The fetal inflammatory response syndrome☆,☆☆,★
Section snippets
Patients and eligibility
Women who were examined at Hutzel Hospital with preterm labor and intact membranes or with preterm premature rupture of membranes, over a 4-year period of time, were offered amniocentesis for the diagnosis of microbial invasion of the amniotic cavity and the assessment of fetal lung maturity. Patients who consented to have an amniocentesis were asked to participate in a research management protocol that included the aspiration of additional amniotic fluid for research purposes and
Study population
One hundred five patients with preterm labor and 52 patients with preterm premature rupture of membranes were included in this study. There were two perinatal deaths. In both cases the infants were delivered before 24 weeks of gestation and were excluded from analysis. The overall prevalence of preterm delivery <37 weeks was 80% (124/155). Severe neonatal morbidity developed in 54 neonates (34.8%). Table I displays the clinical characteristics of patients according to the presence or absence of
Comment
Our results demonstrate that a fetal plasma IL-6 level above 11 pg/mL is a major independent risk factor for the subsequent development of severe neonatal morbidity. The prevalence of an elevated fetal plasma IL-6 value in patients with preterm labor or premature rupture of membranes delivered within 1 week of cordocentesis was about 50% for either condition.
Microbial invasion of the amniotic cavity was associated wiith a fetal plasma IL-6 value >11 pg/mL (63.4% [26/41] vs 14.9% [17/114], for
Acknowledgements
We acknowledge the contribution of Dr Robert Sokol, Dr David Cotton, Dr Ruben Quintero, Dr Mark Evans, Dr Mitchell Dombrowski, Dr Yoram Sorokin, Dr Maurizio Galasso, Dr Karoline Puder, Sandy Field, RN, Carolyn Sudz, RN, Adriana Soto, RDMS, Mary King, RDMS, Tess Tagle, RN, and Elisa Walsh, RN, of Wayne State University/the Detroit Medical Center; Dr John C. Hobbins, Dr E. Albert Reece, Dr Alan H. DeCherney, Dr Maurice H. Mahoney, Dr Frederick Naftolin, and Virginia Sabo, RN, of Yale University;
References (26)
- et al.
Maternal placental vasculopathy and injection: two distinct subgroups among patients with preterm labor and preterm ruptured membranes
Am J Obstet Gynecol
(1993) - et al.
Infection and labor. V. Prevalence, microbiology, and clinical significance of intraamniotic infection in women with preterm labor and intact membranes
Am J Obstet Gynecol
(1989) - et al.
The diagnostic and prognostic value of amniotic fluid white blood cell count, glucose, interleukin-6, and Gram stain in patients with preterm labor and intact membranes
Am J Obstet Gynecol
(1993) - et al.
lntra-amniotic infection and the onset of labor in preterm premature rupture of membranes
Am J Obstet Gynecol
(1988) - et al.
A comparative study of the diagnostic performance of amniotic fluid glucose, white blood cell count, interleukin-6, and Gram stain in the detection of microbial invasion in patients with preterm premature rupture of membranes
Am J Obstet Gynecol
(1993) - et al.
The use of polymerase chain reaction to detect bacteria in amniotic fluid in pregnancies complicated by preterm labor [abstract 100]
Am J Obstet Gynecol
(1997) - et al.
Pathogenesis of preterm labor and preterm premature rupture of membranes associated with intraamniotic infection
Infect Dis Clin North Am
(1997) - et al.
Infection and labor. III. Interleukin 1: a signal for the onset of parturition
Am J Obstet Gynecol
(1989) - et al.
The onset of spontaneous preterm parturition is preceded by an intense pro-inflammatory cytokine response in human fetus [abstract 8]
Am J Obstet Gynecol
(1997) - et al.
A fetal systemic inflammatory response is followed by the spontaneous onset of preterm parturition
Am J Obstet Gynecol
(1998)
Ultrasound guided sampling of umbilical blood and placental blood to assess fetal well being
Lancet
The fetal biophysical profile in patients with premature rupture of membranes—an early predictor of fetal infection
Am J Obstet Gynecol
Obstetric antecedents of intraventricular hemorrhage and periventricular leukomalacia in the low-birth-weight neonate
Am J Obstet Gynecol
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From the Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Wayne State University/Hutzel Hospital,a the Perinatology Research Branch, National Institute of Child Health and Human Development,b the Department of Obstetrics and Gynecology, Sotero del Rio Hospital,c the Department of Obstetrics and Gynecology, Seoul National University,d and the Department of Obstetrics and Gynecology, Ben-Gurion University.e
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Reprint requests: Roberto Romero, MD, Department of Obstetrics and Gynecology, Hutzel Hospital, Perinatology Research Branch, NICHD, 4707 St. Antoine Blvd, Detroit, MI 48201.
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