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Chorioamnionitis

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https://www.readbyqxmd.com/read/27905410/association-between-preterm-brain-injury-and-exposure-to-chorioamnionitis-during-fetal-life
#1
Devasuda Anblagan, Rozalia Pataky, Margaret J Evans, Emma J Telford, Ahmed Serag, Sarah Sparrow, Chinthika Piyasena, Scott I Semple, Alastair Graham Wilkinson, Mark E Bastin, James P Boardman
Preterm infants are susceptible to inflammation-induced white matter injury but the exposures that lead to this are uncertain. Histologic chorioamnionitis (HCA) reflects intrauterine inflammation, can trigger a fetal inflammatory response, and is closely associated with premature birth. In a cohort of 90 preterm infants with detailed placental histology and neonatal brain magnetic resonance imaging (MRI) data at term equivalent age, we used Tract-based Spatial Statistics (TBSS) to perform voxel-wise statistical comparison of fractional anisotropy (FA) data and computational morphometry analysis to compute the volumes of whole brain, tissue compartments and cerebrospinal fluid, to test the hypothesis that HCA is an independent antenatal risk factor for preterm brain injury...
December 1, 2016: Scientific Reports
https://www.readbyqxmd.com/read/27904309/robot-assisted-abdominal-cerclage-during-pregnancy
#2
Burak Zeybek, Amanda Hill, Gulden Menderes, Mostafa A Borahay, Masoud Azodi, Gokhan Sami Kilic
BACKGROUND AND OBJECTIVES: Cervical insufficiency is a difficult condition to diagnose and can lead to preterm birth, miscarriage, or perinatal infant morbidity and mortality. We conducted this retrospective case study and literature review to evaluate the safety and efficacy of robot-assisted abdominal cerclage during pregnancy. METHODS: We conducted a case series and a systematic review that included patients who underwent robot-assisted abdominal cerclage during pregnancy from January 2010 through March 2016...
October 2016: JSLS: Journal of the Society of Laparoendoscopic Surgeons
https://www.readbyqxmd.com/read/27901551/prolonged-second-stage-what-is-the-optimal-length
#3
Alexis C Gimovsky, Vincenzo Berghella
Importance: Prolonged second stage of labor is a clinical dilemma in which controversy exists on whether extending labor in nulliparous women with epidural anesthesia decreases the incidence of cesarean delivery without increasing maternal or neonatal risks. Objective: This narrative review was conducted to assess the current literature on management of and risks associated with a prolonged second stage in nulliparous women with epidurals. Evidence Acquisition: A review of the current literature was performed to evaluate the incidence of cesarean delivery and the maternal and neonatal outcomes...
November 2016: Obstetrical & Gynecological Survey
https://www.readbyqxmd.com/read/27892517/chorioamnionitis-appears-not-to-be-a-risk-factor-for-patent-ductus-arteriosus-in-preterm-infants-a-systematic-review-and-meta-analysis
#4
Elham Behbodi, Eduardo Villamor-Martínez, Pieter L J Degraeuwe, Eduardo Villamor
The contribution of chorioamnionitis (CA) to mortality and morbidity in preterm infants is difficult to assess because observational studies frequently present significant differences in baseline characteristics of the infants exposed or non-exposed to CA. In an attempt to perform a thorough assessment of the possible association between CA and patent ductus arteriosus (PDA) in preterm infants, we conducted a meta-analysis in which adjusted odds ratios (ORs) were pooled and we analyzed the effects of potential confounders, such as gestational age (GA) or birth weight (BW)...
November 28, 2016: Scientific Reports
https://www.readbyqxmd.com/read/27872823/serial-physical-examinations-a-simple-and-reliable-tool-for-managing-neonates-at-risk-for-early-onset-sepsis
#5
Alberto Berardi, Anna Maria Buffagni, Cecilia Rossi, Eleonora Vaccina, Chiara Cattelani, Lucia Gambini, Federica Baccilieri, Francesca Varioli, Fabrizio Ferrari
AIM: To investigate whether serial physical examinations (SPEs) are a safe tool for managing neonates at risk for early-onset sepsis (EOS). METHODS: This is a retrospective cohort study of neonates (≥ 34 wks' gestation) delivered in three high-volume level IIIbirthing centres in Emilia-Romagna (Italy) during a 4-mo period (from September 1 to December 31, 2015). Neonates at risk for EOS were managed according to the SPEs strategy, these were carried out in turn by bedside nursing staff and physicians...
