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Chorio amnionitis

Pietro Presicce, Chan-Wook Park, Paranthaman Senthamaraikannan, Sandip Bhattacharyya, Courtney Jackson, Fansheng Kong, Cesar M Rueda, Emily DeFranco, Lisa A Miller, David A Hildeman, Nathan Salomonis, Claire A Chougnet, Alan H Jobe, Suhas G Kallapur
Neutrophil infiltration of the chorioamnion-decidua tissue at the maternal-fetal interface (chorioamnionitis) is a leading cause of prematurity, fetal inflammation, and perinatal mortality. We induced chorioamnionitis in preterm rhesus macaques by intraamniotic injection of LPS. Here, we show that, during chorioamnionitis, the amnion upregulated phospho-IRAK1-expressed neutrophil chemoattractants CXCL8 and CSF3 in an IL-1-dependent manner. IL-1R blockade decreased chorio-decidua neutrophil accumulation, neutrophil activation, and IL-6 and prostaglandin E2 concentrations in the amniotic fluid...
March 22, 2018: JCI Insight
Ariarathinam Newtonraj, Manmeet Kaur, Madhu Gupta, Rajesh Kumar
BACKGROUND: Globally, India ranks first in the absolute number of stillbirths. Hence, the level, causes, and risk factors of stillbirths were estimated to facilitate designing of prevention strategy. METHODS: Capture and recapture method was used to identify 301 stillbirths from 1st July 2013 to 31st August 2014 in Chandigarh Union Territory of India. Verbal autopsies (n = 181) were done at household level to identify causes of stillbirths. Risk factors were determined using case-control approach...
November 13, 2017: BMC Pregnancy and Childbirth
M Vijayasree
Background Postpartum Haemorrhage causes significant maternal mortality and morbidity all over the world. Active management of the third stage of labour with oxytocics is come into practice. If postpartum haemorrhage is anticipated conservative surgical procedures like B-lynch suture is being applied. Objective To evaluate the effect of elective B-Lynch suture in preventing atonic postpartum haemorrhage during emergency caesarian section with high risk factors for atonicity. Method Forty antenatal women undergoing emergency caesarean section with risk factors for atony of the uterus were selected in our study...
January 2016: Kathmandu University Medical Journal (KUMJ)
Manalee Vishnu Surve, Anjali Anil, Kshama Ganesh Kamath, Smita Bhutda, Lakshmi Kavitha Sthanam, Arpan Pradhan, Rohit Srivastava, Bhakti Basu, Suryendu Dutta, Shamik Sen, Deepak Modi, Anirban Banerjee
Infection of the genitourinary tract with Group B Streptococcus (GBS), an opportunistic gram positive pathogen, is associated with premature rupture of amniotic membrane and preterm birth. In this work, we demonstrate that GBS produces membrane vesicles (MVs) in a serotype independent manner. These MVs are loaded with virulence factors including extracellular matrix degrading proteases and pore forming toxins. Mice chorio-decidual membranes challenged with MVs ex vivo resulted in extensive collagen degradation leading to loss of stiffness and mechanical weakening...
September 2016: PLoS Pathogens
Chan-Wook Park, Joong Shin Park, Errol R Norwitz, Kyung Chul Moon, Jong Kwan Jun, Bo Hyun Yoon
BACKGROUND: Histologic chorio-deciduitis and chorio-deciduo-amnionitis (amnionitis) in extra-placental membranes are known to represent the early and advanced stages of ascending intra-uterine infection. However, there are no data in humans about the time required for chorio-deciduitis to develop and for chorio-deciduitis without amnionitis to progress to chorio-deciduitis with amnionitis, and the effect of prolongation of pregnancy on the development of chorio-deciduitis and amnionitis in patients with preterm labor and intact membranes (PTL) and preterm premature rupture of membranes (preterm-PROM)...
2015: PloS One
Chan-Wook Park, Joong Shin Park, Jong Kwan Jun, Bo Hyun Yoon
INTRODUCTION: The inflammatory milieu decreases in the placenta and amniotic fluid (AF) with gestational age (GA). However, there is no information about whether the inflammatory milieu of AF in the setting of the same placental inflammatory condition decreases with GA. We hypothesized that the inflammatory milieu of AF in acute chorioamnionitis would decrease with increasing GA. METHODS: The inflammatory milieu of AF was examined in 617 singleton preterm pregnancies (<36 weeks) delivered within 5 days of amniocentesis...
