Document Detail


Value of amniotic fluid neutrophil collagenase concentrations in preterm premature rupture of membranes.
MedLine Citation:
PMID:  11717648     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: Neutrophils in amniotic fluid are thought to be of fetal origin, and therefore the detection of these cells and/or their products in amniotic fluid may reflect the fetal inflammatory status. We propose that amniotic fluid neutrophil collagenase (matrix metalloproteinase-8) is a useful parameter to predict adverse neonatal outcome, impending preterm labor/delivery, and intrauterine infection in the setting of preterm premature rupture of the membranes. STUDY DESIGN: Amniotic fluid was obtained by transabdominal amniocentesis from 101 patients with preterm premature rupture of the membranes (gestational age, 24-36 weeks). Fluid was cultured for aerobic and anaerobic bacteria and Mycoplasmas. Amniotic fluid analysis included Gram stain, white blood cell count, and determination of interleukin-6 and matrix metalloproteinase-8 concentrations (enzyme-linked immunosorbent assay). RESULTS: Neonates with adverse neonatal outcome were born to mothers with a significantly higher median amniotic fluid matrix metalloproteinase-8 concentration than those without adverse neonatal outcome (median, 54.4 ng/mL; range, 0.82-14,500 ng/mL vs median, 28.9 ng/mL; range, 0.78-2451.8 ng/mL; P <.05, respectively). The higher the amniotic fluid matrix metalloproteinase-8 concentrations, the shorter the interval to delivery (Cox proportional hazards model adjusting for gestational age at delivery; hazard ratio, 1.9; 95% CI, 1.1-3.5; P <.03). Amniotic fluid matrix metalloproteinase-8 concentration was more sensitive than an amniotic fluid white blood cell count and interleukin-6 in the detection of microbiologically proven intra-amniotic infection. CONCLUSION: Increased concentrations of neutrophil collagenase (matrix metalloproteinase-8) in amniotic fluid are associated with intra-amniotic infection, impending preterm delivery, and adverse neonatal outcome in patients with preterm premature rupture of the membranes. Moreover, matrix metalloproteinase-8 in amniotic fluid is a stronger predictor for the duration of pregnancy and intra-amniotic inflammation than interleukin-6 and an amniotic fluid white blood cell count.
Authors:
E Maymon; R Romero; T Chaiworapongsa; J C Kim; S Berman; R Gomez; S Edwin
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  American journal of obstetrics and gynecology     Volume:  185     ISSN:  0002-9378     ISO Abbreviation:  Am. J. Obstet. Gynecol.     Publication Date:  2001 Nov 
Date Detail:
Created Date:  2001-11-21     Completed Date:  2001-12-19     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0370476     Medline TA:  Am J Obstet Gynecol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1143-8     Citation Subset:  AIM; IM    
Affiliation:
Perinatology Research Branch, National Institute of Child Health and Human Development, Bethesda, Md, USA.
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MeSH Terms
Descriptor/Qualifier:
Amniotic Fluid / enzymology*,  microbiology
Delivery, Obstetric
Female
Fetal Membranes, Premature Rupture / complications,  metabolism*
Fetus / microbiology
Gestational Age
Humans
Infant, Newborn
Infant, Newborn, Diseases / epidemiology
Infection / complications
Matrix Metalloproteinase 8 / metabolism*
Morbidity
Obstetric Labor, Premature / complications
Osmolar Concentration
Pregnancy
Pregnancy Complications, Infectious
Proportional Hazards Models
Chemical
Reg. No./Substance:
EC 3.4.24.34/Matrix Metalloproteinase 8

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


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