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Sarah M Holmen, Tiki Bakhshi, Maria M Molina, Larissa F Weir
BACKGROUND: Chorioamniotic membrane separation (CMS) is a rare finding that is commonly preceded by invasive fetal procedures. The presence of CMS can also be associated with uncommon maternal or fetal conditions as well as preterm delivery, amniotic band syndrome, umbilical cord complications, and fetal and neonatal death. It is classified as a high-risk antepartum condition due to the significant fetal morbidity and mortality that may ensue. CASE REPORT: A 40-year-old gravida 5 para 1212 at 35 weeks presented for antepartum fetal testing...
October 2016: Military Medicine
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
Carolina Bibbo, Sarah E Little, Jad Bsat, Kris Ann Botka, Carol B Benson, Julian N Robinson
Objective This study aims to evaluate pregnancy outcomes in patients with spontaneous and iatrogenic chorioamniotic separation diagnosed by ultrasound after 17 weeks. Methods This is a retrospective cohort study of women with a singleton pregnancy who were diagnosed with chorioamniotic separation (n = 106) after 17 weeks' gestation from January 2000 to January 2013. Patients with chorioamniotic separation were compared with a group of patients who had obstetric ultrasounds without a diagnosis of chorioamniotic separation...
July 2016: American Journal of Perinatology Reports
Mark P Johnson, Kelly A Bennett, Larry Rand, Pamela K Burrows, Elizabeth A Thom, Lori J Howell, Jody A Farrell, Mary E Dabrowiak, John W Brock, Diana L Farmer, N Scott Adzick
BACKGROUND: The Management of Myelomeningocele Study was a multicenter randomized trial to compare prenatal and standard postnatal closure of myelomeningocele. The trial was stopped early at recommendation of the data and safety monitoring committee and outcome data for 158 of the 183 randomized women published. OBJECTIVE: In this report, pregnancy outcomes for the complete trial cohort are presented. We also sought to analyze risk factors for adverse pregnancy outcome among those women who underwent prenatal myelomeningocele repair...
August 2, 2016: American Journal of Obstetrics and Gynecology
Michael A Belfort, William E Whitehead, Robert Ball, Robert Silver, Alireza Shamshirsaz, Rodrigo Ruano, Jimmy Espinoza, Judith Becker, Olutoyin Olutoye, Larry Hollier
Introduction Fetoscopic release of amniotic bands has proved its life- and limb-saving potential. Rupture of the amnion and separation of chorion from the amnion and uterine wall can however preclude the standard fetoscopic approach to release the amniotic bands using a single port. Methods and Materials A 28-year-old G1P0 woman was referred to our unit at 19 weeks due to amniotic band syndrome involving the left ankle, the infrapatellar region of the right leg, and the umbilical cord. Of note, part of the fetus was seen outside the amniotic cavity by ultrasonography and the left ankle and foot were severely swollen...
April 2016: American Journal of Perinatology Reports
Hye Mi Eom, Young Nam Kim, Byung Hee Choi, Eun Jeong Jeong, Jung Mi Byun, Dae Hoon Jeong, Moon Su Sung, Kyung Bok Lee, Ki Tae Kim, Hye Kyoung Yoon
Placental chorioangioma is a benign non-trophoblastic tumor of the placenta that can have various adverse effects on the mother and fetus depending on its size. Chorioamniotic membrane separation is rare condition of detachment between the amniotic membrane and chorionic membrane. Chorioamniotic membrane separation after the second trimester of pregnancy is usually occurs after invasive procedures or may occur spontaneously; it is mostly associated with fetal abnormalities. Here, we report a case of chorioamniotic membrane separation that might be occurred caused by the seromucinous secretion from a placental chorioangioma...
May 2016: Obstetrics & Gynecology Science
Go-Eun Bae, Joon-Seok Hong, Jung-Sun Kim, Ha Young Park, Ja Yun Jang, Yi Seul Kim, Suk-Joo Choi, Soo-Young Oh, Cheong-Rae Roh
AIM: The aim of this study was to investigate the involvement and immunophenotype of macrophages in acute chorioamnionitis (ACA) and chronic chorioamnionitis (CCA), marking amniotic fluid infection and anti-fetal rejection, respectively. METHODS: Chorioamniotic membranes from (1) gestational age-matched cases without chorioamnionitis, (2) cases with ACA, and (3) cases with CCA were studied after immunohistochemical staining using antibodies against CD14, CD68, CD163, and DC-SIGN...
