1.The value of the soluable intercellular adhesion molecule-1 levels in matermal serum for determination of occult chorioamnionitis in premature rupture of membranes.
Li, ZOU ; Huijun, ZHANG ; Jianfang, ZHU ; Jianwen, ZHU
Journal of Huazhong University of Science and Technology (Medical Sciences) 2004;24(2):154-7
To compare the diagnostic value of soluble intercellular adhesion molecule 1 (sICAM-1) with that of c-reactive protein (CRP) for detecting chorioamnionitis (CAM) in serum of women with premature rupture of membranes (PROM), 55 pregnant women with PROM, including 18 pregnant women with preterm premature rupture of membranes (PPROM) and 20 normal pregnant women at term (TPROM) were studied. Maternal serum were measured by Sandwish enzyme-linked immunoabsorbent assay (ELISA) for sICAM. CAM was histologically confirmed after delivery. The results revealed that (1) maternal serum levels of sICAM-1 and CRP were significantly higher in women with PROM than those without it; (2) maternal serum levels of sICAM-1 and CRP were significantly higher in women with CAM than those without it; (3) serum levels of sICAM-1 in PPROM women were similar to those in TPROM women, whereas serum levels of CRP in PPROM women were significantly higher than those in TPROM women; (4) the sensitivity, specificity, positive predictive value, negative predictive value, Kappa index and area under receiver operating characteristic (ROC) curve of maternal serum sICAM-1 (cutoff 104.7 ng/ml) and CRP (cutoff 1.03 mg/dl) for diagnosing CAM were 100%, 91.2%, 87.5%, 100%, 0.20, 0.995 and 81.0%, 73.5%, 65.4%, 86.2%, 0.13, 0.811, respectively; (5) among the mild histological CAM group, severe histological CAM group and clinical CAM group, the difference in maternal serum levels of sICAM-1 were significantly (P<0.001), with the order of concentration from high level to low level corresponding to the severity of CAM. It is concluded that maternal serum level of ICAM-1 is superior to that of CRP as biomarker for diagnosing intraamniotic infection in pregnant women with PROM.
Biological Markers/blood
;
Chorioamnionitis/*blood
;
Chorioamnionitis/diagnosis
;
Chorioamnionitis/etiology
;
Fetal Membranes, Premature Rupture/*blood
;
Intercellular Adhesion Molecule-1/*blood
2.A clinical study on the significance of the C-reactive protein in diagnosing the chorioamnionitis in patients with premature rupture of membrane.
Soo Young CHUNG ; Soo Ha EOM ; Hyung Keun YOON ; Soo Jai SHIN ; Sung Do KIM ; Jai Yeoung AHN
Korean Journal of Obstetrics and Gynecology 1993;36(3):295-302
No abstract available.
C-Reactive Protein*
;
Chorioamnionitis*
;
Female
;
Humans
;
Membranes*
;
Pregnancy
;
Rupture*
3.Association of Membrane Thickness, Histopathologic Findings and Premature Rupture of the Membranes.
Joon Cheol PARK ; Sung Do YOON
Korean Journal of Obstetrics and Gynecology 2003;46(7):1385-1390
OBJECTIVE: The aim of our study was to compare the thickness and histopathologic changes in the fetal membrane between premature rupture of membranes (PROM) and intact membrane after delivery. METHODS: In a prospective study involving 31 patients who were divided into 4 groups such as <37 weeks without PROM, <37 weeks with PROM, >or=37 weeks without PROM, and >or=37 weeks with PROM, we measured the thickness of membrane and studied the histopathologic findings in vitro by light microscopy of histological sections. RESULTS: The membrane thickness of <37 weeks with PROM group was thinner (35.9 micrometer) than that (42.3 micrometer) of <37 weeks without PROM group, but there was no statistical significance. The membrane thickness of >or=37 weeks with PROM and >or=37 weeks without PROM were similar (25.6 micrometer, 26.0 micrometer). But the membrane thickness of >or=37 weeks with/without PROM was significantly thinner (25.8 micrometer) compared with that (38.9 micrometer) of <37 weeks with/without PROM. The histopathologic features of PROM positive group was amnionitis with neutrophilic infiltration, focally or diffusely necrotic change of amniotic membrane, separation of amniotic membrane and degeneration of chorionic villi. CONCLUSION: The thickness of fetal membrane between PROM group and intact membrane group was not different but the thickness of fetal membrane between <37 weeks and >or=37 weeks was statistically significant. The histopathologic change of PROM positive group was prominent as amnionitis. Further evaluation will be needed about the relationship between membrane thickness and PROM.
