scholarly journals Cervical ureaplasma colonization affects intraamniotic inflammation in preterm labor with intact membrane: a cohort study

2021 ◽  
Author(s):  
Jin Gon Bae ◽  
Shin Kim ◽  
Il Seon Hwang ◽  
Ji Min Park ◽  
Jae Hyun Park
Keyword(s):  
Risk Factor ◽  
Preterm Labor ◽  
Independent Risk Factor ◽  
Adverse Outcomes ◽  
Control Group ◽  
Causative Role ◽  
Premature Rupture ◽  
Preterm Premature Rupture ◽  
Intact Membrane ◽  
Histologic Chorioamnionitis

Abstract Background: A causative role between cervical ureaplasma colonization and adverse outcomes during pregnancy has remained controversial. We investigated whether cervical ureaplasma colonization affects the biochemically or histologically intraamniotic inflammation in preterm birth.Methods: Amniotic fluid was retrieved during delivery. Various chorioamnionitis-related cytokines (interleukin (IL)-1β, -6, -8, -10, and tumor necrosis factor-α) and regulators (matrix metalloproteins (MMP)-8 and MMP-9) were measured with Human Magnetic Luminex screening assay. We tested cervical swab specimens using real-time polymerase chain reaction assays for the detection of ureaplasma spp. colonization. Considering the clinical situation that causes intraamniotic infection, we arbitrarily divided into three categories of preterm labor with intact membrane, preterm premature rupture of membrane (PPROM), and control group with no exposure to preterm labor or preterm premature rupture of membrane.Results: The incidence of cervical ureaplasma colonization was 49.3% (136/276). The incidence of histologic chorioamnionitis was 27.5% (76/200). All differences in cytokines and regulators according to histologic chorioamnionitis were significant. Of the 153 cases that experienced preterm labor with intact membrane, IL-10, MMP-8, and MMP-9 levels in the ureaplasma positive group were significantly higher than those of the ureaplasma negative group. According to logistic regression analysis adjusted to preterm labor with intact membrane, PPROM, and gestational age at delivery, cervical ureaplasma colonization was an independent risk factor of histologic chorioamnionitis (odd ratio: 2.622, 95% confidence interval: 1.443-4.766).Conclusions: Cervical ureaplasma colonization augments biochemically intraamniotic inflammation in preterm labor with intact membrane, and was an independent risk factor of histologic chorioamnionitis.

Funisitis is more common in cervical insufficiency than in preterm labor and preterm premature rupture of membranes

2016 ◽  
Vol 44 (5) ◽  
Author(s):  
Joohee Choi ◽  
Jeong Woo Park ◽  
Byoung Jae Kim ◽  
Ye-Jin Choi ◽  
Jong Hee Hwang ◽  
...  
Keyword(s):  
Preterm Birth ◽  
Gestational Age ◽  
Preterm Labor ◽  
Cervical Insufficiency ◽  
Premature Rupture Of Membranes ◽  
Premature Rupture ◽  
Preterm Premature Rupture ◽  
Histologic Chorioamnionitis ◽  
Gestational Age At Delivery ◽  
The Difference

AbstractTo compare the frequency of histologic chorioamnionitis and funisitis among women experiencing preterm labor, preterm premature rupture of membranes (PROM) and cervical insufficiency.This retrospective cohort study included singleton pregnant women who delivered at ≤36 weeks of gestation. The patients with preterm birth were subdivided into preterm labor (n=117), preterm PROM (n=153), and cervical insufficiency (n=20). All placentas were examined for pathology, according to the criteria of1) Histologic chorioamnionitis was diagnosed in 48.7% (57/117) of cases with preterm labor, 47.4% (73/153) with preterm PROM, and 75.0% (15/20) with cervical insufficiency. Funisitis was detected in 11.1% (13/117) of cases with preterm labor, 15.7% (24/153) with preterm PROM, and 40.0% (8/20) with cervical insufficiency. 2) Frequency of histologic chorioamnionitis was higher in cases with cervical insufficiency compared to preterm PROM. Frequency of funisitis was higher in cases with cervical insufficiency compared to both preterm labor and preterm PROM (P<0.05). The difference in frequency of funisitis remained significant after adjustment for gestational age at delivery and cervical dilatation at diagnosis. 3) Frequency of grade 2 funisitis was higher in cases with cervical insufficiency (35.0%, 7/20) compared to both preterm labor (6.8%, 8/117) and preterm PROM (9.8%, 15/153) (P=0.001). And the difference remained significant after adjustment for gestational age at delivery and cervical dilatation at diagnosis.: The highest frequency of funisitis was observed in cervical insufficiency among cases with spontaneous preterm birth.

