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The intensity of the fetal inflammatory response in intraamniotic inflammation with and without microbial invasion of the amniotic cavity

Lee, Si Eun, MD ; Romero, Roberto, MD ; Jung, Hanna, MT ; Park, Chan-Wook, MD ; Park, Joong Shin, MD, PhD ; Yoon, Bo Hyun, MD, PhD

American journal of obstetrics and gynecology, 2007-09, Vol.197 (3), p.294.e1-294.e6 [Periódico revisado por pares]

Philadelphia, PA: Elsevier Inc

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Título:
The intensity of the fetal inflammatory response in intraamniotic inflammation with and without microbial invasion of the amniotic cavity
Autor: Lee, Si Eun, MD ; Romero, Roberto, MD ; Jung, Hanna, MT ; Park, Chan-Wook, MD ; Park, Joong Shin, MD, PhD ; Yoon, Bo Hyun, MD, PhD
Assuntos: Adult ; amniotic fluid ; Amniotic Fluid - immunology ; Amniotic Fluid - microbiology ; Bacteriological Techniques ; Biological and medical sciences ; C-reactive protein ; C-Reactive Protein - analysis ; Chorioamnionitis - immunology ; Chorioamnionitis - microbiology ; cord blood ; Female ; Fetal Blood - chemistry ; fetal inflammatory response syndrome ; Fetal Membranes, Premature Rupture - immunology ; Gynecology. Andrology. Obstetrics ; Humans ; Infant, Newborn ; intraamniotic inflammation ; Medical sciences ; Obstetrics and Gynecology ; Pregnancy ; Risk Factors ; Systemic Inflammatory Response Syndrome - immunology ; Systemic Inflammatory Response Syndrome - microbiology ; Systemic Inflammatory Response Syndrome - physiopathology
É parte de: American journal of obstetrics and gynecology, 2007-09, Vol.197 (3), p.294.e1-294.e6
Notas: ObjectType-Article-1
SourceType-Scholarly Journals-1
ObjectType-Feature-2
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Descrição: Objective Intraamniotic inflammation is a risk factor for adverse pregnancy and neonatal outcome, regardless of the presence or absence of a positive amniotic fluid (AF) culture. The purpose of this study was to determine whether the intensity of a fetal inflammatory response (FIR) differs between cases of intraamniotic inflammation with microbiologically proven infection and cases with negative AF cultures. Study Design The FIR was examined in 89 cases of women with preterm premature rupture of membranes who delivered singleton preterm newborn infants within 48 hours of amniocentesis. AF was cultured for aerobic and anaerobic bacteria and for genital mycoplasmas. AF white blood cell (WBC) count and matrix metalloproteinase-8 (MMP-8) determinations were performed to assess the presence of intraamniotic inflammation. Intraamniotic inflammation was defined as an elevated AF MMP-8 concentration (>23 ng/mL). The intensity of the FIR was determined by the umbilical cord plasma concentrations of C-reactive protein (CRP). Patients were divided into 3 groups according to the presence or absence of intraamniotic inflammation and AF culture results: group 1, without intraamniotic inflammation and with a negative AF culture (n = 28); group 2, with intraamniotic inflammation and with a negative AF culture (n = 26); group 3, with a positive AF culture (n = 35). Results Neonates who were born to mothers with intraamniotic inflammation and negative AF cultures had a significantly higher median umbilical cord plasma CRP concentration than did those without intraamniotic inflammation and a negative AF culture ( P < .005) but a significantly lower median cord plasma CRP concentration than did those with proven AF infection ( P < .05). Patients with intraamniotic inflammation and a negative AF culture had significantly higher median AF MMP-8 concentrations and WBC count than did those without intraamniotic inflammation and a negative AF culture ( P < .001). However, there was no significant difference in the median AF MMP-8 and WBC count between patients with intraamniotic inflammation and a negative AF culture and those with proven AF infection (MMP-8, P > .1, and WBC, P = .09). Conclusion Intraamniotic inflammation without documented AF infection is a risk factor for a systemic FIR. However, the magnitude of the FIR in those cases was lower than in those with documented AF infection.
Editor: Philadelphia, PA: Elsevier Inc
Idioma: Inglês

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The intensity of the fetal inflammatory response in intraamniotic inflammation with and without microbial invasion of the amniotic cavity

Lee, Si Eun, MD ; Romero, Roberto, MD ; Jung, Hanna, MT ; Park, Chan-Wook, MD ; Park, Joong Shin, MD, PhD ; Yoon, Bo Hyun, MD, PhD

Philadelphia, PA: Elsevier Inc

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