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Which is more important for the intensity of intra-amniotic inflammation between total grade or involved anatomical region in preterm gestations with acute histologic chorioamnionitis?

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Objective There is no data on which is more important for the intensity of intra-amniotic inflammation (IAI) between total grade or involved anatomical region in acute histologic chorioamnionitis (acute-HCA) of preterm-gestations. The objective of current study is to examine this issue. Methods The intensity of IAI was measured by amniotic fluid (AF) white blood cell (WBC) count and matrix metalloproteinase-8 (MMP-8) concentration in 225 singleton preterm-gestations (<36 weeks) who had acute-HCA including chorio-decidua involvement and delivered within 5 days of amniocentesis. Acute-HCA was defined in the presence of acute inflammatory changes in each anatomical region (i.e., chorio-decidua, amnion or chorionic plate). Patients were divided into 6 groups according to total grade (i.e., 1−6) and the presence or absence of chorio-decidua restriction (i.e., chorio-decidua restriction vs. extension beyond chorio-decidua) of acute-HCA. Results There was no significant difference in a median AF WBC and MMP-8 between the two groups (group-1, cases with total grade 1 vs. group-2, cases with total grade 2) among cases with chorio-decidua restriction (each for P>0.05) and between the four groups (group-3, cases with total grade 2 vs. group-4, cases with total grade 3 vs. group-5, cases with total grade 4 vs. group-6, cases with total grade 5−6) among cases with extension beyond chorio-decidua (each for P>0.05). However, group-3 (cases with extension beyond chorio-decidua) had a significantly higher median AF WBC and MMP-8 than group-2 (cases with chorio-decidua restriction) among cases with total grade 2 (each for P<0.05). Conclusion Involved anatomical region is more important than total grade for the intensity of IAI in acute-HCA of preterm-gestations.

Abstract

Objective There is no data on which is more important for the intensity of intra-amniotic inflammation (IAI) between total grade or involved anatomical region in acute histologic chorioamnionitis (acute-HCA) of preterm-gestations. The objective of current study is to examine this issue. Methods The intensity of IAI was measured by amniotic fluid (AF) white blood cell (WBC) count and matrix metalloproteinase-8 (MMP-8) concentration in 225 singleton preterm-gestations (<36 weeks) who had acute-HCA including chorio-decidua involvement and delivered within 5 days of amniocentesis. Acute-HCA was defined in the presence of acute inflammatory changes in each anatomical region (i.e., chorio-decidua, amnion or chorionic plate). Patients were divided into 6 groups according to total grade (i.e., 1−6) and the presence or absence of chorio-decidua restriction (i.e., chorio-decidua restriction vs. extension beyond chorio-decidua) of acute-HCA. Results There was no significant difference in a median AF WBC and MMP-8 between the two groups (group-1, cases with total grade 1 vs. group-2, cases with total grade 2) among cases with chorio-decidua restriction (each for P>0.05) and between the four groups (group-3, cases with total grade 2 vs. group-4, cases with total grade 3 vs. group-5, cases with total grade 4 vs. group-6, cases with total grade 5−6) among cases with extension beyond chorio-decidua (each for P>0.05). However, group-3 (cases with extension beyond chorio-decidua) had a significantly higher median AF WBC and MMP-8 than group-2 (cases with chorio-decidua restriction) among cases with total grade 2 (each for P<0.05). Conclusion Involved anatomical region is more important than total grade for the intensity of IAI in acute-HCA of preterm-gestations.

참고문헌 (18)

  1. Redline RW, "Amniotic infection syndrome: nosology and reproducibility of placental reaction patterns", Pediatr Dev Pathol, 6, pp.435~448 (2003)
  2. van Hoeven KH, "Clinical significance of increasing histologic severity of acute inflammation in the fetal membranes and umbilical cord", Pediatr Pathol Lab Med, 16, pp.731~744 (1996)
  3. Keenan WJ, "Placental pathology compared with clinical outcome: a retrospective blind review", Am J Dis Child, 131, pp.1224~1227 (1977)
  4. Romero R, "The relationship between acute inflammatory lesions of the preterm placenta and amniotic fluid microbiology", Am J Obstet Gynecol, 166, pp.1382~1388 (1992)
  5. Park KH, "The relationship between the presence, severity, and pattern of acute placental inflammation and amniotic fluid white blood cell count in preterm labor", Prenat Neonatal Med, 2, pp.294~299 (1997)
  6. Halgunset J, "Cytokine levels in amniotic fluid and inflammatory changes in the placenta from normal deliveries at term", Eur J Obstet Gynecol Reprod Biol, 56, pp.153~160 (1994)
  7. Rogers BB, "Umbilical vein interleukin-6 levels correlate with the severity of placental inflammation and gestational age", Hum Pathol, 33, pp.335~340 (2002)
  8. Park JS, "The relationship between amniotic fluid matrix metalloproteinase-8 and funisitis", Am J Obstet Gynecol, 185, pp.1156~1161 (2001)
  9. Yoon BH, "C-reactive protein in umbilical cord blood : a simple and widely available clinical method to assess the risk of amniotic fluid infection and funisitis", J Matern Fetal Neonatal Med, 14, pp.85~90 (2003)
  10. Yoon BH, "The relationship among inflammatory lesions of the umbilical cord (funisitis), umbilical cord plasma interleukin 6 concentration, amniotic fluid infection, and neonatal sepsis", Am J Obstet Gynecol, 183, pp.1124~1129 (2000)
  11. Park CW, "The involvement of human amnion in histologic chorioamnionitis is an indicator that a fetal and an intra-amniotic inflammatory response is more likely and severe : clinical implications", Placenta, 30, pp.56~61 (2009)
  12. Park CW, "The frequency and clinical significance of intra-uterine infection and inflammation in patients with placenta previa and preterm labor and intact membranes", Placenta, 30, pp.613~618 (2009)
  13. Park CW, "Acute histologic choriodeciduitis is associated with an intra-amniotic inflammatory response, but not a maternal and fetal inflammatory response: implications of the staging of inflammation of the chorioamniotic membranes", Am J Obstet Gynecol, 201, pp.S190~ (2009)
  14. Yoon BH, "Amniotic fluid interleukin-6 : a sensitive test for antenatal diagnosis of acute inflammatory lesions of preterm placenta and prediction of perinatal morbidity", Am J Obstet Gynecol, 172, pp.960~970 (1995)
  15. Yoon BH, "Maternal blood C-reactive protein, white blood cell count, and temperature in preterm labor: a comparison with amniotic fluid white blood cell count", Obstet Gynecol, 87, pp.231~237 (1996)
  16. Yoon BH, "Serum C-reactive protein, white blood cell count, and amniotic fluid white blood cell count in women with preterm premature rupture of membranes", Obstet Gynecol, 88, pp.1034~1040 (1996)
  17. Yoon BH, "Fetal exposure to an intra-amniotic inflammation and the development of cerebral palsy at the age of three years", Am J Obstet Gynecol, 182, pp.675~681 (2000)
  18. Shim SS, "Clinical significance of intra-amniotic inflammation in patients with preterm premature rupture of membranes", Am J Obstet Gynecol, 191, pp.1339~1345 (2004)

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