Document Detail

The relationship between sonographic fetal thymus size and the components of the systemic fetal inflammatory response syndrome in women with preterm prelabour rupture of membranes.
MedLine Citation:
PMID:  18485161     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To assess the relation between sonographic fetal thymus size and the components of fetal inflammatory response syndrome (FIRS) in women with preterm prelabour rupture of membranes (PPROM). DESIGN: Prospective cohort study. SETTING: University hospital from January through October 2006. POPULATION: Fifty-six women with PPROM. METHODS: In these women, fetal thymus perimeter was measured sonographically. At birth, cord venous plasma interleukin-6 (IL-6) level estimation and histopathological examination of the placentas and umbilical cords were performed. MAIN OUTCOME MEASURES: Small thymus size (< 5th percentile for gestational age) and its association with FIRS. RESULTS: From the 56 women with PPROM, 54% had chorioamnionitis (CA), 23% had funisitis. IL-6 level was > 11 pg/ml in 52% of women and > 18 pg/ml in 41%. A small thymus was more associated with male fetuses, shorter preterm prelabour rupture of membranes delivery interval, higher IL-6 level, higher frequency of funisitis and CA. When data were regressed for confounding, only IL-6 level and funisitis remained significant independent factors that influence the thymus size. In the subset of women (n = 19) who delivered within 1 week of first measurements, a small thymus had sensitivity and positive predictive value of 93%, specificity and negative predictive value of 75% and accuracy of 89% in the identification of FIRS (IL-6 >18 pg/ml and/or funisitis). CONCLUSIONS: An association exists between fetal thymic involution and components of FIRS in women with PPROM. Small fetal thymus size may be considered a reliable sonographic marker of fetal involvement in the inflammatory response.
D O El-Haieg; A A Zidan; M M El-Nemr
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  BJOG : an international journal of obstetrics and gynaecology     Volume:  115     ISSN:  1471-0528     ISO Abbreviation:  BJOG     Publication Date:  2008 Jun 
Date Detail:
Created Date:  2008-05-19     Completed Date:  2008-07-21     Revised Date:  2009-04-16    
Medline Journal Info:
Nlm Unique ID:  100935741     Medline TA:  BJOG     Country:  England    
Other Details:
Languages:  eng     Pagination:  836-41     Citation Subset:  AIM; IM    
Department of Obstetrics and Gynecology, Faculty of Medicine, Zagazig, Egypt.
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MeSH Terms
Chorioamnionitis / etiology,  immunology
Cohort Studies
Fetal Development / immunology*
Fetal Diseases / immunology,  pathology*
Fetal Membranes, Premature Rupture / etiology,  immunology,  pathology*
Infant, Newborn
Interleukin-6 / metabolism
Organ Size
Pregnancy Outcome
Pregnancy Trimester, Second
Pregnancy Trimester, Third
Regression Analysis
Systemic Inflammatory Response Syndrome / immunology,  pathology*
Thymus Gland / embryology*,  pathology,  ultrasonography
Reg. No./Substance:
Comment In:
BJOG. 2009 Feb;116(3):461; author reply 461-2   [PMID:  19187382 ]

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