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Roberto Romero - One of the best experts on this subject based on the ideXlab platform.
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a point of care test for interleukin 6 in amniotic fluid in preterm prelabor Rupture of Membranes a step toward the early treatment of acute intra amniotic inflammation infection
Journal of Maternal-fetal & Neonatal Medicine, 2016Co-Authors: Piya Chaemsaithong, Roberto Romero, Bo Hyun Yoon, Tinnakorn Chaiworapongsa, Zhong Dong, Steven J Korzeniewski, Alicia Martinezvarea, Sonia S Hassan, Lami YeoAbstract:Objective: Preterm prelabor Rupture of Membranes (preterm PROM) accounts for 30–40% of spontaneous preterm deliveries and thus is a major contributor to perinatal morbidity and mortality. An amniot...
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sterile and microbial associated intra amniotic inflammation in preterm prelabor Rupture of Membranes
Journal of Maternal-fetal & Neonatal Medicine, 2015Co-Authors: Roberto Romero, Juan Pedro Kusanovic, Tinnakorn Chaiworapongsa, Jezid Miranda, Piya Chaemsaithong, Zhong Dong, Ahmed I Ahmed, Majid Shaman, Kia Lannaman, Bo Hyun YoonAbstract:AbstractObjective: The objectives of this study were to: (1) determine the amniotic fluid (AF) microbiology of patients with preterm prelabor Rupture of Membranes (PROM); and (2) examine the relationship between intra-amniotic inflammation with and without microorganisms (sterile inflammation) and adverse pregnancy outcomes in patients with preterm PROM.Methods: AF samples obtained from 59 women with preterm PROM were analyzed using cultivation techniques (for aerobic and anaerobic bacteria as well as genital mycoplasmas) and with broad-range polymerase chain reaction coupled with electrospray ionization mass spectrometry (PCR/ESI-MS). AF concentration of interleukin-6 (IL-6) was determined using ELISA. Results of both tests were correlated with AF IL-6 concentrations and the occurrence of adverse obstetrical/perinatal outcomes.Results: (1) PCR/ESI-MS, AF culture, and the combination of these two tests each identified microorganisms in 36% (21/59), 24% (14/59) and 41% (24/59) of women with preterm PROM, r...
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intraamniotic infection with genital mycoplasmas exhibits a more intense inflammatory response than intraamniotic infection with other microorganisms in patients with preterm premature Rupture of Membranes
American Journal of Obstetrics and Gynecology, 2010Co-Authors: Kyung A Lee, Roberto Romero, Yoo Kyung Sohn, Chanwook Park, Joon Seok Hong, Bo Hyun YoonAbstract:Objective The objective of the study was to compare the intensity of inflammatory responses between intraamniotic infection with genital mycoplasmas and intraamniotic infection with other microorganisms. Study Design We examined the intensity of intraamniotic and maternal inflammatory responses in 99 patients with preterm premature Rupture of Membranes and a positive amniotic fluid (AF) culture. AF was obtained by transabdominal amniocentesis or at the time of cesarean delivery. Patients were divided according to the recovered microorganisms: (1) genital mycoplasmas (n = 62); (2) other microorganisms (n = 31); or (3) mixed infection (n = 6). Results The median AF white blood cell (WBC) count, maternal blood WBC count, and plasma C-reactive protein concentrations were significantly higher in patients with intraamniotic infection with genital mycoplasmas than in those with intraamniotic infection with other microorganisms ( P Conclusion Intraamniotic and maternal inflammatory responses are more intense in intraamniotic infection with genital mycoplasmas than in intraamniotic infection with other microorganisms in patients with preterm premature Rupture of Membranes.
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prevalence and diversity of microbes in the amniotic fluid the fetal inflammatory response and pregnancy outcome in women with preterm pre labor Rupture of Membranes
American Journal of Reproductive Immunology, 2010Co-Authors: Daniel B Digiulio, Roberto Romero, Ricardo Gomez, Juan Pedro Kusanovic, Chong Jai Kim, Kimberley S Seok, Francesca GotschAbstract:Problem The role played by microbial invasion of the amniotic cavity (MIAC) in preterm prelabor Rupture of Membranes (pPROM) is inadequately characterized, in part because of reliance on cultivation-based methods.