scholarly journals Lower genital tract infections in preterm premature rupture of membranes and preterm labor: a case-control study from Vietnam

2021 ◽  
Vol 15 (06) ◽  
pp. 805-811
Author(s):  
Quoc Huy Vu Nguyen ◽  
Hung Nam Le ◽  
Van Anh Ton Nu ◽  
Nguyen Dac Nguyen ◽  
Minh Tam Le
Keyword(s):  
Preterm Labor ◽  
Case Control Study ◽  
Aerobic Bacteria ◽  
Control Group ◽  
Premature Rupture Of Membranes ◽  
Premature Rupture ◽  
Preterm Premature Rupture ◽  
Group 2 ◽  
Control Study ◽  
Group 1

Introduction: This study aimed to determine the incidence of lower genital infections and related factors in preterm premature rupture of membranes (PPROM) and preterm labor. Methodology: A case-control study was conducted on pregnant women who were admitted to the Hospital of Hue University of Medicine and Pharmacy, Vietnam between November 2017 and May 2019. Cases from 22 to 36 gestational weeks were included as group 1 (patients with preterm labor and intact membranes) or as group 2 (those with PPROM). The control group included women with singleton pregnancies who were matched on gestational age and recruited concurrently with the study cases. Gram stain was perfomed to identify Lactobacillus, Gardnerella, mobiluncus, Candida, and leucocytes. Trichomonas vaginalis was detected by wet mount. Cultures of vaginal secretions and aminotic fluid were performed to identify aerobic bacteria. Results: Bacterial vaginosis was higher in group 1 (28.9%) compared to control (11.4%). The incidence of isolated aerobic bacteria was 44.1% in group 2, 11.1% in group 1, and 12.7% in the control group (p < 0.001). Fungal infection was not shown to be a risk factor for preterm labor (p = 0.990), whereas, bacterial vaginosis was (OR = 3.16; 95%CI = 1.23-8.15; p = 0.016). Isolated aerobic bacteria were associated with premature rupture of membranes (OR = 5.45; 95%CI = 2.11-14.05; p < 0.001). Conclusions: Bacteria vaginosis increased the risk of preterm labor and preterm premature rupture of membranes. Isolated aerobic bacteria were related to PPROM, while fungal infection was not associated with preterm labor.

scholarly journals Significance of bacterial vaginosis and periodontal infection as Predictors of preterm labor

2016 ◽  
Vol 15 (3) ◽  
pp. 441-449
Author(s):  
Gupta Pratiksha ◽  
Aggarwal Neha ◽  
Huria Anju ◽  
Lehl Gurvinder
Keyword(s):  
Bacterial Vaginosis ◽  
Preterm Labor ◽  
Ordinal Data ◽  
Medical Science ◽  
Control Group ◽  
Premature Rupture ◽  
Singleton Pregnancy ◽  
Infection Group ◽  
Preterm Premature Rupture ◽  
Periodontal Infection