November 8, 2016: World Journal of Clinical Pediatrics
https://www.readbyqxmd.com/read/27871473/placental-histology-in-spontaneous-and-indicated-preterm-birth-a-case-control-study
#6
Tobias A J Nijman, Elvira O G van Vliet, Manon J N Benders, Ben Willem J Mol, Arie Franx, Peter G J Nikkels, Martijn A Oudijk
INTRODUCTION: Placental pathology is an important contributor in preterm birth, both spontaneous and indicated. The aim of this study was to describe and compare placental histological features of spontaneous preterm birth versus indicated preterm birth. METHODS: A case control study was performed at the University Medical Center Utrecht. Women with spontaneous or indicated preterm birth (17-37 weeks of gestation) delivered in 2009 were included. Women with a pregnancy complicated by congenital and/or chromosomal abnormalities were excluded...
December 2016: Placenta
https://www.readbyqxmd.com/read/27871460/placental-histological-lesions-in-fetal-and-neonatal-alloimmune-thrombocytopenia-a-retrospective-cohort-study-of-21-cases
#7
Estelle Dubruc, Frédérique Lebreton, Catherine Giannoli, Muriel Rabilloud, Cyril Huissoud, Mojgan Devouassoux-Shisheboran, Fabienne Allias
BACKGROUND: Alloimmunization against human platelet antigens (HPAs) can occur prenatally and induce fetal/neonatal alloimmune thrombocytopenia (FNAIT). The aim of this study was to identify placental histological features associated with platelet alloimmunization and their clinical significance. METHODS: This study examined 21 placentas from FNAIT-affected pregnancies and 42 age-matched control cases, all collected from pathology departments in the Rhône-Alpes region...
December 2016: Placenta
https://www.readbyqxmd.com/read/27870827/augmented-th17-type-immune-responses-in-preterm-neonates-exposed-to-histologic-chorioamnionitis
#8
Daniel C Rito, Luke T Viehl, Paula M Buchanan, Seema Haridas, Joyce M Koenig
BACKGROUND: Histologic chorioamnionitis (HCA) is a placental inflammatory disorder that frequently precedes preterm delivery. HCA increases risk for long-standing inflammatory injury and may influence immune programming, particularly in preterm (PT) neonates. We hypothesized that HCA exposure is associated with an increased circulating frequency of pro-inflammatory, Th17-type responses. METHODS: Placental cord blood was collected from HCA-exposed or control neonates (23-41 weeks gestation)...
November 21, 2016: Pediatric Research
https://www.readbyqxmd.com/read/27861554/high-diversity-and-variability-in-the-vaginal-microbiome-in-women-following-preterm-premature-rupture-of-membranes-pprom-a-prospective-cohort-study
#9
Teenus Paramel Jayaprakash, Emily C Wagner, Julie van Schalkwyk, Arianne Y K Albert, Janet E Hill, Deborah M Money
OBJECTIVE: To characterize the vaginal microbiota of women following preterm premature rupture of membranes (PPROM), and determine if microbiome composition predicts latency duration and perinatal outcomes. DESIGN: A prospective cohort study. SETTING: Canada. POPULATION: Women with PPROM between 24+0 and 33+6 weeks gestational age (GA). METHODS: Microbiome profiles, based on pyrosequencing of the cpn60 universal target, were generated from vaginal samples at time of presentation with PPROM, weekly thereafter, and at delivery...