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A Single Nucleotide Polymorphism in the Promoter of the LOXL1 Gene and Its Relationship to Pelvic Organ Prolapse and Preterm Premature Rupture of Membranes
Reproductive Sciences, 2009Co-Authors: Georgia Ferrell, Paul Stoddard, Mary D. Sammel, Roberto Romero, Jerome F. Strauss, Catherine A. MatthewsAbstract:Pelvic organ prolapse and preterm premature Rupture of Membranes, the 2 conditions which have in common weakening of the tensile strength of tissues, are thought to be caused, in part, by abnormal extracellular matrix synthesis and/or catabolism. We identified a new single nucleotide polymorphism (NT_010194(LOXLl):g.45008784A>C) in the promoter of the LOXL1 gene, which is essential for elastin synthesis. Promoter studies showed that the minor “C” allele had significantly greater activity than the major “A” allele. Case-control studies examined the association of the alleles of this single nucleotide polymorphism with pelvic organ prolapse and preterm premature Rupture of Membranes. When comparing allele frequencies and genotypes in pelvic organ prolapse cases versus controls, no significant associations were found. A case-control study conducted in African American neonates also found no significant associations between the promoter alleles and preterm premature Rupture of Membranes. We conclude that afunctional single nucleotide polymorphism exists in the promoter region of the LOXL1 gene. Association studies suggest that the promoter single nucleotide polymorphism does not contribute significantly to risk of pelvic organ prolapse or preterm premature Rupture of Membranes.
Bo Hyun Yoon - One of the best experts on this subject based on the ideXlab platform.
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a point of care test for interleukin 6 in amniotic fluid in preterm prelabor Rupture of Membranes a step toward the early treatment of acute intra amniotic inflammation infection
Journal of Maternal-fetal & Neonatal Medicine, 2016Co-Authors: Piya Chaemsaithong, Roberto Romero, Bo Hyun Yoon, Tinnakorn Chaiworapongsa, Zhong Dong, Steven J Korzeniewski, Alicia Martinezvarea, Sonia S Hassan, Lami YeoAbstract:Objective: Preterm prelabor Rupture of Membranes (preterm PROM) accounts for 30–40% of spontaneous preterm deliveries and thus is a major contributor to perinatal morbidity and mortality. An amniot...
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sterile and microbial associated intra amniotic inflammation in preterm prelabor Rupture of Membranes
Journal of Maternal-fetal & Neonatal Medicine, 2015Co-Authors: Roberto Romero, Juan Pedro Kusanovic, Tinnakorn Chaiworapongsa, Jezid Miranda, Piya Chaemsaithong, Zhong Dong, Ahmed I Ahmed, Majid Shaman, Kia Lannaman, Bo Hyun YoonAbstract:AbstractObjective: The objectives of this study were to: (1) determine the amniotic fluid (AF) microbiology of patients with preterm prelabor Rupture of Membranes (PROM); and (2) examine the relationship between intra-amniotic inflammation with and without microorganisms (sterile inflammation) and adverse pregnancy outcomes in patients with preterm PROM.Methods: AF samples obtained from 59 women with preterm PROM were analyzed using cultivation techniques (for aerobic and anaerobic bacteria as well as genital mycoplasmas) and with broad-range polymerase chain reaction coupled with electrospray ionization mass spectrometry (PCR/ESI-MS). AF concentration of interleukin-6 (IL-6) was determined using ELISA. Results of both tests were correlated with AF IL-6 concentrations and the occurrence of adverse obstetrical/perinatal outcomes.Results: (1) PCR/ESI-MS, AF culture, and the combination of these two tests each identified microorganisms in 36% (21/59), 24% (14/59) and 41% (24/59) of women with preterm PROM, r...
