Document Detail


The frequency and significance of intraamniotic inflammation in patients with cervical insufficiency.
MedLine Citation:
PMID:  18342290     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
Si Eun Lee; Roberto Romero; Chan-Wook Park; Jong Kwan Jun; Bo Hyun Yoon
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2008-03-14
Journal Detail:
Title:  American journal of obstetrics and gynecology     Volume:  198     ISSN:  1097-6868     ISO Abbreviation:  Am. J. Obstet. Gynecol.     Publication Date:  2008 Jun 
Date Detail:
Created Date:  2008-06-09     Completed Date:  2008-07-08     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0370476     Medline TA:  Am J Obstet Gynecol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  633.e1-8     Citation Subset:  AIM; IM    
Affiliation:
Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Republic of Korea.
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MeSH Terms
Descriptor/Qualifier:
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:
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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