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Amniotic fluid prostaglandin E2 in pregnancies complicated by preterm prelabor rupture of the membranes
Authors:Ivana Musilova  Ctirad Andrys  Marcela Drahosova  Helena Hornychova  Bo Jacobsson  Ramkumar Menon
Affiliation:1. Department of Obstetrics and Gynecology, Faculty of Medicine Hradec Kralove, Charles University in Prague, Hradec Kralove, Czech Republic,;2. Department of Clinical Immunology and Allergy, Faculty of Medicine Hradec Kralove, University in Prague, University Hospital Hradec Kralove, Hradec Kralove, Czech Republic,;3. Fingerland’s Department of Pathology, Faculty of Medicine Hradec Kralove, University in Prague, University Hospital Hradec Kralove, Hradec Kralove, Czech Republic,;4. Department of Obstetrics and Gynecology, Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden,;5. Department of Genes and Environment, Division of Epidemiology, Norwegian Institute of Public Health, Oslo, Norway,;6. Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine &7. Perinatal Research, The University of Texas Medical Branch at Galveston, Galveston, TX, USA,
Abstract:Objective: To determine amniotic fluid prostaglandin E2 concentrations in women preterm prelabor rupture of the membranes (PPROM) with respect to microbial invasion of the amniotic cavity (MIAC), intraamniotic inflammation (IAI), microbial-associated IAI, histological chorioamnionitis, and short-term neonatal morbidity.

Methods: One hundred forty-five women with singleton pregnancies were included in this study. Amniotic fluid samples were obtained by transabdominal amniocentesis and were assayed for prostaglandin E2 concentrations by ELISA. IAI was defined as amniotic fluid interleukin-6 >745?pg/mL. Microbial-associated IAI was defined as the presence of both MIAC and IAI.

Result: No differences in prostaglandin E2 concentrations were found between women with and without MIAC (p?=?0.27). Women with IAI (p?=?0.0008) and microbial-associated IAI (p?=?0.01) had higher prostaglandin E2 concentrations than women without these complications. Women with histological chorioamnionitis had higher prostaglandin E2 concentrations only in crude analysis (p?=?0.02), but not after adjustment for gestational age at sampling (p?=?0.10). No associations between amniotic fluid prostaglandin E2 concentrations and the selected conditions of severe neonatal morbidity were found.

Conclusions: The intraamniotic inflammatory response either to infectious or to non-infectious stimulus, but not MIAC per se, seems to be a main factor associated with the elevation of the amniotic fluid PGE2 concentrations in women with PPROM.
Keywords:Infection  inflammation  placenta  preterm delivery
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