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intraamniotic infection with genital mycoplasmas exhibits a more intense inflammatory response than intraamniotic infection with other microorganisms in patients with preterm premature Rupture of Membranes
American Journal of Obstetrics and Gynecology, 2010Co-Authors: Kyung A Lee, Roberto Romero, Yoo Kyung Sohn, Chanwook Park, Joon Seok Hong, Bo Hyun YoonAbstract:Objective The objective of the study was to compare the intensity of inflammatory responses between intraamniotic infection with genital mycoplasmas and intraamniotic infection with other microorganisms. Study Design We examined the intensity of intraamniotic and maternal inflammatory responses in 99 patients with preterm premature Rupture of Membranes and a positive amniotic fluid (AF) culture. AF was obtained by transabdominal amniocentesis or at the time of cesarean delivery. Patients were divided according to the recovered microorganisms: (1) genital mycoplasmas (n = 62); (2) other microorganisms (n = 31); or (3) mixed infection (n = 6). Results The median AF white blood cell (WBC) count, maternal blood WBC count, and plasma C-reactive protein concentrations were significantly higher in patients with intraamniotic infection with genital mycoplasmas than in those with intraamniotic infection with other microorganisms ( P Conclusion Intraamniotic and maternal inflammatory responses are more intense in intraamniotic infection with genital mycoplasmas than in intraamniotic infection with other microorganisms in patients with preterm premature Rupture of Membranes.
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the relationship between oligohydramnios and the onset of preterm labor in preterm premature Rupture of Membranes
American Journal of Obstetrics and Gynecology, 2001Co-Authors: Joong Shin Park, Roberto Romero, Bo Hyun Yoon, Jeong Bin Moon, Ju Cheol Kim, Jong Kwan JunAbstract:Abstract Objective: The objective of this study was to determine whether a reduced amniotic fluid volume was associated with the onset of preterm parturition in patients with preterm premature Rupture of Membranes. Study Design: An amniotic fluid index was determined before transabdominal amniocentesis in 129 patients with preterm premature Rupture of Membranes (gestational age ≤35 weeks). Amniotic fluid was cultured for aerobic and anaerobic bacteria, as well as for mycoplasmas. Survival techniques were used for analysis. Results: Amniotic fluid index was ≤5 cm in 29% of patients (38/129). Patients with an amniotic fluid index of ≤5 cm had a significantly higher rate of positive amniotic fluid culture than those with an amniotic fluid index of >5 cm (42% [16/38] vs 18% [16/91]; P 5 cm (for 24 hours, 29% vs 12%; for 48 hours, 42% vs 21%; P 5 cm (median, 38 hours; range, 0.2-1310 hours; vs median, 100 hours; range 0.1-2917 hours; P P Conclusion: Patients with preterm premature Rupture of Membranes and an amniotic fluid index of ≤5 cm are at increased risk for a shorter interval to delivery. (Am J Obstet Gynecol 2001;184:459-62.)
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evidence for the participation of interstitial collagenase matrix metalloproteinase 1 in preterm premature Rupture of Membranes
American Journal of Obstetrics and Gynecology, 2000Co-Authors: Eli Maymon, Roberto Romero, Percy Pacora, Mariateresa Gervasi, Katherine Bianco, Fabio Ghezzi, Bo Hyun YoonAbstract:Objective Rupture of Membranes is thought to result from the effects of physical forces in localized areas of the Membranes weakened by the degradation of structural collagens. Matrix metalloproteinases are enzymes that degrade extracellular matrix components and have been implicated in membrane Rupture. The objective of this study was to determine whether spontaneous Rupture of Membranes is associated with a change in the amniotic fluid concentration of interstitial collagenase (matrix metalloproteinase 1 [MMP-1]), a major collagenase. Study design A cross-sectional study was conducted to determine MMP-1 concentrations in amniotic fluid from 353 women in the following categories: (1) term with intact Membranes not in labor and in labor, (2) preterm labor who delivered at term, (3) preterm labor who delivered preterm without microbial invasion of the amniotic cavity, (4) preterm labor who delivered preterm with microbial invasion of the amniotic cavity, (5) preterm premature Rupture of Membranes with and without microbial invasion of the amniotic cavity, (6) term premature Rupture of Membranes not in labor and in labor, and (7) mid trimester of pregnancy. Microbial invasion of the amniotic cavity was determined by an amniotic fluid culture positive for microorganisms. MMP-1 concentrations in amniotic fluid were determined by means of sensitive and specific immunoassays. Results (1) MMP-1 was detectable in 81.3% of amniotic fluid samples (287/353), and its concentrations increased with advancing gestational age (r = 0.4; P Conclusion (1) Collagenase 1 (MMP-1) is a physiologic constituent of amniotic fluid. (2) Preterm premature Rupture of Membranes (in both the presence and absence of infection) was associated with an increase in the amniotic fluid MMP-1 concentrations. (3) Neither term nor preterm parturition was associated with a significant increase in the amniotic fluid concentration of MMP-1.
