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A Murine Model of Fetal Exposure to Maternal Inflammation to Study the Effects of Acute Chorioamnionitis on Newborn Intestinal Development
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Prelabor rupture of membranes between 34 and 37 weeks: the intraamniotic inflammatory response and neonatal outcomes

Marian Kacerovsky1, Ivana Musilova2, Ctirad Andrys3

  • 1Biomedical Research Center, University Hospital in Hradec Kralove, Hradec Kralove, Czech Republic; Department of Obstetrics and Gynecology, Charles University in Prague, Faculty of Medicine in Hradec Kralove, Hradec Kralove, Czech Republic.

American Journal of Obstetrics and Gynecology
|November 5, 2013
PubMed
Abstract

Insights

Microbial invasion of the amniotic cavity (MIAC) and acute histologic chorioamnionitis (HCA) significantly increase intraamniotic inflammation and early-onset sepsis in preterm prelabor rupture of membranes (PPROM) between 34-37 weeks.

Area of Science:

  • Obstetrics and Gynecology
  • Maternal-Fetal Medicine
  • Neonatology

Background:

  • Preterm prelabor rupture of membranes (PPROM) between 34-37 weeks is a significant obstetric complication.
  • Microbial invasion of the amniotic cavity (MIAC) and acute histologic chorioamnionitis (HCA) are potential contributors to adverse pregnancy outcomes.
  • The interplay between MIAC, HCA, and neonatal morbidity requires further elucidation.

Purpose of the Study:

  • To investigate the impact of MIAC and HCA on the intraamniotic inflammatory response.
  • To assess the association between MIAC, HCA, and neonatal morbidity in PPROM pregnancies (34-37 weeks).

Main Methods:

  • Amniocentesis was performed on 99 women with PPROM (34-37 weeks) to determine MIAC and interleukin-6 (IL-6) levels.
  • Placental evaluation for HCA was conducted post-delivery.
  • Neonatal outcomes, including early-onset sepsis, were recorded.

Main Results:

  • Women with both MIAC and HCA exhibited the highest IL-6 concentrations, indicating a heightened inflammatory response.
  • The combined presence of MIAC and HCA was associated with the highest incidence of early-onset sepsis in newborns.
  • Individual presence of MIAC or HCA also correlated with increased inflammation and sepsis risk compared to neither.

Conclusions:

  • Both MIAC and HCA significantly influence the intensity of the intraamniotic inflammatory response in PPROM (34-37 weeks).
  • The presence of MIAC and HCA increases the risk of neonatal early-onset sepsis.
  • Clinical management of PPROM should consider the intensity of the intraamniotic inflammatory response, informed by MIAC and HCA status.
Keywords:
amniotic fluidgestational agehistologic chorioamnionitisinterleukin-6microbial invasion of the amniotic cavity

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