| The frequency and significance of intraamniotic inflammation in patients with cervical insufficiency. | |
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MedLine Citation:
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PMID: 18342290 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: The purpose of this study was to determine the frequency and clinical significance of intraamniotic inflammation in patients with acute cervical insufficiency. STUDY DESIGN: Amniocentesis was performed in 52 patients with acute cervical insufficiency (cervical dilation, > or =1.5 cm) and intact membranes and without regular uterine contractions (gestational age, 17-29 weeks). Amniotic fluid (AF) was cultured for aerobic and anaerobic bacteria and genital mycoplasmas and assayed for matrix metalloproteinase-8. Intraamniotic inflammation was defined as an elevated AF matrix metalloproteinase-8 concentration (>23 ng/mL). Nonparametric statistics and survival techniques were used for analysis. RESULTS: The prevalence of intraamniotic inflammation was 81% (42/52); the prevalence of a positive AF culture was 8% (4/52). Intraamniotic inflammation was present in all cases with a positive AF culture. Preterm delivery within 7 days occurred in 50% of cases (19/38), and delivery before 34 weeks of gestation occurred in 84% of cases (32/38) with intraamniotic inflammation but without AF infection. Fifty-five percent of newborn infants (21/38) who were born to mothers with intraamniotic inflammation but without AF infection died immediately after birth (<1 day). The amniocentesis-to-delivery interval was shorter in patients with intraamniotic inflammation than in those without inflammation (P < .05). There were no differences in the interval-to-delivery or the rate of adverse outcome between patients with intraamniotic inflammation and a negative culture and patients with proven AF infection. CONCLUSION: Intraamniotic inflammation, regardless of AF culture result, is present in approximately 80% of patients with acute cervical insufficiency and is a risk factor for impending preterm delivery and adverse outcomes. |
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Authors:
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Si Eun Lee; Roberto Romero; Chan-Wook Park; Jong Kwan Jun; Bo Hyun Yoon |
Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't Date: 2008-03-14 |
Journal Detail:
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Title: American journal of obstetrics and gynecology Volume: 198 ISSN: 1097-6868 ISO Abbreviation: Am. J. Obstet. Gynecol. Publication Date: 2008 Jun |
Date Detail:
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Created Date: 2008-06-09 Completed Date: 2008-07-08 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0370476 Medline TA: Am J Obstet Gynecol Country: United States |
Other Details:
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Languages: eng Pagination: 633.e1-8 Citation Subset: AIM; IM |
Affiliation:
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Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Republic of Korea. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adult Amniotic Fluid / immunology, microbiology* Chorioamnionitis / epidemiology*, immunology Female Fetal Membranes, Premature Rupture / immunology* Gestational Age Humans Matrix Metalloproteinase 8 / analysis* Obstetric Labor, Premature Pregnancy Pregnancy Outcome Risk Factors Uterine Cervical Incompetence / microbiology* |
| Chemical | |
Reg. No./Substance:
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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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