Bo Jacobsson - One of the best experts on this subject based on the ideXlab platform.
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intraamniotic inflammation in women with preterm prelabor Rupture of Membranes
PLOS ONE, 2015Co-Authors: Ivana Musilova, Bo Jacobsson, Ramkumar Menon, Radka Kutova, Lenka Pliskova, Martin Stepan, Marian KacerovskyAbstract:Objective To characterize subgroups of preterm prelabor Rupture of Membranes (PPROM) and short-term neonatal outcomes based on the presence and absence of intraamniotic inflammation (IAI) and/or microbial invasion of the amniotic cavity (MIAC).
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bedside assessment of amniotic fluid interleukin 6 in preterm prelabor Rupture of Membranes
American Journal of Obstetrics and Gynecology, 2014Co-Authors: Marian Kacerovsky, Helena Hornychova, Ivana Musilova, Milan Kostal, Radka Kutova, Lenka Pliskova, Bo JacobssonAbstract:of 1000 pg/mL was determined to be the best cutoff value for the prediction of MIAC (sensitivity of 50%, specificity of 95%, positive predictive value of 82%, negative predictive value of 81%, and likelihood ratio of 8.4) or both MIAC and HCA (sensitivity of 60%, specificity of 94%, positive predictive value of 75%, negative predictive value of 88%, and likelihood ratio of 9.4). CONCLUSION:ThebedsideassessmentofamnioticfluidIL-6seemsto be an easy, rapid, and inexpensive method for the prediction of MIAC orbothMIACandHCAinpregnanciescomplicatedbypretermprelabor Rupture of Membranes.
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oligohydramnios in women with preterm prelabor Rupture of Membranes and adverse pregnancy and neonatal outcomes
PLOS ONE, 2014Co-Authors: Marian Kacerovsky, Helena Hornychova, Ctirad Andrys, Marcela Drahosova, Ivana Musilova, Adam Rezac, Milan Kostal, Bo JacobssonAbstract: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.
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a prediction model of histological chorioamnionitis and funisitis in preterm prelabor Rupture of Membranes analyses of multiple proteins in the amniotic fluid
Journal of Maternal-fetal & Neonatal Medicine, 2012Co-Authors: Teresa Cobo, Helena Hornychova, Montse Palacio, Marian Kacerovsky, Kristin Skogstrand, David M Hougaard, Bo JacobssonAbstract:Objective: To determine the best prediction model of histological chorioamnionitis and funisitis in preterm prelabor Rupture of Membranes (PPROM) using selected candidate proteins in the amniotic fluid (AF). Material and methods: Prospective cohort study. Twenty-six AF proteins were assayed by a multiple immunoassay from 107 women with Membranes Rupture from 23+0 to 36+6 weeks. The Czech Republic policy is active management, and the majority of women were delivered within 72 h after the Rupture of Membranes, except for women with PPROM <28+0 weeks who were managed conservatively. The best predictive models to diagnose histological chorioamnionitis and funisitis were calculated by logistic regression depending on the gestational age (GA) at membrane Rupture. Results: Both IL-6 and a combination of IL-10, and migration inhibiting factor (MIF) were the best predictive models of histological chorioamnionitis and funisitis, respectively, with sensitivity, specificity, positive and negative predictive values an...
