Abstract
BackgroundTo evaluate the influence of microbial invasion of the amniotic cavity (MIAC) and histological chorioamnionitis (HCA) on the magnitude of intra-amniotic inflammatory response in preterm prelabor rupture of membranes (PPROM).Methodology/Principal FindingA prospective cohort study was performed in 107 women with PPROM between 23.0 and 36.6 weeks of gestational age. Twenty-six proteins were assayed by multiple immunoassay in amniotic fluid. The policy for PPROM in Czech Republic is active, and 90% of the women were delivered within 96 hours of membrane rupture. Histopathological placental findings were evaluated based on the Salafia classification. Data were analyzed in four subgroups of population according to the presence of MIAC and/or HCA. Results were stratified by gestational age at PPROM (< or ≥34.0 weeks). The rates of MIAC and HCA were 44% and 57%, respectively. Regardless of gestational age at PPROM, intra-amniotic inflammatory response was higher when MIAC and HCA were both present. There were no differences in the intra-amniotic inflammatory response between women with MIAC or HCA alone and women without infection.ConclusionA higher intra-amniotic inflammatory response was identified when both HCA and MIAC were detected.
Highlights
Microbial invasion of the amniotic cavity (MIAC) has been extensively related to neonatal morbidity and mortality in pregnancies with preterm prelabor rupture of membranes (PPROM) [1,2,3,4,5]
Higher intraamniotic inflammatory response has been reported in the presence of microbial invasion of the amniotic cavity (MIAC) [6,7,8,9] and in the presence of histological chorioamnionitis (HCA) [10,11], suggesting that the amniotic cavity and the placenta may play a role in the inflammatory response
Since intra-amniotic inflammation seems to be a risk factor for morbidity in PPROM at least as important as MIAC, the aim of this study was to evaluate the magnitude of intra-amniotic inflammatory response according to the presence of MIAC and HCA
Summary
Microbial invasion of the amniotic cavity (MIAC) has been extensively related to neonatal morbidity and mortality in pregnancies with preterm prelabor rupture of membranes (PPROM) [1,2,3,4,5]. Higher intraamniotic inflammatory response has been reported in the presence of MIAC [6,7,8,9] and in the presence of histological chorioamnionitis (HCA) [10,11], suggesting that the amniotic cavity and the placenta may play a role in the inflammatory response. To evaluate the influence of microbial invasion of the amniotic cavity (MIAC) and histological chorioamnionitis (HCA) on the magnitude of intra-amniotic inflammatory response in preterm prelabor rupture of membranes (PPROM)
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