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Marion Rouzaire, Aurélie Comptour, Corinne Belville, Damien Bouvier, Gaël Clairefond, Flora Ponelle, Vincent Sapin, Denis Gallot, Loïc Blanchon
Thirty percent of preterm births directly result from preterm premature rupture of fetal membranes (PPROM). Clinical management currently proposes using a collagen plug to mechanically stop loss of amniotic fluid. Vitamin A and its active metabolite (retinoic acid) have well-known pro-healing properties and could thus make good candidates as a proposable adjuvant to this mechanical approach. Here we investigate the molecular mechanisms involved in the pro-healing properties of all-trans retinoic acid (atRA) in fetal membranes via an approach using an in vitro primary amniocyte wound model and transcriptomics...
October 18, 2016: International Journal of Biochemistry & Cell Biology
George J Daskalakis, Alexis K Karambelas
OBJECTIVE: To examine the influence of vaginal probiotic administration as an adjunct to standard antibiotic treatment on perinatal outcome in women with preterm premature rupture of membranes (PPROM). MATERIALS AND METHODS: This was a prospective randomized trial of cases with PPROM (24-34 weeks) that were admitted to our department between 2011 and 2015. Forty-nine cases received vaginal probiotics for 10 days in combination with antibiotic prophylaxis and were compared to 57 others that received only antibiotics for the same time period...
October 15, 2016: Fetal Diagnosis and Therapy
Akbar Hassanzadeh, Zamzam Paknahad, Masoomeh Goodarzi Khoigani
BACKGROUND: Since preterm premature rupture of membranes (PPROM) is one of the most important complications of pregnancy and its relationship with nutrition status have not been surveyed comprehensively, we decided to study the relationship of maternal received nutrients (36 macro- and micro-nutrients) in three trimesters and PPROM which could be considered as a unique study. MATERIALS AND METHODS: In this prospective cohort study, data was collected by filling a questionnaire through interviews with 620 pregnant women who had no parameters to affect pregnancy outcome...
2016: Advanced Biomedical Research
Cathrine Ebbing, Synnøve Lian Johnsen, Susanne Albrechtsen, Ingvild Dahl Sunde, Christina Vekseth, Svein Rasmussen
INTRODUCTION: Anomalous cord insertion is associated with increased risk of adverse maternal and perinatal outcome. We aimed to study whether anomalous cord insertion is associated with prelabor rupture of membranes (PROM), preterm PROM (pPROM), long or short umbilical cord, and time trend of spontaneous preterm birth (SPTB) and anomalous cord insertion. MATERIAL AND METHODS: A population-based register study using data from the Medical Birth Register of Norway including all singleton births (gestational age >16 weeks and <45 weeks) during the period 1999-2013 (n=860465) to calculate odds ratios (ORs) for PROM, pPROM, SPTB, and cord length (>95(th) or <5(th) centile) according to the cord insertion site by logistic regression with adjustment for possible confounders...
October 3, 2016: Acta Obstetricia et Gynecologica Scandinavica
Ivana Stefanoska, Jasmina Tadić, Aleksandra Vilotić, Milica Jovanović Krivokuća, Tamara Abu Rabi, Ljiljana Vićovac
PURPOSE: Gal-3, which can regulate immune responses upon infection and inflammation, was not studied so far in intrauterine infection leading to pre-term pre-labor rupture of the membranes (PPROM), although gal-1 was reported to be implicated in the process. Gal-3 mRNA and protein expression in amnion and its changes during histological chorioamnionitis were studied here. MATERIALS AND METHODS: Fetal membranes were obtained from women with PPROM with (n =15) and without histological chorioamnionitis (n =15) during second and third trimester...
