chorioamnionitida krev   MeSH
• dospělí MeSH
• lidé MeSH
• novorozenec MeSH
• plodová voda mikrobiologie   MeSH
• porodní děj krev   MeSH
• předčasná porodní činnost krev   MeSH
• předčasný odtok plodové vody krev   MeSH
• těhotenství MeSH
• Ureaplasma fyziologie   MeSH
• věkové rozložení MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• novorozenec MeSH
• těhotenství MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• pozorovací studie 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