Amnion
;
Chorioamnionitis
;
Chorionic Villi
;
Extraembryonic Membranes
;
Female
;
Humans
;
Membranes*
;
Microscopy
;
Neutrophils
;
Pregnancy
;
Prospective Studies
;
Rupture*
4.Positive Maternal C-Reactive Protein Predicts Neonatal Sepsis.
Ji Hyun JEON ; Ran NAMGUNG ; Min Soo PARK ; Koo In PARK ; Chul LEE
Yonsei Medical Journal 2014;55(1):113-117
PURPOSE: To evaluate the diagnostic performance of maternal inflammatory marker: C-reactive protein (CRP) in predicting early onset neonatal sepsis (that occurring within 72 hours after birth). MATERIALS AND METHODS: 126 low birth weight newborns (gestation 32+/-3.2 wk, birth weight 1887+/-623 g) and their mothers were included. Neonates were divided into sepsis group (n=51) including both proven (positive blood culture) and suspected (negative blood culture but with more than 3 abnormal clinical signs), and controls (n=75). Mothers were subgrouped into CRP positive > or =1.22 mg/dL (n=48) and CRP negative <1.22 mg/dL (n=78) group, determined by Receiver Operating Characteristic curves, and odds ratio was calculated for neonatal sepsis according to maternal condition. RESULTS: Maternal CRP was significantly higher in neonatal sepsis group than in control (3.55+/-2.69 vs. 0.48+/-0.31 mg/dL, p=0.0001). Maternal CRP (cutoff value >1.22 mg/dL) had sensitivity 71% and specificity 84% for predicting neonatal sepsis. Maternal CRP positive group had more neonatal sepsis than CRP negative group (71% vs. 29%, p<0.001). Odds ratio of neonatal sepsis in maternal CRP positive group versus CRP negative group was 10.68 (95% confidence interval: 4.313-26.428, p<0.001). CONCLUSION: The risk of early onset neonatal sepsis significantly increased in the case of positive maternal CRP (> or =1.22 mg/dL). In newborn of CRP positive mother, the clinician may be alerted to earlier evaluation for possible neonatal infection prior to development of sepsis.
C-Reactive Protein/*metabolism
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Chorioamnionitis/metabolism
;
Female
;
Humans
;
Infant, Newborn
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Male
;
Mothers
;
Pregnancy
;
Sepsis/diagnosis/*metabolism
5.The relationship between amniotic fluid white blood cell count and the presence and severity of acute placental inflammation in preterm premature rupture of membrane.
Korean Journal of Obstetrics and Gynecology 2000;43(5):885-890
OBJECTIVE: Acute inflammatory lesions in the placenta is one of the most common histopathologic lesions of women with preterm premature rupture of membrane. But there is a few scientific evidence to support the association between amniotic fluid white blood cell count and the presence and severity of acute placental inflammation in preterm premature rupture of membrane. To evaluate the relationship between amniotic fluid white blood cell count and the presence and severity of acute placental inflammatory lesions in preterm premature rupture of membrane. METHODS: The relationship between amniotic fluid white blood cell count and placental histologic finding was examined in 89 consecutive patients who were admitted with the diagnosis of preterm premature rupture of membrane and who delivered singleton gestation within 3 days. RESULTS: The prevalence of acute histologic chorioamnionitis was 68.5%(61/89) and that of positive amniotic fluid culture was 32.6%(29/89). The prevalence of positive amniotic fluid culture increased according to the higher severity of inflammation in each type of placental section(p<0.05 for each). The median amniotic fluid white blood cell count increased significantly according to the presence and higher severity of inflammation in each type of placental section(p<0.01 for each). The median amniotic fluid white blood cell count increased significantly according to the higher total grade of inflammation in placental histologic examination(p<0.01). CONCLUSION: Both the presence and higher severity of acute histologic chorioamnionitis are associated with an elevated amniotic fluid white blood cell count. The total grade of acute histologic chorioamnionitis is associated with an elevated amniotic fluid white blood cell count. Amniotic fluid white blood cell count is a reliable prenatal marker of histologic chorioamnionitis."
Amniotic Fluid*
;
Chorioamnionitis
;
Diagnosis
;
Female
;
Humans
;
Inflammation*
;
Leukocyte Count*
;
Leukocytes*
;
Membranes*
;
Placenta
;
Pregnancy
;
Prevalence
;
Rupture*
6.The Clinical Utility of Amnioinfusion in Oligohydroamnios following PPROM.
