scholarly journals Maternal Plasma Procalcitonin Concentrations in Pregnancy Complicated by Preterm Premature Rupture of Membranes

2007 ◽  
Vol 2007 ◽  
pp. 1-5 ◽  
Author(s):  
Andrzej Torbé
Keyword(s):  
Group Analysis ◽  
Congenital Infection ◽  
Neonatal Infection ◽  
Maternal Plasma ◽  
Vaginal Fluid ◽  
Premature Rupture Of Membranes ◽  
Premature Rupture ◽  
Predictive Values ◽  
Preterm Premature Rupture ◽  
Healthy Women

Objectives. Our objective is to compare maternal plasma procalcitonin concentrations in preterm premature rupture of membranes (pPROM) and premature rupture of membranes (PROM) at term with their levels in uncomplicated pregnancy, and to determine whether these concentrations are useful in the diagnosis of pPROM cases suspected of infection and in the prediction of pPROM-to-delivery interval. Study design. Forty eight patients with pPROM, 30 with PROM at term, 31 healthy women at preterm gestation, and 33 healthy women at term were included. In pPROM group, analysis of procalcitonin concentrations with reference to leucocytosis, serum C-reactive protein, vaginal fluid culture, neonatal infection, histological chorioamnionitis and pPROM-to-delivery interval was carried out.Results. Procalcitonin concentrations in pPROM and PROM at term cases were comparable. However, in both groups procalcitonin values were significantly higher than in healthy controls in approximate gestational age. In pPROM group, procalcitonin concentrations between the patients with and without laboratory indices of infection were comparable, as well as between patients who gave birth to newborns with and without congenital infection, and between patients with and without histological chorioamnionitis. The predictive values of procalcitonin determinations were poor.Conclusion. The value of maternal plasma procalcitonin determinations in the diagnostics of pPROM cases suspected of intraamniotic infection, as well as for the prediction of pPROM-to-delivery interval, newborn's infection or histological chorioamnionitis is unsatisfactory. However, procalcitonin concentrations are elevated, both in patients with preterm and term PROMs in comparison to healthy pregnants, and therefore further evaluations are necessary to establish the role of procalcitonin in the pathophysiology of pregnancy.

Preterm premature rupture of membranes at 32–34 weeks of gestation: duration of membrane rupture period and maternal blood indicators relation with congenital infection

2015 ◽  
Vol 21 (4) ◽  
pp. 161-170
Author(s):  
Ieva Daunoravičienė ◽  
Rūta Lenkutienė ◽  
Audrė Musteikytė ◽  
Diana Ramašauskaitė
Keyword(s):  
Congenital Infection ◽  
Intrauterine Infection ◽  
Maternal Blood ◽  
Maternal Serum ◽  
Prognostic Indicators ◽  
Youden Index ◽  
Premature Rupture Of Membranes ◽  
Premature Rupture ◽  
Membrane Rupture ◽  
Preterm Premature Rupture

Background. The study investigates the influence of the length of membrane rupture period among pregnant women with preterm premature rupture of membranes (PPROM) between the 32nd and 34th weeks of gestation on the development of chorioamnionitis and the congenital infection of a newborn. It seeks to ascertain the values of indicators in mother’s blood that enable to predict chorioamnionitis and funisitis for mothers, and congenital infection for newborns. Materials and methods. A retrospective study of case records of women with PPROM at 32 (32 w. + 0 d)–34 (33 w. + 6 d) weeks of gestation and their newborns was performed. Two comparative groups were made: 1) of women who had funisitis and / or chorioamnionitis with or without deciduitis and 2) of women having no proved inflammation (according to the results of histological examination of placentae). Analogically, comparative groups were made of their newborns: those who had diagnosis of congenital infection and those who had no infection. The duration of membrane rupture period and the blood markers were investigated in all the groups. Results. The study included 135 women. Duration of the membrane rupture period lasted 85.17 ± 84.72 hrs in the group of women who had histological inflammation, and 40.06 ± 56.57 hrs in the group with no inflammation, P = 0.01, AUC = 0.735; the critical membrane rupture period value for developing intrauterine infection by the Youden index was 43.7 hrs. The corresponding maternal CRP values (mg/l) were 25.85 ± 40.27 vs. 5.23 ± 7.88 (P = 0.01, AUC = 0.6), the Youden index 4.6 mg/l. For the mothers of the newborns diagnosed with infection, the duration of the membrane rupture period was 55.95 ± 65.04 hrs, for the mothers of the newborns without congenital infection it was 40.25 ± 73.71 hours. Respectively, CRP values for the mothers of newborns averaged 12.25  ±  22.14  mg/l vs. 4.8 ± 4.82 mg/l (P = 0.005). Conclusions. Longer membrane rupture period and higher maternal CRP are correlated with inflammatory changes in the placenta and umbilical cord, thus they can be used as the prognostic indicators of intrauterine infection. When the duration of the membrane rupture period lasts ≥44 hrs, the risk of chorioamnionitis and funisitis increases five times; when the maternal serum CRP is higher than 5 mg/l, funisitis / chorioamnionitis is twice more frequent than at lower than 5 mg/l CRP values.