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microbial invasion and cytokine response in amniotic fluid in a swedish population of women with preterm prelabor Rupture of Membranes
Acta Obstetricia et Gynecologica Scandinavica, 2003Co-Authors: Bo Jacobsson, Inger Mattsbybaltzer, Bjorn Andersch, Hans Bokstrom, Rosemarie Holst, Natalia Nikolaitchouk, Ullabritt Wennerholm, Henrik HagbergAbstract:Background. Previous studies have shown an association between intra-amniotic microbial invasion and/or inflammation and spontaneous preterm birth. The aim of this study was to investigate the occurrence of intra-amniotic microorganisms and cytokines [interleukin (IL)-6 and IL-8] in a Swedish population, with low incidence of preterm birth, of women with preterm prelabor Rupture of Membranes and their correlation to preterm birth. Methods. Amniotic fluid was retrieved transabdominally from 58 patients with preterm prelabor Rupture of Membranes before 34 weeks of gestation. Polymerase chain reaction (PCR) analyses for Ureaplasma urealyticum and Mycoplasma hominis and culture for aerobic and anaerobic bacteria were performed. IL-6 and IL-8 were analyzed with enzyme-linked immunosorbent assay (ELISA). Results. Microorganisms in amniotic fluid were detected in 13 patients (25%). Patients with bacteria detected in the amniotic fluid had significantly higher levels of IL-6 and IL-8. An amniotic fluid concentrat...
Marian Kacerovsky - One of the best experts on this subject based on the ideXlab platform.
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intraamniotic inflammation in women with preterm prelabor Rupture of Membranes
PLOS ONE, 2015Co-Authors: Ivana Musilova, Bo Jacobsson, Ramkumar Menon, Radka Kutova, Lenka Pliskova, Martin Stepan, Marian KacerovskyAbstract:Objective To characterize subgroups of preterm prelabor Rupture of Membranes (PPROM) and short-term neonatal outcomes based on the presence and absence of intraamniotic inflammation (IAI) and/or microbial invasion of the amniotic cavity (MIAC).
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bedside assessment of amniotic fluid interleukin 6 in preterm prelabor Rupture of Membranes
American Journal of Obstetrics and Gynecology, 2014Co-Authors: Marian Kacerovsky, Helena Hornychova, Ivana Musilova, Milan Kostal, Radka Kutova, Lenka Pliskova, Bo JacobssonAbstract:of 1000 pg/mL was determined to be the best cutoff value for the prediction of MIAC (sensitivity of 50%, specificity of 95%, positive predictive value of 82%, negative predictive value of 81%, and likelihood ratio of 8.4) or both MIAC and HCA (sensitivity of 60%, specificity of 94%, positive predictive value of 75%, negative predictive value of 88%, and likelihood ratio of 9.4). CONCLUSION:ThebedsideassessmentofamnioticfluidIL-6seemsto be an easy, rapid, and inexpensive method for the prediction of MIAC orbothMIACandHCAinpregnanciescomplicatedbypretermprelabor Rupture of Membranes.
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oligohydramnios in women with preterm prelabor Rupture of Membranes and adverse pregnancy and neonatal outcomes
PLOS ONE, 2014Co-Authors: Marian Kacerovsky, Helena Hornychova, Ctirad Andrys, Marcela Drahosova, Ivana Musilova, Adam Rezac, Milan Kostal, Bo JacobssonAbstract: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.
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Azurocidin levels in maternal serum in the first trimester can predict preterm prelabor Rupture of Membranes.
The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine the Federation of Asia and , 2013Co-Authors: Ishraq Dhaifalah, Ctirad Andrys, Marcela Drahosova, Ivana Musilova, Zdenek Adamik, Marian KacerovskyAbstract:AbstractObjective: 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 diffe...