April 28, 2016: Journal of Perinatal Medicine
Eun Joo Joung, Seul Ki You, Ji Yeon Lee, Jun Woo Ahn, Nae Ri Yun, Sung Ook Hwang
Spontaneous complete chorioamniotic membrane separation (CMS) without invasive fetal procedure is extremely rare and associated with adverse perinatal outcomes. A woman with complete CMS which was detected at the 21 weeks' gestation. She did not take any fetal invasive procedures before the diagnosis. At 27 weeks' gestation, an emergency Caesarean section was performed because of fetal distress. The defect of the uterine muscle was detected on the fundus. The baby has grown well without any morbidity. This is the first reported case of complete CMS relative to uterine scar...
March 2016: Obstetrics & Gynecology Science
Roberto Romero, Yi Xu, Olesya Plazyo, Piya Chaemsaithong, Tinnakorn Chaiworapongsa, Ronald Unkel, Nandor Gabor Than, Po Jen Chiang, Zhong Dong, Zhonghui Xu, Adi L Tarca, Vikki M Abrahams, Sonia S Hassan, Lami Yeo, Nardhy Gomez-Lopez
PROBLEM: Inflammasomes are signaling platforms that, upon sensing pathogens and sterile stressors, mediate the release of mature forms of interleukin (IL)-1β and IL-18. The aims of this study were to determine (i) the expression of major inflammasome components in the chorioamniotic membranes in spontaneous labor at term, (ii) whether there are changes in the inflammasome components associated with the activation of caspase-1 and caspase-4, and (iii) whether these events are associated with the release of the mature forms of IL-1β and IL-18...
March 8, 2016: American Journal of Reproductive Immunology: AJRI
Shelly Soni, Julie S Moldenhauer, Susan S Spinner, Norma Rendon, Nahla Khalek, Juan Martinez-Poyer, Mark P Johnson, N Scott Adzick
BACKGROUND: Since the results of the Management of Myelomeningocele Study were published, maternal-fetal surgery for the in utero treatment of spina bifida has become accepted as a standard of care alternative. Despite promise with fetal management of myelomeningocele repair, there are significant complications to consider. Chorioamniotic membrane separation and preterm premature rupture of membranes are known complications of invasive fetal procedures. Despite their relative frequency associated with fetal procedures, few data exist regarding risk factors that may be attributed to their occurrence or the natural history of pregnancies that are affected with chorionic membrane separation or preterm premature rupture of membranes related to the procedure...
May 2016: American Journal of Obstetrics and Gynecology
Ayumi Taguchi, Aki Yamashita, Kei Kawana, Takeshi Nagamatsu, Hitomi Furuya, Eri Inoue, Yutaka Osuga, Tomoyuki Fujii
Preterm birth is one of the most common obstetrical complications, with an incidence of about 5% to 18% of all pregnancies worldwide. Acute chorioamniotic infection is likely antecedent to preterm birth through the local production of inflammatory mediators, followed by uterine contraction and cervical ripening. Microbial chorioamnionitis and local inflammation synergistically form a vicious circle toward preterm birth. Principal therapeutic interventions focus on anti-infection and anti-inflammation strategies to block this vicious circle...
December 1, 2015: Reproductive Sciences
P L Tran, G Payet, G Barau, M Boukerrou
UNLABELLED: Cervical incompetency is one of the direct causes of neonatal morbidity and mortality; a unique and efficient treatment of which is cervical cerclage. The objective of this study was the evaluation of physicians' practice patterns concerning cerclage in Reunion Island, in order to reinforce the management and information of patients at risk. The indications and complications of cerclages effectuated in 2010 and 2011 were compared to the literature. MATERIAL AND METHODS: In this retrospective study, all the medical records of cerclage realized in Reunion Island during two years were collected and analyzed, specifically data concerning patients' cerclage, the complications, and the outcome of the pregnancy...
September 2016: Journal de Gynécologie, Obstétrique et Biologie de la Reproduction
Heejin Bang, Go Eun Bae, Ha Young Park, Yeon Mee Kim, Suk-Joo Choi, Soo-Young Oh, Cheong-Rae Roh, Jung-Sun Kim
BACKGROUND: Chronic placental inflammation, such as villitis of unknown etiology (VUE) and chronic chorioamnionitis (CCA), is considered a placental manifestation of maternal anti-fetal rejection. The aim of this study is to investigate its frequency in twin pregnancies compared to singleton pregnancies. METHODS: Three hundred twin placentas and 1,270 singleton placentas were consecutively collected at a tertiary medical center in Seoul, Republic of Korea from 2009 to 2012...
