Maternal blood endotoxin activity in pregnancies complicated by preterm premature rupture of membranes |
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Authors: | Stefania Ronzoni Rohan D’Souza Oksana Shynlova Stephen Lye Kellie E. Murphy |
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Affiliation: | 1. Department of Obstetric and Gynecology, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Canada;2. Department of Obstetrics and Gynecology, Mount Sinai Hospital, University of Toronto, Toronto, Canada;3. Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital, University of Toronto, Toronto, Canada |
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Abstract: | Objective: To compare maternal blood endotoxin activity (EA) in women with preterm premature rupture of membranes (PPROM) with gestational age (GA) matched controls; to evaluate serial EA till birth in PPROM and its correlation with latency to delivery.Methods: We followed singleton preterm pregnancies from admission with PPROM until birth. Uncomplicated, GA-matched pregnancies served as controls. Demographics, birth and neonatal outcomes were collected. EA (EAA?) was assessed serially in PPROM and at study entry in controls. EA was compared using Mann Whitney and Wilcoxon tests, p value <.05 was considered significant.Results: We recruited 20 cases of PPROM and 20 controls. Demographics were similar between groups. Mean GA of PPROM was 29.0?±?2.2 weeks and median latency was 7.5 (IQR 14.1) weeks. Median EA at admission following PPROM was significantly elevated over controls (0.43 (0.18) versus 0.36 (0.2); p?.02). Overall there was no difference in median EA at admission and in labor (0.43 (0.18) versus 0.33 (0.21); p?=?.2) following PPROM. However, on comparing cases with latency to delivery ≤7 days (n?=?10) versus >7 days (n?=?10), there was a significant drop in EA in the latter group (0.44 (0.2) versus 0.34 (0.2); p?.004). Conclusions: EA in PPROM represents a promising biomarker in predicting the clinical evolution of preterm birth. |
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Keywords: | Chorioamnionitis endotoxin activity preterm premature rupture of membranes |
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