2016: PloS One
https://www.readbyqxmd.com/read/27856214/inflammation-induced-preterm-lung-maturation-lessons-from-animal-experimentation
#10
REVIEW
Timothy J M Moss, Alana J Westover
Intrauterine inflammation, or chorioamnionitis, is a major contributor to preterm birth. Prematurity per se is associated with considerable morbidity and mortality resulting from lung immaturity but exposure to chorioamnionitis reduces the risk of neonatal respiratory distress syndrome (RDS) in preterm infants. Animal experiments have identified that an increase in pulmonary surfactant production by the preterm lungs likely underlies this decreased risk of RDS in infants exposed to chorioamnionitis. Further animal experimentation has shown that infectious or inflammatory agents in amniotic fluid exert their effects on lung development by direct effects within the developing respiratory tract, and probably not by systemic pathways...
October 20, 2016: Paediatric Respiratory Reviews
https://www.readbyqxmd.com/read/27855117/comparison-of-the-duo-of-insulin-like-growth-factor-binding-protein-1-alpha-fetoprotein-amnioquick-duo-%C3%A2-and-traditional-clinical-assessment-for-diagnosing-premature-rupture-of-fetal-membranes
#11
George Uchenna Eleje, Euzebus Chinonye Ezugwu, Ahizechukwu Chigoziem Eke, Joseph Ifeanyichukwu Ikechebelu, Chukwudi Celestine Obiora, Nnabuike Okechukwu Ojiegbe, Ifeanyichukwu Uzoma Ezebialu, Chukwuemeka Okwudili Ezeama, Betrand Obi Nwosu, Gerald Okanandu Udigwe, Charles Ikechukwu Okafor, Frank Okechukwu Ezugwu
PURPOSE: To determine the diagnostic accuracy of insulin-like growth factor binding protein-1/alpha fetoprotein (Amnioquick duo+®) compared with traditional clinical assessment (TCA) of nitrazine, ferning and pooling for the diagnosis of prelabor rupture of membranes (PROM). METHODS: A double-blinded, multicenter clinical study was conducted between February 2015 and August 2015 among pregnant women presenting with symptoms or features suggestive of PROM between 24 and 42 weeks gestation...
November 17, 2016: Journal of Perinatal Medicine
https://www.readbyqxmd.com/read/27854133/focusing-on-developmental-origins-and-disease-inception-for-the-prevention-of-pulmonary-hypertension
#12
Bradley A Maron, Steven H Abman
Despite the growing armamentarium of therapies, pulmonary vascular disease continues to cause significant morbidity and mortality in neonates, children and adults in diverse clinical settings. To address this challenge, a strategic shift is underway that emphasizes disease recognition prior to the onset of clinical signs and symptoms when substantial pulmonary vascular remodeling is already present. Specifically, there is growing interest regarding the i) molecular events that define pulmonary vascular disease inception, ii) range of early cardiopulmonary hemodynamic measures that are associated with adverse outcome, and iii) widening utility of exercise for risk-stratification...
November 17, 2016: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/27852921/a-role-for-the-inflammasome-in-spontaneous-labor-at-term-with-acute-histologic-chorioamnionitis
#13
Nardhy Gomez-Lopez, Roberto Romero, Yi Xu, Olesya Plazyo, Ronald Unkel, Nandor Gabor Than, Piya Chaemsaithong, Tinnakorn Chaiworapongsa, Zhong Dong, Adi L Tarca, Vikki M Abrahams, Lami Yeo, Sonia S Hassan
Inflammasomes are cytosolic signaling platforms that regulate the activation of caspase (CASP)-1, which induces the maturation of interleukin (IL)-1β and IL-18. Herein, we determined whether the chorioamniotic membranes from women in spontaneous labor at term with acute histologic chorioamnionitis express major inflammasome components and whether these changes are associated with the activation of CASP-1 and CASP-4 and the release of mature IL-1β and IL-18. When comparing the chorioamniotic membranes from women in spontaneous labor at term with acute histologic chorioamnionitis to those without this placental lesion, we found that (1) the messenger RNA (mRNA) abundance of NLR family pyrin domain containing 3 (NLRP3), NLR family CARD domain containing 4 (NLRC4), absent in melanoma 2 (AIM2), and nucleotide binding oligomerization domain 2 (NOD2) was higher; (2) the NLRP3 and NLRC4 protein quantities were increased; (3) the mRNA and protein expressions of CASP-1 and its active forms were greater; (4) CASP-4 was increased at the mRNA level only; (5) the mRNA and protein expressions of IL-1β and its mature form were higher; and (6) a modest increase in the total protein concentration and abundance of the mature form of IL-18 was observed...
