Abstract:
BACKGROUND:Intra-amniotic infection or inflammation (IAI) is common in early preterm birth and associated with significant neonatal lung morbidity due to fetal exposure to pro-inflammatory cytokines and infectious organisms. Amniotic fluid interleukin-8 (IL-8), a pro-inflammatory cytokine, was previously correlated with development of neonatal bronchopulmonary dysplasia, but whether amniotic fluid cytokines or placental pathology more accurately predicts neonatal lung pathology and morbidity is unknown. We have used a pregnant nonhuman primate (NHP) model of Group B Streptococcus (GBS) infection to study the pathogenesis of IAI, bacterial invasion of the amniotic cavity and fetus, as well as microbial-host interactions. In this NHP model, we have studied the pathogenesis of several GBS strains with differing potential for virulence, which has resulted in a spectrum of IAI and fetal lung injury that affords the opportunity to study the inflammatory predictors of fetal lung pathology and injury. OBJECTIVES:To determine whether fetal lung injury is best predicted by placental histopathology or the cytokine response in amniotic fluid or maternal plasma. STUDY DESIGN:Chronically catheterized pregnant monkeys (Macaca nemestrina, pigtail macaque) at 116-125 days gestation (term=172 days) received a choriodecidual inoculation of either saline (n=5), weakly hemolytic (WH) GBS strain (N=5, low virulence), or hyper-hemolytic (HH) GBS strain (N=5, high virulence). Adverse pregnancy outcomes were defined as either preterm labor, microbial invasion of the amniotic cavity or development of the fetal inflammatory response syndrome (FIRS). Amniotic fluid, maternal and fetal plasma samples were collected after inoculation and pro-inflammatory cytokines (TNF-α, IL-β, IL-6, IL-8) were measured by a multiplex assay. Cesarean section was performed at the time of preterm labor or within one week of inoculation. Fetal necropsy was performed at the time of delivery. Placental pathology was scored by a pediatric pathologist and fetal lung injury was determined by semi-quantitative score from histopathology evaluating inflammatory infiltrate, necrosis, tissue thickening or collapse scored by a veterinary pathologist. RESULTS:The principal findings in our study are: (1) adverse pregnancy outcomes occurred more frequently in animals receiving HH GBS (80% with preterm labor, 80% with FIRS) compared to WH GBS (40% with preterm labor, 20% with FIRS) and controls (0% preterm labor, 0% FIRS); (2) despite differences in the rate of adverse pregnancy outcomes and FIRS, fetal lung injury scores were similar between animals receiving the WH and HH GBS strains; (3) fetal lung injury score was significantly correlated with peak amniotic fluid cytokines IL-6 and IL-8, but not TNF-α or IL-1β; and (4) fetal lung scores were poorly correlated with maternal and fetal plasma cytokine levels and placental pathology. CONCLUSIONS:Amniotic fluid IL-6 and IL-8 levels were a superior predictor of fetal lung injury compared to placental histopathology or maternal plasma cytokines. This evidence supports a role for amniocentesis in the prediction of neonatal lung morbidity due to IAI, which cannot be provided by cytokine analysis of the maternal plasma or placental histopathology.
journal_name
Am J Obstet Gynecoljournal_title
American journal of obstetrics and gynecologyauthors
McCartney SA,Kapur R,Liggitt HD,Baldessari A,Coleman M,Orvis A,Ogle J,Katz R,Rajagopal L,Waldorf KMAdoi
10.1016/j.ajog.2020.12.1214subject
Has Abstractpub_date
2021-01-04 00:00:00eissn
0002-9378issn
1097-6868pii
S0002-9378(20)32631-4pub_type
杂志文章abstract:OBJECTIVE:Circulating adrenomedullin is increased in pregnancy, and placental and fetal membranes participate significantly in its secretion. Recent studies have suggested a potential role for this peptide in the regulation of fetoplacental circulation and placental hormonal secretion. Because adrenomedullin acts also ...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1067/mob.2001.117189
更新日期:2001-09-01 00:00:00
abstract:OBJECTIVE:To compare postoperative pain after laparoscopic and vaginal hysterectomy for benign disease.
STUDY DESIGN:A prospective randomized trial was designed to compare laparoscopic hysterectomy and vaginal hysterectomy in patients with uterine volume journal_title:American journal of obstetrics and gynecology pub_type: 杂志文章,随机对照试验 doi:10.1016/j.ajog.2010.04.026 更新日期:2010-08-01 00:00:00
abstract:OBJECTIVE:The purpose of this research was to test a widely publicized theory that nausea and vomiting of pregnancy protects women from ingesting certain vegetables and other foods that produce congenital anomalies and other adverse outcomes of pregnancy. STUDY DESIGN:The theory was tested with use of data on dietary ...
