Abstract
ObjectiveTo evaluate the inflammatory pattern in maternal circulation, amniotic cavity, cervix and vagina from women with preterm prelabor rupture of membranes (PPROM) considering the occurrence of microbial invasion of the amniotic cavity (MIAC).MethodologyA prospective study was performed in 58 women with PPROM before 34+0 weeks of gestational age. Twenty-six proteins were analyzed by a multiple immunoassay in samples of amniotic fluid, serum, cervix and vagina. Association of an inflammatory response in the invasive and non-invasive samples with MIAC was investigated.ResultsThe rate of MIAC was 36.2% (21/58). Both amniotic fluid IL-6 and cervical C-reactive protein (CRP) showed to be independent predictors of MIAC. A cut-off level of cervical CRP≥1836 pg/mL showed a detection rate of 75%, false positive rate of 19% and positive and negative predictive values to predict MIAC of 67% and 87%, respectively. There were no independent biomarkers of MIAC either in the serum or vaginal compartment.ConclusionA cervical inflammatory response mediated by CRP was observed in PPROM women with MIAC. Evaluation of serum or vaginal samples did not add valuable information regarding the outcome evaluated.
Highlights
Preterm prelabor rupture of membranes (PPROM) is responsible for approximately one-third of spontaneous preterm deliveries and for a substantial proportion of neonatal morbidity and mortality in relation to gestational age and the risk of infection [1].Several inflammatory biomarkers alone or in combination have been previously reported as predictors of microbial invasion of the amniotic cavity (MIAC) in the amniotic fluid compartment in women with preterm labor either with intact membranes (PTL) or with PPROM [2,3,4,5,6,7,8,9]
A cervical inflammatory response mediated by C-reactive protein (CRP) was observed in PPROM women with MIAC
The identification of non-invasive inflammatory biomarkers in women with PPROM is relevant from a clinical point of view, considering the risk but the difficulty of an invasive procedure to obtain amniotic fluid in these women, most of them complicated with oligohydramnios
Summary
Several inflammatory biomarkers alone or in combination have been previously reported as predictors of microbial invasion of the amniotic cavity (MIAC) in the amniotic fluid compartment in women with preterm labor either with intact membranes (PTL) or with PPROM [2,3,4,5,6,7,8,9]. Few studies have been carried out in the subgroup of women with PPROM with poor predictive capacity to predict MIAC by non-invasive fluids [10,12]. Few information is available on this topic and studies are needed to determine whether the inflammatory status in non-invasive samples predict either the inflammatory/infectious status in the amniotic cavity. The identification of non-invasive inflammatory biomarkers in women with PPROM is relevant from a clinical point of view, considering the risk but the difficulty of an invasive procedure to obtain amniotic fluid in these women, most of them complicated with oligohydramnios
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