October 3, 2016: Journal of Maternal-fetal & Neonatal Medicine
Kylie Hae-Jin Chang, Hyun-Joo Kim, Hee Joon Yu, Jeehun Lee, Jung-Sun Kim, Suk-Joo Choi, Soo-Young Oh, Cheong-Rae Roh, Jong-Hwa Kim
OBJECTIVES: The objective of this study was to compare neonatal morbidity and neurologic outcome at 2 years between groups treated with antibiotics regimens consisting clarithromycin and erythromycin in preterm premature rupture of the membranes (pPROM) patients delivered before 32 weeks of gestation. METHODS: This was retrospective study comparing neonatal morbidity as primary outcome measures and the neurological outcome at 2 years as secondary outcome. RESULTS: A total of 166 women were included: 80 treated with erythromycin and 86 treated with clarithromycin...
September 30, 2016: Journal of Maternal-fetal & Neonatal Medicine
Xiao-Yuan Qiu, Lu Sun, Xue-Ling Han, Ying Chang, Lan Cheng, Li-Rong Yin
Chorioamnionitis is associated with an increased risk of spontaneous preterm birth. The aim of this study was to investigate the serum levels of high mobility group box-1 (HMGB1) in pregnancies with histological chorioamnionitis (HCA)-associated preterm labor (PTL) with intact membranes or preterm premature rupture of membranes (PPROM), and to access the role of serum HMGB1 in HCA and HCA-associated PTL. A total of 190 pregnant women were enrolled in this study: PLT patients with (n = 28) or without HCA (n = 36), PPROM patients with (n = 26) or without HCA (n = 65), and non-HCA PTL controls (n = 35)...
August 12, 2016: Gynecological Endocrinology
Varsha L Deshmukh, Milind Jadhav, Kanan Yelikar
AIM AND OBJECTIVES: To review the effects of obesity (BMI > 30) on antepartum risk/intrapartum risk. To study neonatal outcome of pregnant women with raised BMI. MATERIAL METHOD: BMI of 500 pregnant women booked before 12 weeks calculated and categorised as normal, overweight, obese and morbidly obese at GMCH, Aurangabad. Pregnant women with systemic disease and previous LSCS were excluded. Antepartum, intrapartum and neonatal variables were studied, and statistical analysis was carried out...
October 2016: Journal of Obstetrics and Gynaecology of India
Ivana Musilova, Ctirad Andrys, Marcela Drahosova, Ondrej Soucek, Lenka Pliskova, Martin Stepan, Tomas Bestvina, Jan Maly, Bo Jacobsson, Marian Kacerovsky
OBJECTIVE: The aim of this study was to evaluate the amniotic fluid cathepsin-G concentrations in women with preterm prelabor rupture of membranes (PPROM) based on the presence of the microbial invasion of the amniotic cavity (MIAC) and/or intra-amniotic inflammation (IAI). METHODS: A total of 154 women with singleton pregnancies complicated by PPROM were included in this study. Amniotic fluid samples were obtained by transabdominal amniocentesis. Amniotic fluid cathepsin-G concentrations were assessed by ELISA...
October 9, 2016: Journal of Maternal-fetal & Neonatal Medicine
Jovana Lekovich, Joshua Stewart, Sarah Anderson, Erin Niemasik, Nigel Pereira, Stephen Chasen
OBJECTIVE: Müllerian anomalies are associated with increased risk of miscarriage, intrauterine growth restriction (IUGR) and preterm birth. While a commonly implicated cause is restricted expansion of endometrial cavity, alternatively it could be due to abnormal placentation. We sought to examine clinical and histopathologic factors associated with preterm delivery in women with Müllerian anomalies. STUDY DESIGN: One hundred and eleven singleton pregnancies in 85 women were analyzed retrospectively...
August 17, 2016: Journal of Perinatal Medicine
Praveen Chandrasekharan, Rafal Kozielski, Vasantha H S Kumar, Munmun Rawat, Veena Manja, Changxing Ma, Satyan Lakshminrusimha
Inhaled nitric oxide (iNO) is being increasingly used in preterm infants < 34 weeks with hypoxemic respiratory failure (HRF) and/or pulmonary hypertension (PH). Objective To evaluate the risk factors, survival characteristics, and lung histopathology in preterm infants with PH/HRF. Methods Retrospective chart review was conducted to determine characteristics of 93 preterm infants treated with iNO in the first 28 days and compared with 930 matched controls. Factors associated with survival with preterm HRF and smooth muscle actin from nine autopsies were evaluated...