October 2015: Journal of Pathology and Translational Medicine
Chong Jai Kim, Roberto Romero, Piya Chaemsaithong, Jung-Sun Kim
Chronic inflammatory lesions of the placenta are characterized by the infiltration of the organ by lymphocytes, plasma cells, and/or macrophages and may result from infections (viral, bacterial, parasitic) or be of immune origin (maternal anti-fetal rejection). The 3 major lesions are villitis (when the inflammatory process affects the villous tree), chronic chorioamnionitis (which affects the chorioamniotic membranes), and chronic deciduitis (which involves the decidua basalis). Maternal cellular infiltration is a common feature of the lesions...
October 2015: American Journal of Obstetrics and Gynecology
Chong Jai Kim, Roberto Romero, Piya Chaemsaithong, Noppadol Chaiyasit, Bo Hyun Yoon, Yeon Mee Kim
Acute inflammatory lesions of the placenta consist of diffuse infiltration of neutrophils at different sites in the organ. These lesions include acute chorioamnionitis, funisitis, and chorionic vasculitis and represent a host response (maternal or fetal) to a chemotactic gradient in the amniotic cavity. While acute chorioamnionitis is evidence of a maternal host response, funisitis and chorionic vasculitis represent fetal inflammatory responses. Intraamniotic infection generally has been considered to be the cause of acute chorioamnionitis and funisitis; however, recent evidence indicates that "sterile" intraamniotic inflammation, which occurs in the absence of demonstrable microorganisms induced by "danger signals," is frequently associated with these lesions...
October 2015: American Journal of Obstetrics and Gynecology
J U Ortiz, E Eixarch, A Peguero, S M Lobmaier, M Bennasar, J M Martinez, E Gratacós
OBJECTIVE: To evaluate the incidence of chorioamniotic membrane separation (CMS) after fetoscopy in monochorionic diamniotic (MCDA) twins and its impact on pregnancy outcome. METHODS: The study group comprised a consecutive series of 338 women with an MCDA pregnancy complicated by twin-twin transfusion syndrome (TTTS) or selective intrauterine growth restriction (sIUGR) treated with selective laser photocoagulation of communicating vessels (SLPCV) or cord occlusion (CO)...
March 2016: Ultrasound in Obstetrics & Gynecology
Lorenza Pugni, Carlo Pietrasanta, Barbara Acaia, Daniela Merlo, Andrea Ronchi, Manuela Wally Ossola, Silvano Bosari, Fabio Mosca
The term chorioamnionitis is used to refer to an intrauterine infection/inflammation occurring between the maternal tissues and the fetal membranes (choriodecidual space) or in the fetal annexes (chorioamniotic membranes, amniotic fluid, umbilical cord). Histological examination of the placenta is the gold standard for diagnosis. However, clinical, biochemical and microbiological criteria are also used to define the disease. The literature contains a large body of evidence showing that chorioamnionitis is the leading cause of very preterm birth and, therefore, contributes significantly to neonatal morbidity and mortality...
2016: Journal of Maternal-fetal & Neonatal Medicine
Thomas Gabas, Marianne Leruez-Ville, Delphine Le Mercier, Olivier Lortholary, Marc Lecuit, Caroline Charlier
Influenza is a respiratory disease caused by influenza viruses. The virus is responsible for pandemics by emergence of new viral strains, then for seasonal flu by antigenic drift. Seasonal flu is more frequent and severe in pregnant women, with increased risk of pneumonia and increased risk of hospitalization (but no increased death reported). Pandemic flu is more severe in pregnant women, with increased risk of pneumonia and increased mortality. Influenza vaccination is recommended for all women who are or will be pregnant (in any trimester) during influenza season...
June 2015: La Presse Médicale
Faranak Behnia, Brandie D Taylor, Michael Woodson, Marian Kacerovsky, Hal Hawkins, Stephen J Fortunato, George R Saade, Ramkumar Menon
OBJECTIVE: Senescence is an important biological phenomenon involved in both physiologic and pathologic processes. We propose that chorioamniotic membrane senescence is a mechanism associated with human parturition. The present study was conducted to explore the association between senescence and normal term parturition by examining the morphologic and biochemical evidences in chorioamniotic membranes. STUDY DESIGN: Chorioamniotic membranes were collected from normal term deliveries; group 1: term labor and group 2: term, not in labor...
September 2015: American Journal of Obstetrics and Gynecology
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