Value of Vaginal Fluid Proinflammatory Cytokines for the Prediction of Early-Onset Neonatal Infection in Preterm Premature Rupture of the Membranes

2007 ◽  
Vol 27 (5) ◽  
pp. 393-398 ◽  
Author(s):  
Andrzej Torbé ◽  
Ryszard Czajka ◽  
Agnieszka Kordek ◽  
Rafał Rzepka ◽  
Sebastian Kwiatkowski ◽  
...  
Keyword(s):  
Proinflammatory Cytokines ◽  
Early Onset ◽  
Neonatal Infection ◽  
Vaginal Fluid ◽  
Premature Rupture ◽  
Preterm Premature Rupture

Daily monitoring of vaginal interleukin 6 as a predictor of intraamniotic inflammation after preterm premature rupture of membranes – a new method of sampling studied in a prospective multicenter trial

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Gregor Seliger ◽  
Michael Bergner ◽  
Roland Haase ◽  
Holger Stepan ◽  
Ekkehard Schleußner ◽  
...  
Keyword(s):  
Synthetic Fiber ◽  
New Technique ◽  
Vaginal Fluid ◽  
Daily Routine ◽  
Premature Rupture Of Membranes ◽  
Premature Rupture ◽  
Daily Monitoring ◽  
Preterm Premature Rupture ◽  
A New Technique ◽  
Fluid Sampling

Abstract Objectives (A) To introduce a new technique for vaginal fluid sampling (biocompatible synthetic fiber sponge) and (B) evaluate the collected vaginal fluid interleukine-6 (IL-6vag)-concentration as a new diagnostic tool for daily monitoring of intrauterine inflammation after preterm premature rupture of membranes (PPROM). Secondary objectives were to compare the potential to predict an intrauterine inflammation with established inflammation parameters (e.g., maternal white blood cell count). Methods This prospective clinical case-control diagnostic accuracy multicenter study was performed with women after PPROM (gestational age 24.0/7 – 34.0/7 weeks). Sampling of vaginal fluid was performed once daily. IL-6vag was determined by electrochemiluminescence-immunoassay-kit. Neonatal outcome and placental histology results were used to retrospectively allocate the cohort into two subgroups: 1) inflammation and 2) no inflammation (controls). Results A total of 37 cases were included in the final analysis. (A): Measurement of IL-6 was successful in 86% of 172 vaginal fluid samples. (B): Median concentration of IL-6vag in the last vaginal fluid sample before delivery was significantly higher within the inflammation group (17,085 pg/mL) compared to the controls (1,888 pg/mL; p=0.01). By Youden’s index an optimal cut-off for prediction an intrauterine inflammation was: 6,417 pg/mL. Two days before delivery, in contrast to all other parameters IL-6vag remained the only parameter with a sufficient AUC of 0.877, p<0.001, 95%CI [0.670–1.000]. Conclusions This study established a new technique for vaginal fluid sampling, which permits assessment of IL-6vag concentration noninvasively in clinical daily routine monitoring.

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