journal_title:American journal of obstetrics and gynecology
pub_type: 临床试验,杂志文章
doi:10.1016/s0002-9378(97)80032-4
更新日期:1997-01-01 00:00:00
abstract:OBJECTIVE:The efficacy, safety, and antibiotic-related charges for once-daily gentamicin with twice-daily clindamycin were compared with those of thrice-daily dosing of these antibiotics. STUDY DESIGN:Patients with puerperal endometritis or with chorioamnionitis in labor assessed to be at risk for endometritis were ra...
journal_title:American journal of obstetrics and gynecology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/s0002-9378(97)70269-2
更新日期:1997-10-01 00:00:00
abstract::Placental steroid sulfatase deficiency is an unusual cause of low estriol production during pregnancy. Its importance lies in the differentiation of this disorder from the more ominous fetal defects that result in low estriol levels. Serum free estriol levels were found to be low or absent in a 25-year-old gravida 3, ...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(76)90526-3
更新日期:1976-11-15 00:00:00
abstract:OBJECTIVE:Our purpose was to evaluate and compare the conversion of 5-aminolevulinic acid into the endogenous photosensitizer protoporphyrin IX in experimentally induced endometriosis and in other normal tissues in a rat model. STUDY DESIGN:Fluorescence of experimental endometriotic lesions, uterus, peritoneum, bowel ...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0002-9378(96)70388-5
更新日期:1996-01-01 00:00:00
abstract::A patient with preexisting multiple endocrine neoplasia type IIA had normal 24-hour urinary metanephrine and vanillylmandelic acid excretions before and during pregnancy. After a benign prenatal course, the patient had a term spontaneous vaginal delivery. Multiple endocrine neoplasia type IIA antedating pregnancy may ...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0002-9378(97)70217-5
更新日期:1997-08-01 00:00:00
abstract::The effect of Danazol, a new gonadotropin inhibitor, was examined in four categories of patients. (1) Ten normal women medicated orally with Danazol, 800 mg. daily for 91 days, showed no depression of serum LH, estrone, estradiol, or progesterone below control, second-day levels. The serum FSH was slightly depressed; ...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1975-03-15 00:00:00
abstract:OBJECTIVE:The purpose of this study was to evaluate maternal alloimmunization to paternal leukocytes as a treatment for hemolytic disease of the fetus/newborn in a rabbit model. STUDY DESIGN:Twelve does and paired red blood cell-incompatible bucks underwent the experimental protocol. Fetal hematologic parameters that ...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1067/mob.2002.126960
更新日期:2002-10-01 00:00:00
abstract::The specific purposes of this report are twofold: (1) to summarize the descriptive epidemiology of urethral-vesical dysfunction in a population of 1439 female patients referred for urodynamic evaluation of symptoms and (2) to analyze the association between demographic, clinical, and investigative data. On the basis o...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(85)90016-x
更新日期:1985-01-15 00:00:00
abstract::Radical trachelectomy is an effective fertility-sparing treatment for women with early-stage cervical cancer. We describe the first reported ovarian recurrence after radical trachelectomy for stage IB1 adenocarcinoma cervical cancer. ...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2005.03.071
更新日期:2005-10-01 00:00:00
abstract:OBJECTIVE:Neurotrophins are proteins that promote neuronal growth and differentiation. In this pilot study we determined whether the neurotrophins nerve growth factor, brain-derived neurotrophic factor, and neurotrophin-3 were present in amniotic fluid specimens to begin to elucidate their developmental regulation. We ...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0002-9378(99)70113-4
更新日期:1999-11-01 00:00:00
abstract::The pronounced hepatic impact of oral ethinyl estradiol has been attributed by some to its so-called first-pass effect through the liver as only some 40% of ingested ethinyl estradiol reaches the systemic circulation. Others believe that ethinyl estradiol exerts its hepatic effects because of its chemical composition,...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(85)90664-7
更新日期:1985-04-01 00:00:00
abstract::We report a case of splenic rupture after cesarean delivery for abruptio placentae. The diagnosis was not suspected until a laparotomy was performed. Diagnosis and management were complicated by disseminated intravascular coagulation and renal failure. The importance of early diagnosis and management modalities are di...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(95)90199-x
更新日期:1995-07-01 00:00:00
abstract:OBJECTIVE:Defecatory symptoms, such as a sense of incomplete emptying and straining with bowel movements, are paradoxically present in women with fecal incontinence. Treatments for fecal incontinence, such as loperamide and biofeedback, can worsen or improve defecatory symptoms, respectively. The primary aim of this st...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.ajog.2019.11.1256
更新日期:2020-06-01 00:00:00
abstract::If the parents do not want to take the 50% chance that a male fetus will be involved with an x-linked disease, it is desirable to predict fetal sex early enough to safely terminate pregnancy. Slides obtained from midcervical smears of 20 consecutive patients at different stages of gestation were stained with .5% aque...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(73)90541-3
更新日期:1973-03-15 00:00:00
abstract::Uterine fibroid tumors (leiomyomas) are the most common benign pelvic tumors in women and are the major indication for hysterectomy. Fibroid tumors are more common and more severe among African American women. Although this disease disproportionately affects the African American population, we understand little about ...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章,评审
doi:10.1016/j.ajog.2013.08.008
更新日期:2014-03-01 00:00:00
abstract:OBJECTIVE:We report our experience with a technique for planning the final vaginal caliber and location of the vaginal apex in patients with severe vaginal prolapse. STUDY DESIGN:During the 2-year period ending April 1998, the technique was used in all 27 patients who were undergoing vaginal repair of prolapse perform...
