Intra-Amniotic Infection and Sterile Intra-Amniotic Inflammation in Cervical Insufficiency with Prolapsed Fetal Membranes: Clinical Implications
Introduction: The aim of this study was to identify the rates of 2 phenotypes of intra-amniotic inflammation: intra-amniotic infection (with microbial invasion of the amniotic cavity [MIAC]) and sterile intra-amniotic inflammation (without MIAC), and their outcomes, among women with cervical insuffi...
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| Veröffentlicht in: | Fetal diagnosis and therapy 2021-01, Vol.48 (1), p.58-69 |
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| creator | Chalupska, Martina Kacerovsky, Marian Stranik, Jaroslav Gregor, Miroslav Maly, Jan Jacobsson, Bo Musilova, Ivana |
| description | Introduction: The aim of this study was to identify the rates of 2 phenotypes of intra-amniotic inflammation: intra-amniotic infection (with microbial invasion of the amniotic cavity [MIAC]) and sterile intra-amniotic inflammation (without MIAC), and their outcomes, among women with cervical insufficiency with prolapsed fetal membranes. Methods of Study: This is a retrospective study of women admitted to the Department of Obstetrics and Gynecology, University Hospital Hradec Kralove between January 2014 and May 2020. Transabdominal amniocentesis to evaluate intra-amniotic inflammation (amniotic fluid interleukin-6) and MIAC (culturing and molecular biology methods) was performed as part of standard clinical management. Results: In total, 37 women with cervical insufficiency and prolapsed fetal membranes were included; 11% (4/37) and 43% (16/37) of them had intra-amniotic infection and sterile intra-amniotic inflammation, respectively. In women with intra-amniotic infection and sterile intra-amniotic inflammation, we noted shorter intervals between admission and delivery (both p < 0.0001), and lower gestational age at delivery (p < 0.0001 and p = 0.004) and percentiles of birth/abortion weight (p = 0.03 and p = 0.009, respectively) than in those without intra-amniotic inflammation. Conclusions: Both phenotypes of intra-amniotic inflammation, with sterile intra-amniotic inflammation being more frequent, are associated with worse outcomes in pregnancies with cervical insufficiency with prolapsed fetal membranes. |
| doi_str_mv | 10.1159/000512102 |
| format | Article |
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Methods of Study: This is a retrospective study of women admitted to the Department of Obstetrics and Gynecology, University Hospital Hradec Kralove between January 2014 and May 2020. Transabdominal amniocentesis to evaluate intra-amniotic inflammation (amniotic fluid interleukin-6) and MIAC (culturing and molecular biology methods) was performed as part of standard clinical management. Results: In total, 37 women with cervical insufficiency and prolapsed fetal membranes were included; 11% (4/37) and 43% (16/37) of them had intra-amniotic infection and sterile intra-amniotic inflammation, respectively. In women with intra-amniotic infection and sterile intra-amniotic inflammation, we noted shorter intervals between admission and delivery (both p < 0.0001), and lower gestational age at delivery (p < 0.0001 and p = 0.004) and percentiles of birth/abortion weight (p = 0.03 and p = 0.009, respectively) than in those without intra-amniotic inflammation. Conclusions: Both phenotypes of intra-amniotic inflammation, with sterile intra-amniotic inflammation being more frequent, are associated with worse outcomes in pregnancies with cervical insufficiency with prolapsed fetal membranes.