Maternal-Fetal Medicine Department, ICGON, Hospital Clinic, Universitat de Barcelona, Barcelona, Spain.
PLoS One. 2012;7(8):e43677. doi: 10.1371/journal.pone.0043677. Epub 2012 Aug 20.
To evaluate the influence of microbial invasion of the amniotic cavity (MIAC) and histological chorioamnionitis (HCA) on the magnitude of intra-amniotic inflammatory response in preterm prelabor rupture of membranes (PPROM).
METHODOLOGY/PRINCIPAL FINDING: A prospective cohort study was performed in 107 women with PPROM between 23.0 and 36.6 weeks of gestational age. Twenty-six proteins were assayed by multiple immunoassay in amniotic fluid. The policy for PPROM in Czech Republic is active, and 90% of the women were delivered within 96 hours of membrane rupture. Histopathological placental findings were evaluated based on the Salafia classification. Data were analyzed in four subgroups of population according to the presence of MIAC and/or HCA. Results were stratified by gestational age at PPROM (< or ≥ 34.0 weeks). The rates of MIAC and HCA were 44% and 57%, respectively. Regardless of gestational age at PPROM, intra-amniotic inflammatory response was higher when MIAC and HCA were both present. There were no differences in the intra-amniotic inflammatory response between women with MIAC or HCA alone and women without infection.
A higher intra-amniotic inflammatory response was identified when both HCA and MIAC were detected.
评估微生物侵袭羊膜腔（MIAC）和组织学绒毛膜羊膜炎（HCA）对早产胎膜早破（PPROM）患者羊水中炎症反应程度的影响。
方法/主要发现：对 107 例妊娠 23.0 至 36.6 周的 PPROM 患者进行前瞻性队列研究。通过多重免疫分析法检测羊水中 26 种蛋白。捷克共和国的 PPROM 治疗方案是积极的，90%的患者在胎膜破裂后 96 小时内分娩。根据 Salafia 分类评估胎盘的组织病理学发现。根据 MIAC 和/或 HCA 的存在，将数据分为四组人群进行分析。结果按 PPROM 时的孕周（<34.0 周或≥34.0 周）进行分层。MIAC 和 HCA 的发生率分别为 44%和 57%。无论 PPROM 时的孕周如何，当 MIAC 和 HCA 同时存在时，羊水中的炎症反应都更高。MIAC 或 HCA 单独存在的女性与无感染的女性之间，羊水中的炎症反应无差异。
当同时检测到 HCA 和 MIAC 时，羊水中的炎症反应更高。