journal_title:American journal of obstetrics and gynecology
pub_type: 临床试验,杂志文章
doi:10.1067/mob.2000.107658
更新日期:2000-08-01 00:00:00
abstract:OBJECTIVE:We sought to evaluate whether serial amnioinfusions for persistent oligohydramnios can affect the perinatal and long-term outcomes in extreme cases of preterm premature rupture of membranes. STUDY DESIGN:All singleton pregnancies with preterm premature rupture of membranes at <26 weeks' gestation and lasting...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1067/mob.2000.108873
更新日期:2000-10-01 00:00:00
abstract:BACKGROUND:Addressing record high rates of Chlamydia trachomatis incidence in the United States requires the utilization of effective strategies, such as expedited partner therapy, to reduce reinfection and further transmission. Expedited partner therapy, which can be given as a prescription or medication, is a strateg...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2018.01.036
更新日期:2018-05-01 00:00:00
abstract:OBJECTIVE:We sought to determine maternal factors that influence success of labor induction and whether the probability of cesarean delivery changed with time during induction. STUDY DESIGN:We performed a retrospective cohort study of 1650 singleton pregnancies induced at a gestation of 37 weeks or longer, with birthw...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2008.06.072
更新日期:2008-09-01 00:00:00
abstract::Sixty-six patients with fibrocystic mastopathy were enrolled in the trial after being selected according to clinical, radioultrasonographic, and histologic criteria. No characteristic hormonal profile was noted in most patients (52%). Estrogen receptors or progesterone receptors, or both, were found in 57% of patients...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(91)90680-p
更新日期:1991-05-01 00:00:00
abstract:BACKGROUND:Preeclampsia (PE) affects 2-3% of all pregnancies and is a major cause of maternal and perinatal morbidity and mortality. The traditional approach to screening for PE is to use a risk-scoring system based on maternal demographic characteristics and medical history (maternal factors), but the performance of s...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2015.11.016
更新日期:2016-05-01 00:00:00
abstract::Twin-twin transfusion syndrome associated with acute polyhydramnios in one sac and severe oligohydramnios in the other, which characteristically is diagnosed between 18 and 28 weeks, is associated with a high mortality rate for the involved twins. Patients who are managed without intervention have essentially 100% per...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(90)90618-h
更新日期:1990-11-01 00:00:00
abstract::Pancervicovaginal (Papanicolaou) smears exhibiting pseudomycilial-like clumps of organisms obtained from 35 women employing IUD's were studied by direct immunofluorescent technique for identification of A. israelii and A. naeslundi. In every case the specific fluorescence was achieved with species-specific antiserum a...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(78)90604-x
更新日期:1978-06-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to evaluate which variables predict neonatal depression in vaginal deliveries that result in permanent brachial plexus injury. STUDY DESIGN:With the use of a data set of litigated vaginal deliveries (n = 103 deliveries) from 1978 through 1999 that resulted in permanent brachial ...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1067/mob.2002.127128
更新日期:2002-10-01 00:00:00
abstract::A protein showing strong antigenic cross-reactivity with the "pregnancy-specific" beta1-glycoprotein (PSbetaG) was demonstrated in serum of pregnant women during the second and third trimesters, but not in sera from normal men and nonpregnant women. The described protein had alpha2-electrophoretic mobility and its mol...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(78)90597-5
更新日期:1978-06-01 00:00:00
abstract:OBJECTIVE:We tested the hypothesis that preterm delivery in women with twins or polyhydramnios is associated with enhanced expression and activity of cyclooxygenase type 2 in the amnion. STUDY DESIGN:We obtained amniotic tissue samples from women undergoing preterm delivery complicated by either twins or polyhydramnio...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1067/mob.2001.108076
更新日期:2001-01-01 00:00:00
abstract::Although sacrococcygeal teratoma is a rare and potentially malignant tumor, 10 cases were documented during a 5-year period at the University of Toronto Perinatal Complex. Diagnosis was made in the six cases in which prenatal ultrasound examination was performed. One patient with twins elected to terminate the pregnan...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(87)90290-0
更新日期:1987-02-01 00:00:00
abstract::The possible role of reproductive steroids in the vascular changes o f the estrous and menstrual cycles and of pregnancy has prompted both clinical observations and animal experiments on the influence of sex hormones on the physiology of blood vessels. Research was carried out to develop a method for exposing blood ...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(72)90637-0
更新日期:1972-07-01 00:00:00