</description><identifier>ISSN: 1015-3837</identifier><identifier>ISSN: 1421-9964</identifier><identifier>EISSN: 1421-9964</identifier><identifier>DOI: 10.1159/000512102</identifier><identifier>PMID: 33291113</identifier><language>eng</language><publisher>Basel, Switzerland: S. Karger AG</publisher><subject>Amniocentesis ; Amniotic Fluid ; Cerclage ; Cervix uteri ; Chorioamnionitis ; Complications and side effects ; Diagnosis ; Dilatation ; Emergency cerclage ; Extraembryonic Membranes ; Female ; Fetal Membranes, Premature Rupture ; Fetus ; Growth retardation ; Humans ; Inflammation ; Interleukin-6 ; Microorganism ; Mycoplasma ; Nonelective cerclage ; Obstetrics, Gynecology and Reproductive Medicine ; Physical exam-indicated cerclage ; Pregnancy ; Pregnancy Complications, Infectious ; Pregnancy, Complications of ; Preterm delivery ; Reproduktionsmedicin och gynekologi ; Rescue cerclage ; Research Article ; Retrospective Studies ; Risk factors ; Second trimester abortion ; Second trimester loss ; Sterile inflammation ; Ureaplasma</subject><ispartof>Fetal diagnosis and therapy, 2021-01, Vol.48 (1), p.58-69</ispartof><rights>2020 The Author(s)Published by S. Karger AG, Basel</rights><rights>2020 The Author(s)Published by S. Karger AG, Basel.</rights><rights>COPYRIGHT 2021 S. Karger AG</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c505t-fbef18ecde8c9c9cfdb1732b0f632a3977ce6668c5790a336cdf74c58fa12bc3</citedby><cites>FETCH-LOGICAL-c505t-fbef18ecde8c9c9cfdb1732b0f632a3977ce6668c5790a336cdf74c58fa12bc3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,780,784,885,2429,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33291113$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink><backlink>$$Uhttps://gup.ub.gu.se/publication/299198$$DView record from Swedish Publication Index$$Hfree_for_read</backlink></links><search><creatorcontrib>Chalupska, Martina</creatorcontrib><creatorcontrib>Kacerovsky, Marian</creatorcontrib><creatorcontrib>Stranik, Jaroslav</creatorcontrib><creatorcontrib>Gregor, Miroslav</creatorcontrib><creatorcontrib>Maly, Jan</creatorcontrib><creatorcontrib>Jacobsson, Bo</creatorcontrib><creatorcontrib>Musilova, Ivana</creatorcontrib><title>Intra-Amniotic Infection and Sterile Intra-Amniotic Inflammation in Cervical Insufficiency with Prolapsed Fetal Membranes: Clinical Implications</title><title>Fetal diagnosis and therapy</title><addtitle>Fetal Diagn Ther</addtitle><description>Introduction: The aim of this study was to identify the rates of 2 phenotypes of intra-amniotic inflammation: intra-amniotic infection (with microbial invasion of the amniotic cavity [MIAC]) and sterile intra-amniotic inflammation (without MIAC), and their outcomes, among women with cervical insufficiency with prolapsed fetal membranes. Methods of Study: This is a retrospective study of women admitted to the Department of Obstetrics and Gynecology, University Hospital Hradec Kralove between January 2014 and May 2020. Transabdominal amniocentesis to evaluate intra-amniotic inflammation (amniotic fluid interleukin-6) and MIAC (culturing and molecular biology methods) was performed as part of standard clinical management. Results: In total, 37 women with cervical insufficiency and prolapsed fetal membranes were included; 11% (4/37) and 43% (16/37) of them had intra-amniotic infection and sterile intra-amniotic inflammation, respectively. In women with intra-amniotic infection and sterile intra-amniotic inflammation, we noted shorter intervals between admission and delivery (both p < 0.0001), and lower gestational age at delivery (p < 0.0001 and p = 0.004) and percentiles of birth/abortion weight (p = 0.03 and p = 0.009, respectively) than in those without intra-amniotic inflammation. Conclusions: Both phenotypes of intra-amniotic inflammation, with sterile intra-amniotic inflammation being more frequent, are associated with worse outcomes in pregnancies with cervical insufficiency with prolapsed fetal membranes.