Document Detail

The clinical significance of eosinophils in the amniotic fluid in preterm labor.
MedLine Citation:
PMID:  19900034     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: White blood cells are not traditionally considered to be normally present in amniotic fluid. This study was conducted after the observation that a patient with preterm labor and intact membranes had eosinophils as a predominant cell in the amniotic fluid, and had an episode of asthma during the index pregnancy. The goal of this study was to determine whether women presenting with preterm labor with eosinophils in the amniotic fluid had a different outcome than those without eosinophils as the predominant white blood cell in the amniotic cavity.
METHODS: This retrospective case-control study included women who presented with preterm labor and intact membranes between 24 and 34 weeks of gestation. Patients underwent an amniocentesis shortly after admission for the assessment of the microbiologic status of the amniotic cavity and/or fetal lung maturity. Amniotic fluid was cultured for aerobic and anaerobic bacteria as well as genital mycoplasmas. Cytologic studies included amniotic fluid white blood cell count and differential, which was performed on cytocentrifuged specimens. Patients with microbial invasion of the amniotic cavity and/or an amniotic fluid white blood cell count >20 cells/mm(3) were excluded from the study. Cases were defined as women in whom the differential contained >20% of eosinophils. Controls were selected among women with an amniotic fluid eosinophil count <or=20% and matched for gestational age at amniocentesis. The analysis was conducted with non-parametric statistics.
RESULTS: The study population consisted of 10 cases and 50 controls. Gestational age and cervical dilatation at admission were similar in both groups. Cases had a lower gestational age at delivery than controls [34.6 weeks, inter-quartile range (IQR) 32-37.3 weeks vs. 38.0 weeks, IQR 35-40 weeks, respectively; p = 0.018]. The prevalence of preterm delivery <or=35 weeks was higher among patients who had >20% eosinophils than in the control group [50% (5/10) vs. 18% (9/50), respectively; p = 0.029]. Similar results were observed for delivery at <37 weeks [cases: 70% (7/10) vs. controls: 36% (18/50); p = 0.046].
CONCLUSIONS: Women with preterm labor and intact membranes who have a large proportion of eosinophils in the amniotic fluid are at an increased risk for spontaneous preterm delivery. These patients may have had an episode of preterm labor related to a type I hypersensitivity reaction.
Roberto Romero; Juan Pedro Kusanovic; Ricardo Gomez; Ronald Lamont; Egle Bytautiene; Robert E Garfield; Pooja Mittal; Sonia S Hassan; Lami Yeo
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Intramural    
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:  23     ISSN:  1476-4954     ISO Abbreviation:  J. Matern. Fetal. Neonatal. Med.     Publication Date:  2010 Apr 
Date Detail:
Created Date:  2010-03-12     Completed Date:  2010-06-07     Revised Date:  2013-03-27    
Medline Journal Info:
Nlm Unique ID:  101136916     Medline TA:  J Matern Fetal Neonatal Med     Country:  England    
Other Details:
Languages:  eng     Pagination:  320-9     Citation Subset:  IM    
Perinatology Research Branch, NICHD/NIH/DHHS, Bethesda, Maryland, USA.
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MeSH Terms
Amniotic Fluid / cytology*
Asthma / pathology
Case-Control Studies
Eosinophils / pathology*
Gestational Age
Obstetric Labor, Premature / pathology*
Pregnancy Complications / pathology
Retrospective Studies
Grant Support

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

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