November 16, 2016: Reproductive Sciences
https://www.readbyqxmd.com/read/27824748/oregon-s-hard-stop-policy-limiting-elective-early-term-deliveries-association-with-obstetric-procedure-use-and-health-outcomes
#14
Jonathan M Snowden, Ifeoma Muoto, Blair G Darney, Brian Quigley, Mark W Tomlinson, Duncan Neilson, Steven A Friedman, Joanne Rogovoy, Aaron B Caughey
OBJECTIVE: To evaluate the association of Oregon's hard-stop policy limiting early elective deliveries (before 39 weeks of gestation) and the rate of elective early-term inductions and cesarean deliveries and associated maternal-neonatal outcomes. METHODS: This was a population-based retrospective cohort study of Oregon births between 2008 and 2013 using vital statistics data and multivariable logistic regression models. Our exposure was the Oregon hard-stop policy, defined as the time periods prepolicy (2008-2010) and postpolicy (2012-2013)...
December 2016: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/27823918/the-association-between-intrauterine-balloon-tamponade-duration-and-postpartum-hemorrhage-outcomes
#15
Brett D Einerson, Moeun Son, Patrick Schneider, Ian Fields, Emily S Miller
BACKGROUND: Intrauterine balloon tamponade is an effective treatment for postpartum hemorrhage when first-line treatments fail. The optimal duration of intrauterine balloon tamponade for management of postpartum hemorrhage is unclear. OBJECTIVE: The objective of the study was to determine whether intrauterine balloon tamponade removal >12 hours of duration is associated with postpartum hemorrhage-related clinical outcomes. STUDY DESIGN: This was a retrospective cohort study of women with postpartum hemorrhage from 2007 through 2014 who underwent intrauterine balloon tamponade...
November 4, 2016: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/27821647/preclinical-evaluation-of-drugs-to-block-inflammation-driven-preterm-birth
#16
Demelza J Ireland, Elizabeth A Nathan, Shaofu Li, Adrian K Charles, Lisa F Stinson, Matthew W Kemp, John P Newnham, Jeffrey A Keelan
Intrauterine inflammation, the major cause of early preterm birth, can have microbial and sterile aetiologies. We assessed in a Transwell model the anti-inflammatory efficacies of five drugs on human extraplacental membranes delivered after preterm spontaneous labour (30-34 wk). Drugs [TPCA1 (IKKβ inhibitor), 5 z-7-oxozeaenol (OxZ, TAK1 inhibitor), inhibitor of NF-κB essential modulator binding domain (iNBD), SB239063 (p38 MAPK inhibitor) and N-acetyl cysteine (free radical scavenger free radicals)] were added after 12 h equilibration to the amniotic compartment...
November 7, 2016: Innate Immunity
https://www.readbyqxmd.com/read/27819066/group-b-streptococcus-circumvents-neutrophils-and-neutrophil-extracellular-traps-during-amniotic-cavity-invasion-and-preterm-labor
#17
Erica Boldenow, Claire Gendrin, Lisa Ngo, Craig Bierle, Jay Vornhagen, Michelle Coleman, Sean Merillat, Blair Armistead, Christopher Whidbey, Varchita Alishetti, Veronica Santana-Ufret, Jason Ogle, Michael Gough, Sengkeo Srinouanprachanh, James W MacDonald, Theo K Bammler, Aasthaa Bansal, H Denny Liggitt, Lakshmi Rajagopal, Kristina M Adams Waldorf
Preterm birth is a leading cause of neonatal morbidity and mortality. Although microbial invasion of the amniotic cavity (MIAC) is associated with the majority of early preterm births, the temporal events that occur during MIAC and preterm labor are not known. Group B Streptococci (GBS) are β-hemolytic, gram-positive bacteria, which commonly colonize the vagina but have been recovered from the amniotic fluid in preterm birth cases. To understand temporal events that occur during MIAC, we utilized a unique chronically catheterized nonhuman primate model that closely emulates human pregnancy...