September 14, 2016: American Journal of Perinatology
Meryem Kurek Eken, Abdülhamit Tüten, Enis Özkaya, Güner Karatekin, Ateş Karateke
OBJECTIVE: To assess the predictors of outcome in terms of length of stay in the neonatal intensive care unit (NICU) and survival of neonates from women with preterm premature rupture of membranes (PPROM). METHODS: A population-based retrospective study including three hundred thirty-one singleton pregnant women with PPROM at 24-34 gestational weeks between January 2013 and December 2015 was conducted. Gestational age at delivery, birth weight, route of delivery, newborn gender, maternal age,oligohydramnios, premature retinopathy (ROP), necrotising enterocolitis (NEC), sepsis, fetal growth retardation (FGR), intracranial hemorrhagia (ICH), bronchopulmonary dysplasia (BPD), respiratory distress syndrome (RDS), primary pulmonary hypertension (PPH), congenital cardiac disease (CCD), patent ductus arteriosus (PDA), use of cortisol (betamethasone) and maternal complications including gestational diabetes, preeclampsia, and chorioamnionitis were used to predict neonatal outcomes in terms of length of stay in the NICU and survival...
September 14, 2016: Journal of Maternal-fetal & Neonatal Medicine
C Genovese, S Corsello, D Nicolosi, V Aidala, E Falcidia, G Tempera
OBJECTIVE: Preterm premature rupture of membranes (pPROM) is a significant issue in obstetric practice. One of the risk factors for pPROM are vaginal infections in the third trimester of pregnancy. PATIENTS AND METHODS: We performed an observational study on 600 pregnant women, analyzing the lactobacillary grade (LBG) and the presence of any pathogenic bacteria and/or Candida at weeks 28 and 32 of pregnancy and recording any pPROM events at delivery. At week 28, in the case of vaginal infection, the patients were treated for 6 days with a topical association of metronidazole+clotrimazole...
August 2016: European Review for Medical and Pharmacological Sciences
Philipp Wagner, Jiri Sonek, Stefanie Mayr, Harald Abele, Rangmar Goelz, Markus Hoopmann, Karl Oliver Kagan
OBJECTIVE: The objective of this study is to examine the outcome in dichorionic diamniotic twin pregnancies with rupture of membranes (PPROM) before 24 weeks' gestation. MATERIAL AND METHODS: Retrospective analysis of fetal and neonatal outcomes in women with spontaneous PPROM before 24 weeks' gestation that were treated at a single tertiary center. RESULTS: Twenty-nine pregnancies fulfilled the inclusion criteria. Mean gestational age at the time of PPROM was 20...
September 8, 2016: Journal of Maternal-fetal & Neonatal Medicine
Jonathan Caloone, Muriel Rabilloud, Florent Boutitie, Alexandra Traverse-Glehen, Fabienne Allias-Montmayeur, Laure Denis, Catherine Boisson-Gaudin, Isabelle Jaisson Hot, Pascale Guerre, Marion Cortet, Cyril Huissoud
OBJECTIVE: To assess and compare several maternal seric markers for the prediction of histological chorioamnionitis (HCA) after preterm premature rupture of membranes (PPROM). Study design A prospective and multicentric observational study was undertaken, including six French tertiary referral centres. Pregnant women over 18 years, with PPROM between 22+0 and 36+6 WG were enrolled. A blood sample was obtained before delivery and analysed for C-Reactive Protein (CRP), InterCellular Adhesion Molecule-1 (ICAM-1), Interleukin-6 (IL-6), Interleukin-8 (IL-8), Matrix-Metalloproteinase 8 and 9 (MMP-8, MMP-9), Triggering receptor on myeloid cells (TREM-1), and Human Neutrophile Peptides (HNP)...