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a prediction model of histological chorioamnionitis and funisitis in preterm prelabor Rupture of Membranes analyses of multiple proteins in the amniotic fluid
Journal of Maternal-fetal & Neonatal Medicine, 2012Co-Authors: Teresa Cobo, Helena Hornychova, Montse Palacio, Marian Kacerovsky, Kristin Skogstrand, David M Hougaard, Bo JacobssonAbstract:Objective: To determine the best prediction model of histological chorioamnionitis and funisitis in preterm prelabor Rupture of Membranes (PPROM) using selected candidate proteins in the amniotic fluid (AF). Material and methods: Prospective cohort study. Twenty-six AF proteins were assayed by a multiple immunoassay from 107 women with Membranes Rupture from 23+0 to 36+6 weeks. The Czech Republic policy is active management, and the majority of women were delivered within 72 h after the Rupture of Membranes, except for women with PPROM <28+0 weeks who were managed conservatively. The best predictive models to diagnose histological chorioamnionitis and funisitis were calculated by logistic regression depending on the gestational age (GA) at membrane Rupture. Results: Both IL-6 and a combination of IL-10, and migration inhibiting factor (MIF) were the best predictive models of histological chorioamnionitis and funisitis, respectively, with sensitivity, specificity, positive and negative predictive values an...
Ricardo Gomez - One of the best experts on this subject based on the ideXlab platform.
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prevalence and diversity of microbes in the amniotic fluid the fetal inflammatory response and pregnancy outcome in women with preterm pre labor Rupture of Membranes
American Journal of Reproductive Immunology, 2010Co-Authors: Daniel B Digiulio, Roberto Romero, Ricardo Gomez, Juan Pedro Kusanovic, Chong Jai Kim, Kimberley S Seok, Francesca GotschAbstract:Problem The role played by microbial invasion of the amniotic cavity (MIAC) in preterm prelabor Rupture of Membranes (pPROM) is inadequately characterized, in part because of reliance on cultivation-based methods.
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matrilysin matrix metalloproteinase 7 in parturition premature Rupture of Membranes and intrauterine infection
American Journal of Obstetrics and Gynecology, 2000Co-Authors: Eli Maymon, Roberto Romero, Ricardo Gomez, Percy Pacora, Mariateresa Gervasi, Samuel S Edwin, David E SeubertAbstract:Abstract Objective: Matrix metalloproteinases are enzymes capable of degrading extracellular matrix components. Matrilysin (matrix metalloproteinase 7), a novel member of this family, degrades fibronectin and proteoglycans. The objective of this study was to determine whether parturition (either term or preterm), premature Rupture of the Membranes, and microbial invasion of the amniotic cavity are associated with changes in the amniotic fluid concentration of matrilysin. Study Design: A cross-sectional study was conducted with 275 women in the following categories: (1) second trimester, (2) term not in labor, (3) term in labor, (4) term with microbial invasion of the amniotic cavity, (5) preterm labor with intact Membranes without microbial invasion of the amniotic cavity who delivered at term, (6) preterm labor without microbial invasion of the amniotic cavity who delivered preterm, (7) preterm labor with microbial invasion of the amniotic cavity, (8) preterm premature Rupture of Membranes with and without microbial invasion of the amniotic cavity, and (9) term premature Rupture of Membranes not in labor and without microbial invasion of the amniotic cavity. Matrilysin concentrations were measured with a sensitive specific immunoassay that was validated for amniotic fluid. Results: Matrilysin was detectable in 97.4% (268/275) of the samples. The concentration of matrilysin increased with advancing gestational age ( r = 0.8; P P P P Conclusion: Matrilysin is a physiologic constituent of amniotic fluid, and its concentration increases with advancing gestational age. Microbial invasion of the amniotic cavity in preterm gestations was associated with a significant increase in amniotic fluid concentration of matrilysin. Matrilysin therefore may play a role in the host defense mechanism. (Am J Obstet Gynecol 2000;182:1545-53.)