November 2015: Placenta
L Mandelbrot, A Berrébi, S Matheron, S Blanche, R Tubiana, C Rouzioux, P Faucher, M Partisani, V Boyer, C Taeron, A Faye, L Bujan, F Dabis, J Warszawski, P Morlat
With effective antiretroviral therapy, the risk of mother to child transmission (MTCT) is now under 1%. The 2013 French guidelines emphasize early antiretroviral lifelong antiretroviral therapy. Thus, the current trend for women living with HIV is to take antiretroviral therapy before, during and after their pregnancies. A major issue today is the choice of antiretroviral drugs, to maximize the benefits and minimize the risks of fetal exposure. This requires interdisciplinary care. The use of effective therapies permits gradual but profound changes in obstetric practice...
September 2014: Journal de Gynécologie, Obstétrique et Biologie de la Reproduction
M Meinert, A Malmström, A C Petersen, G V Eriksen, N Uldbjerg
OBJECTIVE: The proteoglycan decorin stabilizes collagen whereas biglycan and hyaluronan disrupt well-organized collagen. The aim was to determine the concentrations of these constituents in fetal membranes in relation to gestational age, preterm labour, PPROM and chorioamnionitis. STUDY DESIGN: Preterm fetal membranes (24-34 weeks gestation) were obtained from elective caesarean deliveries (N = 4), from PPROM (N = 14), and from preterm labour (N = 14). Term fetal membranes from elective caesarean deliveries (N = 9) and spontaneous vaginal deliveries (N = 11) were used for comparison...
August 2014: Placenta
Peter Angura, Sithembiso Velaphi
BACKGROUND: Several risk factors have been implicated in the development of necrotising enterocolitis (NEC). However, little has been reported on the risk factors for NEC in infants born in a setting where exposure to maternal human immunodeficiency virus (HIV) is prevalent. OBJECTIVES: To determine maternal and infant characteristics associated with NEC in a setting with a high prevalence of HIV infection and to compare clinical presentation and mortality of NEC in HIV-exposed and unexposed infants...
August 2014: Paediatrics and International Child Health
Chan-Wook Park, Bo Hyun Yoon, Sun Min Kim, Joong Shin Park, Jong Kwan Jun
OBJECTIVE: There is no data on which is more important for the intensity of intra-amniotic inflammation (IAI) between total grade or involved anatomical region in acute histologic chorioamnionitis (acute-HCA) of preterm-gestations. The objective of current study is to examine this issue. METHODS: The intensity of IAI was measured by amniotic fluid (AF) white blood cell (WBC) count and matrix metalloproteinase-8 (MMP-8) concentration in 225 singleton preterm-gestations (<36 weeks) who had acute-HCA including chorio-decidua involvement and delivered within 5 days of amniocentesis...
July 2013: Obstetrics & Gynecology Science
Chan-Wook Park, Sun Min Kim, Joong Shin Park, Jong Kwan Jun, Bo Hyun Yoon
OBJECTIVE: No data exist on the frequency and intensity of the fetal, intraamniotic and maternal inflammation in preterm-gestations with inflammation restricted to chorio-decidua, early stage of ascending intrauterine infection. The objective of the study is to examine this issue. STUDY DESIGN: The frequency and intensity of fetal (cord blood C-reactive protein [CRP] at birth >200 ng/ml), intraamniotic (amniotic fluid matrix metalloproteinase-8 [MMP-8] >23 ng/ml) and maternal (maternal serum CRP >0...
January 2014: Journal of Maternal-fetal & Neonatal Medicine
Pc Ibekwe, Hu Ugboma, N Onyire, U Muoneke
BACKGROUND: Perinatal mortality is one of the essential indicators of the health status of a country and by extension its state of development. Reduction in perinatal mortality rate is an important aspect of the MDGs. OBJECTIVES: To determine the perinatal mortality rate (PMR) in 2 tertiary institutions in Southern Nigeria and the factors responsible for the deaths. METHODS: This was a retrospective, observational study conducted amongst 2 groups of subjects (A and B) located in 2 tertiary hospitals in Southern Nigeria over a 2-year period (1(st) Jan 2004 to 31(st) Dec...
July 2011: Annals of Medical and Health Sciences Research
Sriparna Basu, Shashikant Dewangan, Ram Chandra Shukla, Shampa Anupurva, Ashok Kumar
BACKGROUND: Diagnosis of early-onset neonatal sepsis (EONS) is often difficult because of vague clinical signs and non-specific laboratory parameters. OBJECTIVE: To assess the statistical validity of thymic size estimation as a diagnostic marker of EONS compared with cord blood interleukin-6 (IL-6) concentrations. SUBJECTS AND METHODS: Thirty-two neonates delivered in hospital and admitted to the neonatal unit with EONS comprised the study group...