October 2016: Science Immunology
https://www.readbyqxmd.com/read/27814345/pro-inflammatory-immune-responses-in-leukocytes-of-premature-infants-exposed-to-maternal-chorioamnionitis-or-funisitis
#18
Courtney M Jackson, Casey B Wells, Meredith E Tabangin, Jareen Meinzen-Derr, Alan H Jobe, Claire A Chougnet
BACKGROUND: Acute chorioamnionitis contributes to premature birth, and is associated with post-birth complications. How chorioamnionitis impacts neonate's developing immune system has not been well defined. METHODS: Blood from extremely preterm infants (=28 weeks gestation) was drawn at the 1(st), 2(nd), and 4(th) week of life. Blood was either left unstimulated or stimulated for 4 hours with PMA/ionomycin. mRNA expression of transcription factors in unstimulated cells (RORC, TBET, GATA3, FOXP3) and inflammatory cytokines (IFN-γ, TNF-α, IL-2, IL-4, IL-5, and IL-6) in unstimulated and stimulated cells were analyzed...
November 4, 2016: Pediatric Research
https://www.readbyqxmd.com/read/27806943/hmgb1-induces-an-inflammatory-response-in-the-chorioamniotic-membranes-that-is-partially-mediated-by-the-inflammasome
#19
Olesya Plazyo, Roberto Romero, Ronald Unkel, Amapola Balancio, Tara N Mial, Yi Xu, Zhong Dong, Sonia S Hassan, Nardhy Gomez-Lopez
Spontaneous preterm labor occurs in two subsets of patients with sterile intra-amniotic inflammation, which is induced by alarmins such as high-mobility group box-1 (HMGB1). Inflammasomes are also implicated in the process of spontaneous preterm labor with acute chorioamnionitis. Therefore, we investigated whether HMGB1 initiates an inflammasome-associated inflammatory response in the chorioamniotic membranes. Incubation of the chorioamniotic membranes with HMGB1: 1) induced the release of mature IL-1beta and IL-6; 2) upregulated the mRNA expression of the pro-inflammatory mediators NFKB1, IL6, TNF, IL1A, IFNG, and HMGB1 receptors RAGE and TLR2; 3) upregulated the mRNA expression of the inflammasome components NLRP3 and AIM2, and NOD proteins (NOD1 and NOD2); 4) increased the protein concentrations of NLRP3 and NOD2; 5) increased the concentration of caspase-1 and the quantity of its active form (p20); and 6) upregulated the mRNA expression and active form of MMP-9...
November 2, 2016: Biology of Reproduction
https://www.readbyqxmd.com/read/27780541/atf3-is-a-negative-regulator-of-inflammation-in-human-fetal-membranes
#20
Ratana Lim, Gillian Barker, Stella Liong, Caitlyn Nguyen-Ngo, Stephen Tong, Tu'uhevaha Kaitu'u-Lino, Martha Lappas
INTRODUCTION: Infection and inflammation stimulate pro-inflammatory cytokines, prostaglandins and matrix metalloproteinase (MMP)-9, which play a central role in myometrial contractions and rupture of fetal membranes. In human and mouse immune cells, activating transcription factor 3 (ATF3) is a negative regulator of inflammation. No studies have examined the role of ATF3 in human labour. METHODS: Primary amnion cells were used to determine the effect of interleukin (IL)-1β and the bacterial product fibroblast-stimulating lipopeptide (fsl-1) on ATF3 expression, and the effect of ATF3 siRNA on pro-labour mediators...
November 2016: Placenta
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