Department of Obstetrics and Gynecology, University Hospital in Hradec Kralove, Charles University, Faculty of Medicine Hradec Kralove, Hradec Kralove, Czech Republic.
Department of Clinical Immunology and Allergy, University Hospital in Hradec Kralove, Charles University, Faculty of Medicine Hradec Kralove, Hradec Kralove, Czech Republic.
Pediatr Res. 2018 Aug;84(2):240-247. doi: 10.1038/s41390-018-0073-1. Epub 2018 May 31.
To determine changes in the intraamniotic environment during the latency period using paired amniotic and gastric fluid samples in pregnancies complicated by preterm prelabor rupture of membranes (PPROM).
A total of 34 women with singleton pregnancies complicated by PPROM prior to 34 weeks were included in the study. Amniotic fluid was obtained by transabdominal amniocentesis at the time of admission. Immediately after delivery, umbilical cord blood and gastric fluid were obtained.
Microorganisms in amniotic and gastric fluid samples were found in 38% and 59% of women, respectively. Bedside IL-6 levels were higher in amniotic than in gastric fluid in pregnancies without fetal inflammatory response syndrome (FIRS) (263 pg/mL vs. 50 pg/mL; p < 0.0001), but not in pregnancies with FIRS (318 pg/mL vs. 444 pg/mL; p = 0.91). Funisitis and FIRS was associated with the highest bedside IL-6 levels in gastric fluid. A gastric fluid bedside IL-6 level of 275 pg/mL was found to be the ideal cutoff value to predict funisitis and FIRS.
The microbial and inflammatory status of the intraamniotic compartment changes during the latency period in PPROM. Bedside IL-6 assessment of gastric fluid may be useful in the rapid diagnosis of funisitis and FIRS.
通过对合并早产胎膜早破（PPROM）的孕妇的配对羊膜和胃液体样本，确定潜伏期内羊膜内环境的变化。
本研究共纳入 34 例在 34 周前发生 PPROM 的单胎妊娠妇女。入院时通过经腹羊膜穿刺术获取羊水。分娩后立即采集脐静脉血和胃液。
在分别有 38%和 59%的孕妇的羊膜和胃液样本中发现了微生物。在无胎儿炎症反应综合征（FIRS）的孕妇中，羊膜内的床边 IL-6 水平高于胃液（263 pg/mL 比 50 pg/mL；p < 0.0001），但在有 FIRS 的孕妇中则无差异（318 pg/mL 比 444 pg/mL；p = 0.91）。胎膜炎和 FIRS 与胃液中最高的床边 IL-6 水平相关。发现胃液床边 IL-6 水平为 275 pg/mL 时，是预测胎膜炎和 FIRS 的理想临界值。
PPROM 潜伏期羊膜内腔的微生物和炎症状态发生变化。床边 IL-6 评估胃液可能有助于快速诊断胎膜炎和 FIRS。