Aims: To study the relationship between bacterial vaginosis and periodontal infection in third trimester and preterm labor.Settings and Design: The present prospective case control study was conducted in the Department of Obstetrics and Gynaecology from January 2007 to June 2008, Government Medical College and Hospital, Sector 32 Chandigarh in collaboration with Department of Dentistry of the same hospital. Institutional Ethics Committee approval was taken, a written informed consent was taken from the patients.Methods and Material: Antenatal patients after 28 weeks of period of gestation and with singleton pregnancy attending OPD were included. Besides routine antenatal examination, screening and clinical examination for bacterial vaginosis, dental examination for periodontal infection was done. A total of 500 patients were enrolled for the study. Out of the 500 patients examined, 200 patients were randomly selected and divided into 4 groups with 50 women in each. Group 1 was the control group and the subjects were negative for bacterial vaginosis and periodontal infection. Group 2 was positive for periodontal infection. Group 3 was positive for bacterial vaginosis. Group 4 was positive for both bacterial vaginosis and periodontal infection. All these patients were followed up till their pregnancy outcomes.Statistical analysis used: A sample size of 50 patients in each group was calculated to conduct study with a power greater than 80% at a significance level of 5%. Data was analyzed using SPSS version 15.0 for Windows. Bacterial vaginosis and periodontal infection were separately correlated to the preterm birth and perinatal outcome. For ordinal data, groups were compared using Mann Whitney U-test, for continuous data groups were tested for normal distribution using the Kolmogorov-Smirnov test and for categorical data groups were compared using the chi-square test. p<0.05 was considered statistically significant.Results: significant correlation was seen between periodontal infection and preterm labor & preterm premature rupture of membranes.Conclusions: significant correlation is seen between periodontal infection and preterm labor & preterm premature rupture of membranes.Key Messages: Prevention and treatment of periodontal infection in third stage of labour prevents preterm births.Bangladesh Journal of Medical Science Vol.15(3) 2016 p.441-449

scholarly journals Risk Factors for Neonatal Bronchopulmonary Dysplasia in Extremely Preterm Premature Rupture of Membranes: A Retrospective Study

2020 ◽  
Author(s):  
Eishin Nakamura ◽  
Shigetaka Matsunaga ◽  
Yoshihisa Ono ◽  
Yasushi Takai ◽  
Hiroyuki Seki
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Independent Risk Factor ◽  
Optimal Timing ◽  
Premature Rupture Of Membranes ◽  
Premature Rupture ◽  
Preterm Premature Rupture ◽  
Extremely Preterm ◽  
Gestational Week ◽  
The Mean

Abstract Background:Determination of the optimal timing for termination of pregnancy in cases of preterm premature rupture of membranes (pPROM) during the extremely preterm period is still difficult. Bronchopulmonary dysplasia (BPD) is a major disease widely taken into account when determining the prognosis of respiratory disorders in a neonate. Many aspects of this disease remain unclear. With the aim of further improving the prognosis of neonates born to mothers with pPROM, this study examined cases who were diagnosed with pPROM before 28 weeks of gestation. The study analysed risk factors for neonatal BPD and the optimal timing for termination of pregnancy in pPROM cases.Methods:Subjects were 73 cases of single pregnancy who were diagnosed with pPROM during the period from 22 weeks and 0 days to 27 weeks and 6 days of gestation. The following factors were retrospectively examined: the gestational week at which a diagnosis of pPROM was made; the gestational week at which delivery occurred; the period for which the volume of amniotic fluid was maintained; and neonatal BPD as a complication. A receiver operating characteristic (ROC) curve was drawn in order to analyse the relationship between the duration of oligohydramnios and the onset of BPD.ResultsThe mean gestational week at which a diagnosis of amniorrhexis was made was 24.5 ± 1.9 weeks (mean ± SD), and that at which delivery occurred was 27.0 ± 3.0 weeks. Fifty-seven cases (78.1%) were diagnosed with oligohydramnios, the mean duration of which was 17.4 ± 20.5 days. The mean birth weight of neonates was 1000 ± 455 g, of which 49 (67.1%) were diagnosed with BPD following birth. No neonates died in this study. Multivariate analysis of various risk factors for the onset of BPD indicated that oligohydramnios is an independent risk factor for BPD. The ROC curve indicated that the cut-off value was 4 days. In this case, the levels of sensitivity and specificity for predicting the onset of neonatal BPD were 0.941 and 0.917 respectively.ConclusionOur findings suggest that oligohydramnios is an independent risk factor for BPD in cases who are diagnosed with pPROM before 28 weeks of gestation.

scholarly journals Risk Factors for Neonatal Bronchopulmonary Dysplasia in Extremely Preterm Premature Rupture of Membranes: A Retrospective Study

2020 ◽  
Author(s):  
Eishin Nakamura ◽  
Shigetaka Matsunaga ◽  
Yoshihisa Ono ◽  
Yasushi Takai ◽  
Hiroyuki Seki
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Independent Risk Factor ◽  
Optimal Timing ◽  
Premature Rupture Of Membranes ◽  
Premature Rupture ◽  
Preterm Premature Rupture ◽  
Extremely Preterm ◽  
Gestational Week ◽  
The Mean