</description><subject>Amniocentesis</subject><subject>Amniotic Fluid</subject><subject>Cerclage</subject><subject>Cervix uteri</subject><subject>Chorioamnionitis</subject><subject>Complications and side effects</subject><subject>Diagnosis</subject><subject>Dilatation</subject><subject>Emergency cerclage</subject><subject>Extraembryonic Membranes</subject><subject>Female</subject><subject>Fetal Membranes, Premature Rupture</subject><subject>Fetus</subject><subject>Growth retardation</subject><subject>Humans</subject><subject>Inflammation</subject><subject>Interleukin-6</subject><subject>Microorganism</subject><subject>Mycoplasma</subject><subject>Nonelective cerclage</subject><subject>Obstetrics, Gynecology and Reproductive Medicine</subject><subject>Physical exam-indicated cerclage</subject><subject>Pregnancy</subject><subject>Pregnancy Complications, Infectious</subject><subject>Pregnancy, Complications of</subject><subject>Preterm delivery</subject><subject>Reproduktionsmedicin och gynekologi</subject><subject>Rescue cerclage</subject><subject>Research Article</subject><subject>Retrospective Studies</subject><subject>Risk factors</subject><subject>Second trimester abortion</subject><subject>Second trimester loss</subject><subject>Sterile inflammation</subject><subject>Ureaplasma</subject><issn>1015-3837</issn><issn>1421-9964</issn><issn>1421-9964</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>M--</sourceid><sourceid>EIF</sourceid><recordid>eNpt0kGL1DAUAOAiiruuHryLFATRQ9ekaZPG2zDr6MCKgnMPafoyE02TmrQu-y_2J5vZjqOLSw4JyfdeeI-XZc8xOse45u8QQjUuMSofZKe4KnHBOa0epjPCdUEawk6yJzF-T6xhhD7OTggpOcaYnGY3azcGWSx6Z_xoVL52GtRovMul6_JvIwRjIf8fWdn38tYZly8h_DJK2vQQJ62NMuDUdX5lxl3-NXgrhwhdvoIxkc_Qt0E6iO_zpTVuDusHmw77dPFp9khLG-HZYT_LNqsPm-Wn4vLLx_VycVmoGtVjoVvQuAHVQaN4WrprMSNlizQlpSScMQWU0kbVjCNJCFWdZpWqGy1x2SpylhVz2ngFw9SKIZhehmvhpRHbaRDpajuJCKLkHPMm-TezH4L_OUEcRW-iAmtTKX6KoqxoQxmqWZnoq5lupQVhnPapeWrPxYJyVPMKszqp83tUWh30RnkHOjX-bsDrfwJ2IO24i95Ot127C9_OUAUfYwB9LA4jsZ8XcZyXZF8eypraHrqj_DMgf4v5IcMWwhGsLjZzCjF0OqkX96rDL78BHgLQUQ</recordid><startdate>20210101</startdate><enddate>20210101</enddate><creator>Chalupska, Martina</creator><creator>Kacerovsky, Marian</creator><creator>Stranik, Jaroslav</creator><creator>Gregor, Miroslav</creator><creator>Maly, Jan</creator><creator>Jacobsson, Bo</creator><creator>Musilova, Ivana</creator><general>S. Karger AG</general><scope>M--</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>ADTPV</scope><scope>AOWAS</scope><scope>F1U</scope></search><sort><creationdate>20210101</creationdate><title>Intra-Amniotic Infection and Sterile Intra-Amniotic Inflammation in Cervical Insufficiency with Prolapsed Fetal Membranes: Clinical Implications</title><author>Chalupska, Martina ; Kacerovsky, Marian ; Stranik, Jaroslav ; Gregor, Miroslav ; Maly, Jan ; Jacobsson, Bo ; Musilova, Ivana</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c505t-fbef18ecde8c9c9cfdb1732b0f632a3977ce6668c5790a336cdf74c58fa12bc3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Amniocentesis</topic><topic>Amniotic Fluid</topic><topic>Cerclage</topic><topic>Cervix uteri</topic><topic>Chorioamnionitis</topic><topic>Complications and side effects</topic><topic>Diagnosis</topic><topic>Dilatation</topic><topic>Emergency cerclage</topic><topic>Extraembryonic Membranes</topic><topic>Female</topic><topic>Fetal Membranes, Premature Rupture</topic><topic>Fetus</topic><topic>Growth retardation</topic><topic>Humans</topic><topic>Inflammation</topic><topic>Interleukin-6</topic><topic>Microorganism</topic><topic>Mycoplasma</topic><topic>Nonelective cerclage</topic><topic>Obstetrics, Gynecology and Reproductive Medicine</topic><topic>Physical exam-indicated cerclage</topic><topic>Pregnancy</topic><topic>Pregnancy Complications, Infectious</topic><topic>Pregnancy, Complications of</topic><topic>Preterm delivery</topic><topic>Reproduktionsmedicin och gynekologi</topic><topic>Rescue cerclage</topic><topic>Research Article</topic><topic>Retrospective Studies</topic><topic>Risk factors</topic><topic>Second trimester abortion</topic><topic>Second trimester loss</topic><topic>Sterile