August 2012: Paediatrics and International Child Health
Tinnakorn Chaiworapongsa, Roberto Romero, Stanley M Berry, Sonia S Hassan, Bo Hyun Yoon, Samuel Edwin, Moshe Mazor
OBJECTIVES: Fetal neutrophilia is present in two-thirds of cases with the fetal inflammatory response syndrome (FIRS). The mechanisms responsible for this finding have not been elucidated. Granulocyte colony-stimulating factor (G-CSF) is the primary physiologic regulator of neutrophil production and plays a key role in the rapid generation and release of neutrophils in stressful conditions (i.e., infection). The objective of this study was to determine: 1) whether FIRS was associated with changes in fetal plasma G-CSF concentrations; and 2) if fetal plasma G-CSF concentrations correlated with fetal neutrophil counts, chorioamnionitis, neonatal morbidity/mortality and cordocentesis-to-delivery interval...
November 2011: Journal of Perinatal Medicine
Michael Tchirikov, Georgios Gatopoulos, Joscha Steetskamp, Ulf-Rüdiger Heinrich, Jürgen Brieger, Kristina Heidner, Heinz Koelbl
OBJECTIVE: To compare perforation characteristics of standard 22 G (0.7 mm) to 29 G needle (0.34 mm) for amniocentesis. METHODS: Seventeen human chorio-amnion membranes were perforated immediately after cesarean section using 22 G needle for spinal anesthesia and 29 G "pencil-point" needles for amniocentesis under in-vitro conditions. Area of perforation was determined using a microscope and volume of fluid leakage was measured over a period of 5 min. RESULTS: Membrane perforation with the 22 G needle resulted in a mean damaged area of 225,147...
July 2011: Journal of Perinatal Medicine
B Bessières, P Bernard
The authors present fetal and maternal risks in chorio-amnionitis diseases. Major fetal risk is the increase of the rate of cerebral palsy which is growing to five. The protocol of 2011 is presented for the prevention and treatment of chorio-amnionitis in premature rupture of the membranes in relation with gestational age. A French statistical survey, period 2001 to 2006, indicates maternal risks of chorio-amnionitis. Medicolegal implications of the chorio-amnionitis diseases emphasize the importance of placental investigations and bacteriological tests...
June 2011: Gynécologie, Obstétrique & Fertilité
Giovanni Nigro, Manuela Mazzocco, Elisabetta Mattia, Gian Carlo Di Renzo, Gaspare Carta, Maurizio M Anceschi
Embryo-fetal infections have been reported to cause recurrent spontaneous abortions (RSAs) at a rate lower than 4%. The possible mechanisms include production of toxic metabolic byproducts, fetal or placental infection, chronic endometrial infection, and chorio-amnionitis. Viruses appear to be the most frequently involved pathogens, since some of them can produce chronic or recurrent maternal infection. In particular, cytomegalovirus during pregnancy can reach the placenta by viremia, following both primary and recurrent infection, or by ascending route from the cervix, mostly following reactivation...
August 2011: Journal of Maternal-fetal & Neonatal Medicine
J V Been, P L Degraeuwe, B W Kramer, L J I Zimmermann
BACKGROUND: There is debate concerning the safety and efficacy of antenatal steroids in preterm labour with suspected intrauterine infection (chorioamnionitis). OBJECTIVES: We performed a systematic literature review and meta-analysis aimed at evaluating the efficacy and safety of antenatal steroids in clinical and histological chorioamnionitis. SEARCH STRATEGY: MEDLINE, EMBASE, BioMed Central and the Cochrane databases were searched using the terms 'chorioamnionitis OR intrauterine infection' and '*steroids OR *corticoids'...
January 2011: BJOG: An International Journal of Obstetrics and Gynaecology
A C Assis Neto, F T V Pereira, T C Santos, C E Ambrosio, R Leiser, M A Miglino
The study is based on 141 pregnant Bos indicus cows, from days 20 to 70 post-insemination. First, special attention was given to the macroscopically observable phenomena of attachment of the conceptus to the uterus, i.e. the implantation, from about days 20 to 30 post-insemination up to day 70, and placentome development by growth, vascularization and increase in the number of cotyledons opposite to the endometrial caruncles. Secondly, as for the conceptuses, semiquantitative, statistical analyses were performed of the lengths of chorio-allantois, amnion and yolk sac; and the different parts of the centre and two extremes of the yolk sacs were also analysed...
October 2010: Reproduction in Domestic Animals, Zuchthygiene
A El Kateb, Y Ville
Fetal and perinatal loss rates are much higher in monochorionic than in dichorionic pregnancies. This is likely to be at least in part a consequence of chorio-angiopagus and severe early onset of twin-to-twin transfusion syndrome (TTTS). TTTS occurs in approximately 15% of all monochorionic pregnancies and is defined sonographically by the combination of polyhydramnios in one sac and oligohydramnios in the other. Intertwin anastomoses on the chorionic plate are responsible for the development of a net imbalance in blood flow and subsequent development of TTTS...
February 2008: Best Practice & Research. Clinical Obstetrics & Gynaecology
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