Abstract Background: Determination of the optimal timing for termination of pregnancy in cases of preterm premature rupture of membranes (pPROM) during the extremely preterm period is still difficult. Bronchopulmonary dysplasia (BPD) is a major disease widely taken into account when determining the prognosis of respiratory disorders in a neonate. Many aspects of this disease remain unclear. With the aim of further improving the prognosis of neonates born to mothers with pPROM, this study examined cases who were diagnosed with pPROM before 28 weeks of gestation. The study analysed risk factors for neonatal BPD and the optimal timing for termination of pregnancy in pPROM cases.Methods:Subjects were 73 cases of singleton pregnancy who were diagnosed with pPROM during the period from 22 weeks and 0 days to 27 weeks and 6 days of gestation. The following factors were retrospectively examined: the gestational week at which a diagnosis of pPROM was made; the gestational week at which delivery occurred; the period for which the volume of amniotic fluid was maintained; and neonatal BPD as a complication. A receiver operating characteristic (ROC) curve was drawn in order to analyse the relationship between the duration of oligohydramnios and the onset of BPD.Results: The mean gestational week at which a diagnosis of amniorrhexis was made was 24.5±1.9 weeks (mean±SD), and that at which delivery occurred was 27.0±3.0 weeks. Fifty-seven cases (78.1%) were diagnosed with oligohydramnios, the mean duration of which was 17.4±20.5 days. The mean birth weight of neonates was 1000±455 g, of which 49 (67.1%) were diagnosed with BPD following birth. No neonates died in this study. Multivariate analysis of various risk factors for the onset of BPD indicated that oligohydramnios is an independent risk factor for BPD. The ROC curve indicated that the cut-off value was 4 days. In this case, the levels of sensitivity and specificity for predicting the onset of neonatal BPD were 0.941 and 0.917 respectively.Conclusion: Our findings suggest that oligohydramnios is an independent risk factor for BPD in cases who are diagnosed with pPROM before 28 weeks of gestation.

scholarly journals Sildenafil versus Nifedipine Treatment of PRETERM LABOR: RCT

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
M A Alkady ◽  
M H Mostafa ◽  
R K Elkattan
Keyword(s):  
Preterm Labor ◽  
Normal Pregnancy ◽  
The United States ◽  
Labor Pain ◽  
University Hospital ◽  
P Value ◽  
Term Pregnancy ◽  
Premature Rupture ◽  
Preterm Premature Rupture ◽  
Future Therapy

Abstract Background a normal pregnancy lasts 37 to 42 weeks, counting from the first day of the last menstrual period. A pregnancy that continues beyond 37 weeks is called a “term” pregnancy. Preterm labor is defined as labor that begins before 37 weeks of pregnancy. Approximately 12 percent of babies in the United States are born preterm; 80 percent of these are due to preterm labor that occurs on its own or after preterm premature rupture of the fetal membranes (or “broken bag of waters”). The remaining 20 percent are planned early deliveries that are done for maternal or fetal problems that prevent the woman from being able to safely continue with her pregnancy. Aim of the Work to assess the efficacy of sildenafil for stopping the labor for 48 hrs compared to nifedipine in women with preterm labor. Patients and Methods this prospective study was carried on pregnant women with preterm labor pain at Ain Shams University Hospital from March 2018 till September 2018. Study includes 88 patients which were distributed into two groups: Group S: received Sildenafil to stop preterm labor.Group N: received Nifedipine to stop preterm labor. Results in the present study we found that mean age in group receiving sildenafil (group S) was 26.55 years and in group receiving nifidpine (group N) was 26.75 years with insignificant differences between two groups as regard age p-value 0.798, also as regard. BMI and parity there was insignificant differences between two groups as regard BMI p-value 0.727, 0.815 respectively, Mean Gestational age at admission was 27.1 weeks in group S and in group N was 28.16 with insignificant differences between two groups p-value 0.705. Conclusion administration of Sildenafil in women with preterm labor pain seems to be a promising future therapy of preterm labor with, limiting the teratogenic influence of the drugs on the fetus.

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