Musilova Ivana, Andrys Ctirad, Drahosova Marcela, Hornychova Helena, Jacobsson Bo, Menon Ramkumar, Laudanski Piotr, Stepan Martin, Bestvina Tomas, Kacerovsky Marian
a Department of Obstetrics and Gynecology , Faculty of Medicine Hradec Kralove, Charles University in Prague, Hradec Kralove , Czech Republic .
b Department of Clinical Immunology and Allergy , Faculty of Medicine Hradec Kralove, University in Prague, University Hospital Hradec Kralove , Hradec Kralove , Czech Republic .
J Matern Fetal Neonatal Med. 2016 Sep;29(18):2915-23. doi: 10.3109/14767058.2015.1112372. Epub 2015 Nov 23.
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.
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.
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.
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.
确定胎膜早破（PPROM）孕妇羊水中前列腺素E2的浓度，并分析其与羊膜腔微生物入侵（MIAC）、羊膜腔内炎症（IAI）、微生物相关的IAI、组织学绒毛膜羊膜炎及短期新生儿发病率之间的关系。
本研究纳入145名单胎妊娠妇女。经腹羊膜腔穿刺获取羊水样本，采用酶联免疫吸附测定法（ELISA）检测前列腺素E2浓度。IAI定义为羊水白细胞介素-6>745 pg/mL。微生物相关的IAI定义为同时存在MIAC和IAI。
有无MIAC的孕妇前列腺素E2浓度无差异（p = 0.27）。有IAI（p = 0.0008）和微生物相关IAI（p = 0.01）的孕妇前列腺素E2浓度高于无这些并发症的孕妇。组织学绒毛膜羊膜炎孕妇仅在粗分析中前列腺素E2浓度较高（p = 0.02），但在调整取样时的孕周后无差异（p = 0.10）。未发现羊水前列腺素E2浓度与所选严重新生儿发病情况之间存在关联。
对于PPROM孕妇，羊膜腔内对感染性或非感染性刺激的炎症反应，而非MIAC本身，似乎是与羊水PGE2浓度升高相关的主要因素。