Mi Kyung KIM ; Hye Sung WON ; Myung Shin SHIN ; So Ra KIM ; Ji Yoon CHUNG ; Pil Ryang LEE ; In Sik LEE ; Ahm KIM
Korean Journal of Obstetrics and Gynecology 2001;44(2):364-368
OBJECTIVE: This study was performed to evaluate the clinical utility of transabdominal prophylactic amnioinfusion on oligohydroamnios caused by preterm premature rupture of membrane(PPROM). METHODS: There were 59 singleton pregnant women with oligohydroamnios caused by PPROM who were treated by transabdominal amnioinfusion at the department of from March 1997 to December 1998. Nineteen pregnant women who underwent prophylactic amnioinfusion were designated as study group and 40 pregnant women who did not undergo prophylactic amnioinfusion were designated as control group. Clinical data were drawn from medical records, such as time interval from amnioinfusion to deliver, birth weight, incidence of variable deceleration, Apgar score at 1 minute, Apgar score at 5 minutes, and so on. Statistical analyses were performed by means of Student t test, Mann Whitney U-test, Fisher's exact test where appropriate. P value below 0.05 was considered significant. RESULTS: The median interval from amnioinfusion to delivery w as longer in study group than in control group (13.0 29.3 days vs. 5.0 13.0 days, p<0.05). The incidence of variable deceleration during labor in study group was 16% and that in control group was 43%(p<0.05). The incidence of Apgar score at 5 minutes below 7 was lower in study group than that in control group(39% vs. 43%, p<0.05). The incidence of respiratory distress syndrome was lower in study group than that in control group(16% vs. 83%, p=0.05) However, there were no significant difference in the incidence of respiratory distress syndrome between them who did not undergo dexamethasone treatment, in mode of delivery, birth weight, and incidence of chorioamnionitis between two groups. CONCLUSION: Transabdominal prophylactic amnioinfusion may have a positive role in the management of PPROM.
Apgar Score
;
Birth Weight
;
Chorioamnionitis
;
Deceleration
;
Dexamethasone
;
Female
;
Humans
;
Incidence
;
Medical Records
;
Pregnancy
;
Pregnant Women
;
Rupture
7.The relationship between the presence, severity and pattern of acute placental inflammation and amniotic fluid interleukin-8 in preterm labor.
Jae Weon CHANG ; Bo Hyun YOON ; Hee Chul SYN
Korean Journal of Obstetrics and Gynecology 1999;42(12):2669-2674
OBJECTIVE: To evaluate the relationship between amniotic fluid interleukin-8 and the presence, severity and pattern of acute inflammatory lesions in the placenta delivered after preterm labor with intact membranes. METHODS: The relationship between placental histologic finding and amniotic fluid interleukin-8 was examined in 46 consecutive patients who were admitted with the diagnosis of preterm labor with intact membranes and who delivered singleton gestations within 5 days. RESULTS: The prevalence of acute histologic chorioamnionitis was 63.0%(29/46) and that of positive amniotic fluid culture was 17.4%(8/46). The most frequent site of histologic inflammation was chorion-decidua(56.5%, 26/46). The median amniotic fluid interleukin-8 increased significantly according to the presence and higher severity of inflammation in each type of placental section (p<0.05 for each). Three patterns of inflammation were identified in chorion-decidua: non-marginating, marginating, and mixed. Median amniotic fluid interleukin-8 and the rate of severe histologic chorioamnionitis (grade> or = 4) increased significantly in the order of non-marginating, marginating, and mixed (p<0.05 for each). CONCLUSION: Both the presence and greater severity of acute histologic chorioamnionitis are associated with an elevated amniotic fluid interleukin-8. A marginating and mixed pattern of inflammation are associated with a higher amniotic fluid interleukin-8. Amniotic fluid interleukin-8 is a reliable prenatal marker of histologic chorioamnionitis.
Amniotic Fluid*
;
Chorioamnionitis
;
Diagnosis
;
Female
;
Humans
;
Inflammation*
;
Interleukin-8*
;
Membranes
;
Obstetric Labor, Premature*
;
Placenta
;
Pregnancy
;
Prevalence
8.A systematic review of amniopatch.