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a comparative study of the diagnostic performance of amniotic fluid glucose white blood cell count interleukin 6 and gram stain in the detection of microbial invasion in patients with preterm premature Rupture of Membranes
American Journal of Obstetrics and Gynecology, 1993Co-Authors: Roberto Romero, Moshe Mazor, Bo Hyun Yoon, Ricardo Gomez, Michael P Diamond, John S Kenney, R Gonzalez, Peter Baumann, Heriberto Araneda, David B CottonAbstract:OBJECTIVE: Our aim was to compare the value of amniotic fluid tests for the detection of microbial invasion of the amniotic cavity and in the prediction of the amniocentesis-to-delivery interval and neonatal complications in patients with preterm premature Rupture of Membranes. STUDY DESIGN: Amniotic fluid was obtained by transabdominal amniocentesis from 110 consecutive patients with preterm premature Rupture of Membranes. Fluid was cultured for aerobic and anaerobic bacteria, as well as mycoplasmas. Amniotic fluid analysis included a Gram stain examination, white blood cell count, and glucose and interleukin-6 determinations. Logistic regression and survival techniques (proportional hazards model) were used for statistical analysis. RESULTS: (1) The prevalence of positive amniotic fluid cultures in patients with preterm premature Rupture of Membranes was 38% (42/110); (2) patients with microbial invasion had a shorter amniocentesis-to-delivery interval and a higher neonatal complication rate than patients with negative cultures; (3) the most sensitive test for the detection of microbial invasion of the amniotic cavity was amniotic fluid interleukin-6 determinations (cutoff 7.9 ng/ml) (sensitivity: for IL-6 80.9%; for white blood cell count 57.1%; for glucose 57.1%; for Gram stain 23.8%; p p CONCLUSION: Interleukin-6 concentrations in amniotic fluid are a better predictor of microbial invasion of the amniotic cavity, amniocentesis-to-delivery interval and neonatal complications than the amniotic fluid Gram stain, glucose, or white blood cell count in patients with preterm premature Rupture of Membranes.
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The relationship between spontaneous Rupture of Membranes, labor, and microbial invasion of the amniotic cavity and amniotic fluid concentrations of prostaglandins and thromboxane B2 in term pregnancy.
American Journal of Obstetrics and Gynecology, 1993Co-Authors: R Romero, Ricardo Gomez, David B Cotton, Peter Baumann, C Salafia, L Rittenhouse, D Barberio, E Behnke, M D MitchellAbstract:Objective: The purpose of this study was to examine the relationship between Rupture of Membranes, labor, and microbial invasion of the amniotic cavity and amniotic fluid concentrations of eicosanoids in patients with spontaneous Rupture of Membranes at term. Study Design: Amniotic fluid was retrieved by transabdominal amniocentesis from patients with Rupture of Membranes and patients with intact Membranes at term. Studies to determine the microbial state of the amniotic cavity included culture for bacteria and mycoplasmas, Gram stain, amniotic fluid white blood cell count, and Limulus amebocyte lysate. Eicosanoids (prostaglandin E 2 , prostaglandin F 2α and its stable metabolite, 6-keto-prostaglandin F 1α , and thromboxane B 2 ) were determined with sensitive and specific radioimmunoassays validated for human amniotic fluid. Statistical inference was conducted with analysis of variance and linear contrast. Results: (1) Spontaneous Rupture of Membranes at term was associated with a significant increase in amniotic fluid concentrations of all eicosanoids measured in this study except 6-keto-prostaglandin F 2α (2) Early labor in patients with Rupture of Membranes was associated with a significant increase in the amniotic fluid concentration of all eicosanoids. (3) A significant increase in amniotic fluid eicosanoids in women with microbial invasion of the amniotic cavity could not be documented. Conclusions: Whereas preterm labor in the absence of microbial invasion of the amniotic cavity is not associated with a significant increase in amniotic fluid concentrations of prostaglandins, a clear increase was documented in women with early labor after spontaneous Rupture of Membranes. These observations suggest that there are fundamental differences in the biochemistry of term and preterm parturition.
