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J. Perinat. Med. 40 (2012) 33–37 • Copyright by Walter de Gruyter • Berlin • Boston. DOI 10.1515/JPM.2011.110 2011/0144 Article in press - uncorrected proof Optimized amniotic fluid analysis in patients suspected of intrauterine infection/inflammation Catherine Ford1 and Mehmet R. Genc2,*¸ 1 Harvard School of Public Health, Boston, MA, USA 2 Division of Maternal Fetal Medicine, Department of Obstetrics, Gynecology and Reproductive Biology, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA Abstract Objective: To determine the combination of

, M Tani, VK Tuohy, RJ Tuthill, RM Ransohoff: Central nervous system chemokine mRNA accumulation follows initial leukocyte entry at the onset of acute murine experimental autoimmune encephalomyelitis. Brain Behav Immun 9 ( 1995 ) 315 10 Hausmann EH, NE Berman, YY Wang, JB Meara, GW Wood, RM Klein: Selective chemokine mRNA expression following brain injury. Brain Res 788 ( 1998 ) 49 11 Huleihel M, H Golan, M Hallak: Intrauterine infection/inflammation during pregnancy and offspring brain damages: possible mechanisms involved. Reprod Biol Endocrinol 2 ( 2004

al. Adiponectin in amniotic fluid in normal pregnancy, spontaneous labor at term, and preterm labor: a novel association with subclinical intrauterine infection/inflammation. J Matern Fetal Neonatal Med 2010; 23 (2): 120–30. 15. Lappas M, Yee K, Permezel M, et al. Release and regulation of leptin, resistin and adiponectin from human placenta, fetal membranes and maternal adipose tissue and skeletal muscle from normal and gestational diabetes mellitus-complicated pregnancies. J Endocrinol 2005; 186 (3): 457–65. 16. Ichida K, Moriyama T, Morrita H, et al. Plasma

a significant effect on the negative predictive value (92%) in a population with a 35% prevalence of intrauterine infection/inflammation. Although fFN >150 ng/mL identified 86% of all women with intrauterine infection and/or inflammation, approximately 40% of women who test positive would have had unnecessary intervention. Such performance is obviously not acceptable to use cervical fFN to diagnose and manage intrauterine infection and/or inflammation. On the other hand, cervical fFN may be useful as a screening test to select patients for amniocentesis to collect

fluid glucose concentration: a rapid and simple method for the detection of intraamniotic infection in preterm labor Am J Obstet Gynecol 1990 163 968 74 24. Ford C, Genç MR. Optimized amniotic fluid analysis in patients suspected of intrauterine infection/inflammation. J Perinat Med 2011;40:33–7. 21933040 Ford C Genç MR Optimized amniotic fluid analysis in patients suspected of intrauterine infection/inflammation J Perinat Med 2011 40 33 7 25. Chaiyasit N, Romero R, Chaemsaithong P, Docheva N, Bhatti G, Kusanovic JP, et al. Clinical chorioamnionitis at term VIII: a

Sadowsky D Witkin M Novy M Immunomodulators plus antibiotics to prevent preterm delivery in experimental intra-amniotic infection (IAI) Am J Obstet Gynecol 2003 189 S56 20. Archabald KL, Buhimschi IA, Bahtiyar MO, Dulay AT, Abdel-Razeq SS, Pettker CM, et al. Limiting the exposure of select fetuses to intrauterine infection/inflammation improves short-term neonatal outcomes in preterm premature rupture of membranes. Fetal Diagn Ther 2017;42:99–110. 27794570 10.1159/000450997 Archabald KL Buhimschi IA Bahtiyar MO Dulay AT Abdel-Razeq SS Pettker CM Limiting the exposure of

, et al. BDNF blocks caspase-3 activation in neonatal hypoxia-ischemia. Neurobiol Dis. 2000;7:38–53. 10.1006/nbdi.1999.0275 [19] Hiroshi S, Tsuyomu I. Long term magnesium sulfate treatment as protection gainst hypoxic ischemic brain injury in seven day old rats. Am J Obstet Gynaecol. 2001;184:185–90. 10.1067/mob.2001.108343 [20] Huleihel M, Golan H, Hallak M. Intrauterine infection/inflammation during pregnancy and offspring brain damages: possible mechanism involved. Reprod Biol Endocrinol. 2004;2:1–8. 10.1186/1477-7827-2-17 [21] Husson I, Rangon CM, Lelièvre V

the genesis of LGA in the absence of gestational diabetes mellitus. J Perinat Med. 2010;38:147–55. 10.1515/jpm.2010.044 [45] Mazaki-Tovi S, Romero R, Vaisbuch E, Kusanovic JP, Erez O, Gotsch F, et al. Maternal serum adiponectin multimers in preeclampsia. J Perinat Med. 2009;37:349–63. 10.1515/JPM.2009.085 [46] Mazaki-Tovi S, Romero R, Vaisbuch E, Kusanovic JP, Erez O, Mittal P, et al. Adiponectin in amniotic fluid in normal pregnancy, spontaneous labor at term, and preterm labor: A novel association with subclinical intrauterine infection/inflammation. J Matern

oxidative stress might contribute to the lowering of sRAGE levels in preterm labor w4, 17, 28x. The second part of our study examined changes within the group of women with preterm labor (Group 1) in relation to the presence or absence of FIRS. Antenatal identification of intrauterine infection/inflammation and of FIRS is of major relevance regarding short- and long-term morbidity. In con- trast to acute chorioamnionitis, funisitis is a histological marker for a purely FIRS that might occur in the absence of maternal inflammatory response w26, 27x. The majority of

,2,6,18–21].Collectively, these data suggest that intrauterine infection/inflammation is a part of the host response to intra-amniotic infection. MMP-3 is usually expressed in macrophages, en- dothelial cells, fibroblasts, smooth muscle, and en- dometrial stromal cells [23, 25, 31]. Its production is greatly enhanced by a number of factors includ- ing lipopolysaccharide, tumor necrosis factor (TNF), and interleukin-1 (IL-1) [12, 17, 25, 38, 42]. Therefore, in the context of intrauterine infection, bacterial and host products (pro-inflammatory cy- tokines), which were produced in the