Journal of the Korean Medical Association 2016;59(5):387-394
The objective of this review is to evaluate the safety and effectiveness of the amniopatch procedure for the treatment ofpreterm premature rupture of the membranes. The searches were conducted via electronic databases including Ovid-MEDLINE, Ovid-Embase, the Cochrane Library, and eight Korean databases. In the study design, in addition to randomized controlled trials, case report studies in which patients underwent the amniopatch procedure were included. Two reviewers independently selected data in standardized form and assessed the methodological quality. Quality evaluation was performed by the SIGN (Scottish Intercollegiate Guideline Network) method. A total of 11 studies (2 cohort studies, 1 case series, and 8 case reports) were included. There were no serious maternal or fetal complications. It was reported that there were lower rates of maternal chorioamnionitis after the amniopatch relative to conservative treatment (control). The mean gestational age at delivery was 27.7 weeks (a total of 70 cases in 10 studies; spontaneous group, 27.6 weeks; iatrogenic group, 27.8 weeks). The amniopatch was successful in 46.6% of cases (33/71 cases in 11 studies). The overall neonatal survival rate was 55.3% (52/94 cases in 11 studies). Neonatal morbidity was 23.4% (11/47 cases in 7 studies). Although this systematic review, did not find clear evidence of the safety and effectiveness, the amniopatch procedure is a viable treatment option to prolong a pregnancy with previable premature rupture of membranes.
Blood Platelets
;
Chorioamnionitis
;
Cohort Studies
;
Female
;
Gestational Age
;
Humans
;
Membranes
;
Pregnancy
;
Rupture
;
Survival Rate
9.Neonatal Spontaneous Gastric Perforation Caused by Group B Streptococcus (GBS) Chorioamnionitis.
Korean Journal of Perinatology 2007;18(4):438-442
We describe a case of spontaneous neonatal gastric perforation in a premature infant girl of 27(+1)- week gestational age with respiratory distress syndrome baby. The patient presented within postnatal 36 hours with abdominal distension, respiratory distress, and massive pneumoperitoneum on radiography. Ischemic perforation of the stomach tissues caused by an intrauterine infection from group B streptococcus chorioamnionitis was noted. This is the first report of a spontaneous neonatal gastric perforation caused by group B streptococcus chorioamnionitis in the literature.
Chorioamnionitis*
;
Female
;
Gestational Age
;
Humans
;
Infant, Newborn
;
Infant, Premature
;
Pneumoperitoneum
;
Pregnancy
;
Radiography
;
Stomach
;
Streptococcus*
10.Influence of histologic chorioamnionitis and funisitis on the level of peripheral blood C-reactive protein at birth in preterm infants.
Do Hyun KIM ; Heun Ji LEE ; Hee Sup KIM ; Byoung Hoon YOO
Korean Journal of Pediatrics 2010;53(1):33-40
PURPOSE: The objective of this study is to determine the change of C-reactive protein (CRP) levels in the peripheral blood of preterm infants at birth according to the stage of intrauterine inflammation. METHODS: A total of 187 infants (<32 weeks of gestation) were divided into a "no histologic chorioamnionitis" [HCAM (-), n=85] group and a "histologic chorioamnionitis" [HCAM (+), n=102] group according to placental pathologic findings. Furthermore, the HCAM (+) group was subdivided into a "funisitis" [F (+), n=49] group and a "no funisitis" [F (-), n=53] group and also into a "funisitis/amnionitis" [FA (+), n=58] group and an "isolated chorio-deciduitis" [FA (-), n=44] group. High-sensitivity CRP levels in the peripheral blood at birth were measured. RESULTS: Peripheral blood CRP levels were significantly higher in the HCAM (+), F (+), F (-), and FA (+) groups than in the HCAM (-) group, but were not significantly different between the FA (-) and HCAM (-) groups. In addition, peripheral blood CRP levels were significantly higher in the F (+) and FA (+) groups than in the F (-) and FA (-) groups, respectively. For identification of amnionitis or funisitis, a cut-off value of 0.02 mg/dL was chosen. Clinical chorioamnionitis, proven early onset sepsis, histologic chorioamnionitis, and funisitis had higher incidences in infants with peripheral blood CRP levels higher than 0.02 mg/dL. CONCLUSION: The present study shows that peripheral blood CRP levels at birth in preterm infants born before 32 weeks' gestation is significantly increased in amnionitis or funisitis and might reflect the progress of histologic chorioamnionitis.
Amnion
;
C-Reactive Protein
;
Chorioamnionitis
;
Female
;
Humans
;
Incidence
;
Infant
;
Infant, Newborn
;
Infant, Premature
;
Parturition
;
Pregnancy
;
Sepsis