Document Detail


Maternal and fetal inflammatory responses in unexplained fetal death.
MedLine Citation:
PMID:  14694969     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: The role of intra-amniotic infection in the etiology of fetal death has been proposed. This study was conducted to determine the prevalence of microbial invasion of the amniotic cavity (MIAC) and the frequency of maternal and/or fetal inflammation in patients presenting with a fetal death. METHODS: A prospective study was conducted in patients with a fetal death. Amniocenteses were performed for clinical indications (karyotype), as well as to assess the microbiological and cytological state of the amniotic cavity. Fluid was cultured for aerobic and anaerobic bacteria and genital mycoplasmas. An amniotic fluid white blood cell count and glucose determinations were also performed. Histological examination of the placenta was conducted to identify a maternal inflammatory response (acute chorioamnionitis) or a fetal inflammatory response (funisitis). RESULTS: This study included 44 patients with intrauterine fetal death. The median gestational age at diagnosis was 30.1 weeks (range 16.3-40.4 weeks). One patient had documented MIAC (1/44). Acute histological chorioamnionitis was found in 20.9% (9/43), but a fetal inflammatory response was observed in only 2.3% (1/43) of cases. One patient had a positive amniotic fluid culture for Streptococcus agalactiae (group B streptococcus). CONCLUSION: Histological chorioamnionitis was present in 20.9% of cases, but MIAC could be demonstrated with conventional microbiological techniques in only one case. A fetal inflammatory response was nine times less frequent than a maternal inflammatory response (maternal 20.9% vs. fetal 2.3%, p = 0.008) in cases of fetal death.
Authors:
S Blackwell; R Romero; T Chaiworapongsa; Y M Kim; E Bujold; J Espinoza; N Camacho; S Hassan; B H Yoon; J S Refuerzo
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians     Volume:  14     ISSN:  1476-7058     ISO Abbreviation:  J. Matern. Fetal. Neonatal. Med.     Publication Date:  2003 Sep 
Date Detail:
Created Date:  2003-12-25     Completed Date:  2004-03-04     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  101136916     Medline TA:  J Matern Fetal Neonatal Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  151-7     Citation Subset:  IM    
Affiliation:
Department of Obstetrics and Gynecology, Wayne State University/Hutzel Hospital, Detroit, Michigan, 48201, USA.
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MeSH Terms
Descriptor/Qualifier:
Adult
Amniotic Fluid / chemistry,  microbiology*
Chorioamnionitis / diagnosis*
Female
Fetal Death / etiology*
Gestational Age
Glucose / analysis
Humans
Inflammation / complications
Leukocyte Count
Placenta / immunology,  microbiology,  pathology*
Pregnancy
Prospective Studies
Streptococcus agalactiae / isolation & purification
Umbilical Cord / immunology,  microbiology,  pathology*
Chemical
Reg. No./Substance:
50-99-7/Glucose

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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