Department of Pediatrics, School for Mental Health and Neuroscience, School for Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht, The Netherlands.
Neonatology. 2012;102(2):81-8. doi: 10.1159/000338015. Epub 2012 May 17.
Chorioamnionitis is a major risk factor for preterm birth in multifetal pregnancies. However, there is little clinical data whether chorioamnionitis is restricted to one amniotic compartment in multifetal pregnancies.
To explore whether chorioamnionitis is confined to the exposed compartment and does not cross to the unaffected fetus in twin pregnancy.
In twin pregnant sheep, one of the twins was exposed to either 2 or 14 days of intra-amniotic lipopolysaccharide (LPS) while the co-twin was exposed to either 2 or 14 days of intra-amniotic saline (n = 3 for each exposure). Singletons were included in this study to compare the grade of inflammation with twins. All fetuses were delivered at 125 days of gestation (term = 150 days). Chorioamnionitis was confirmed by histological examination. Lung inflammation was assessed by cell count in bronchoalveolar lavage. Lung compliance was assessed at 40 cm H(2)O. Results were compared using analysis of variance (ANOVA) with a post-hoc Tukey analysis.
Inflammation in placenta, membranes and lung of LPS-exposed twins was significantly higher after 2 and 14 days of exposure when compared to the saline-exposed co-twins. Lung compliance in LPS-exposed twins was significantly increased after 14 days when compared to saline-exposed co-twins. Intrauterine LPS exposure increased lung compliance and inflammation in the membranes, placenta and lung to the same extent in twins as in singletons.
In twin pregnant sheep, inflammation of the membranes, placenta and fetal lung was strictly limited to the exposed fetus in the amniotic compartment in which the LPS was injected.
羊膜腔炎是多胎妊娠早产的主要危险因素。然而,在多胎妊娠中,羊膜腔炎是否局限于一个羊膜腔的临床数据很少。
探讨羊膜腔炎是否局限于暴露的羊膜腔,而不会穿过未受影响的胎儿进入双胎妊娠。
在双胎妊娠绵羊中,一只胎儿接受 2 天或 14 天的羊膜内脂多糖(LPS)暴露,而另一只胎儿接受 2 天或 14 天的羊膜内生理盐水暴露(每种暴露各有 3 只胎儿)。本研究纳入了单胎妊娠的胎儿以比较其与双胎妊娠的炎症程度。所有胎儿均在妊娠 125 天(足月= 150 天)分娩。通过组织学检查确认羊膜腔炎。通过支气管肺泡灌洗中的细胞计数评估肺炎症。在 40cmH2O 时评估肺顺应性。使用方差分析(ANOVA)并进行事后 Tukey 分析比较结果。
与生理盐水暴露的同胎相比,LPS 暴露的双胎在暴露 2 天和 14 天后,胎盘、胎膜和肺的炎症明显升高。与生理盐水暴露的同胎相比,LPS 暴露的双胎在暴露 14 天后肺顺应性明显增加。宫内 LPS 暴露在双胎中增加了肺顺应性和胎膜、胎盘及肺的炎症,其程度与单胎相同。
在双胎妊娠绵羊中,羊膜腔炎、胎膜、胎盘和胎儿肺的炎症严格局限于接受 LPS 注射的羊膜腔内暴露的胎儿。