inflammation</topic><topic>Ureaplasma</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Chalupska, Martina</creatorcontrib><creatorcontrib>Kacerovsky, Marian</creatorcontrib><creatorcontrib>Stranik, Jaroslav</creatorcontrib><creatorcontrib>Gregor, Miroslav</creatorcontrib><creatorcontrib>Maly, Jan</creatorcontrib><creatorcontrib>Jacobsson, Bo</creatorcontrib><creatorcontrib>Musilova, Ivana</creatorcontrib><collection>Karger Open Access</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>SwePub</collection><collection>SwePub Articles</collection><collection>SWEPUB Göteborgs universitet</collection><jtitle>Fetal diagnosis and therapy</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Chalupska, Martina</au><au>Kacerovsky, Marian</au><au>Stranik, Jaroslav</au><au>Gregor, Miroslav</au><au>Maly, Jan</au><au>Jacobsson, Bo</au><au>Musilova, Ivana</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Intra-Amniotic Infection and Sterile Intra-Amniotic Inflammation in Cervical Insufficiency with Prolapsed Fetal Membranes: Clinical Implications</atitle><jtitle>Fetal diagnosis and therapy</jtitle><addtitle>Fetal Diagn Ther</addtitle><date>2021-01-01</date><risdate>2021</risdate><volume>48</volume><issue>1</issue><spage>58</spage><epage>69</epage><pages>58-69</pages><issn>1015-3837</issn><issn>1421-9964</issn><eissn>1421-9964</eissn><abstract>Introduction: The aim of this study was to identify the rates of 2 phenotypes of intra-amniotic inflammation: intra-amniotic infection (with microbial invasion of the amniotic cavity [MIAC]) and sterile intra-amniotic inflammation (without MIAC), and their outcomes, among women with cervical insufficiency with prolapsed fetal membranes. Methods of Study: This is a retrospective study of women admitted to the Department of Obstetrics and Gynecology, University Hospital Hradec Kralove between January 2014 and May 2020. Transabdominal amniocentesis to evaluate intra-amniotic inflammation (amniotic fluid interleukin-6) and MIAC (culturing and molecular biology methods) was performed as part of standard clinical management. Results: In total, 37 women with cervical insufficiency and prolapsed fetal membranes were included; 11% (4/37) and 43% (16/37) of them had intra-amniotic infection and sterile intra-amniotic inflammation, respectively. In women with intra-amniotic infection and sterile intra-amniotic inflammation, we noted shorter intervals between admission and delivery (both p < 0.0001), and lower gestational age at delivery (p < 0.0001 and p = 0.004) and percentiles of birth/abortion weight (p = 0.03 and p = 0.009, respectively) than in those without intra-amniotic inflammation. Conclusions: Both phenotypes of intra-amniotic inflammation, with sterile intra-amniotic inflammation being more frequent, are associated with worse outcomes in pregnancies with cervical insufficiency with prolapsed fetal membranes.</abstract><cop>Basel, Switzerland</cop><pub>S. Karger AG</pub><pmid>33291113</pmid><doi>10.1159/000512102</doi><tpages>12</tpages><oa>free_for_read</oa></addata></record> |
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| source | Karger Journal Archive Collection; MEDLINE; Karger Journals; Alma/SFX Local Collection |
| subjects | Amniocentesis Amniotic Fluid Cerclage Cervix uteri Chorioamnionitis Complications and side effects Diagnosis Dilatation Emergency cerclage Extraembryonic Membranes Female Fetal Membranes, Premature Rupture Fetus Growth retardation Humans Inflammation Interleukin-6 Microorganism Mycoplasma Nonelective cerclage Obstetrics, Gynecology and Reproductive Medicine Physical exam-indicated cerclage Pregnancy Pregnancy Complications, Infectious Pregnancy, Complications of Preterm delivery Reproduktionsmedicin och gynekologi Rescue cerclage Research Article Retrospective Studies Risk factors Second trimester abortion Second trimester loss Sterile inflammation Ureaplasma |
| title | Intra-Amniotic Infection and Sterile Intra-Amniotic Inflammation in Cervical Insufficiency with Prolapsed Fetal Membranes: Clinical Implications |
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