October 2016: European Journal of Obstetrics, Gynecology, and Reproductive Biology
Cecilia Stalberg, Nathalia Noda, Jossimara Polettini, Bo Jacobsson, Ramkumar Menon
OBJECTIVE: Elafin is a low molecular weight protein with antileukoproteinase, anti-inflammatory, antibacterial and immunomodulating properties. The profile of Elafin in fetal membranes is not well characterized. This study determined the changes in Elafin expression and concentration in human fetal membrane from patients with preterm prelabor rupture of membranes (PPROM) and in vitro in response to intra-amniotic polymicrobial pathogens. METHOD: Elafin messenger RNA (mRNA) expressions were studied in fetal membranes from PPROM, normal term as well as in normal term not in labor membranes in an organ explant system treated (24 h) with lipopolysaccharide (LPS), using quantitative reverse transcription-polymerase chain reaction (RT-PCR)...
August 31, 2016: Journal of Perinatal Medicine
Lili Sheibani, Alex Fong, Dana E Henry, Mary E Norton, Yen N Truong, Adanna Anyikam, Louise C Laurent, Rashmi Rao, Deborah A Wing
BACKGROUND: Preterm Premature Rupture of Membranes (PPROM) precedes many deliveries and experts agree with expectant management until 34 weeks gestation. However, there is controversy regarding the gestational age (GA) for administration of corticosteroids. STUDY DESIGN: We performed a retrospective cohort study in the University of California Fetal Consortium (UCfC). We searched available charts of singleton pregnancies with PPROM between 32 and 33 6/7 weeks GA...
August 31, 2016: Journal of Maternal-fetal & Neonatal Medicine
Tobias A J Nijman, Elvira O G van Vliet, Christiana A Naaktgeboren, Katrien Oude Rengerink, Thomas S de Lange, Caroline J Bax, Kitty W M Bloemenkamp, Jim van Eyck, Marjolein Kok, Hubertina C J Scheepers, Mallory Woiski, Arie Franx, Ben Willem J Mol, Martijn A Oudijk
OBJECTIVE: Preterm birth is the most common cause of neonatal morbidity and mortality. Around one third of preterm deliveries starts with preterm prelabor rupture of membranes (PPROM). The aim of this trial was to study the effect of prolonged tocolysis with nifedipine versus placebo in women with PPROM on perinatal outcome and prolongation of pregnancy. STUDY DESIGN: The Apostel IV was a nationwide multicenter randomized placebo controlled trial. We included women with PPROM without contractions between 24(+0) and 33(+6) weeks of gestation...
October 2016: European Journal of Obstetrics, Gynecology, and Reproductive Biology
Olivia Myrick, Sarah Dotters-Katz, Matthew Grace, Tracy Manuck, Kim Boggess, William Goodnight
OBJECTIVE: This study aims to determine if antibiotics given for latency to women with twins and previable preterm premature rupture of membranes (PPROM) affect the duration from membrane rupture to delivery. METHODS: A retrospective cohort study of twin pregnancies at a single center from 2000 to 2015 with previable (14 (0/7)-22 (6/7) weeks) PPROM was conducted. Women who were not candidates for expectant management or who elected for immediate delivery were excluded...
July 2016: American Journal of Perinatology Reports
Mia Kibel, Jon Barrett, Carly Tward, Alex Pittini, Michael Kahn, Nir Melamed
OBJECTIVE: To compare the characteristics of preterm premature rupture of membranes (PPROM) between twin and singleton pregnancies. METHODS: This was a retrospective study of all women with twin and singleton pregnancies admitted with PPROM between 24-34 weeks of gestation. RESULTS: Overall 698 women with PPROM were eligible for the study: 101 (14.5%) twins and 597 (85.5%) singletons. Twins presented with PPROM at a more advanced gestational age compared with singletons (29...
August 22, 2016: Journal of Maternal-fetal & Neonatal Medicine
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