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Acute chorioamnionitis

Chaini Konwar, Giulia F Del Gobbo, Jefferson Terry, Wendy P Robinson
BACKGROUND: Acute chorioamnionitis (aCA), inflammation of the placenta and fetal membranes, is a frequently reported lesion in preterm deliveries. Genetic variants in innate immune system genes such as Interleukin-6 (IL6) may contribute to the placenta's inflammatory response, thus predisposing some pregnancies to aCA. These genetic variants may modulate molecular processes such as DNA methylation and gene expression, and in turn might affect susceptibility to aCA. Currently, there is remarkably little research on the role of fetal (placental) genetic variation in aCA...
February 22, 2019: BMC Medical Genetics
Adrienne Bingham, Fusun Gundogan, Katherine Rand, Abbot R Laptook
OBJECTIVE: To determine if pre-specified placental abnormalities among newborns with hypoxic-ischemic encephalopathy (HIE) differ compared to newborns admitted to a NICU without encephalopathy. STUDY DESIGN: Retrospective case-control study of newborns with HIE (2006-2014) and controls matched for birth year, gestational age, weight, and gender. One pathologist reviewed archived placental sections using pre-specified criteria. RESULTS: Sixty-seven newborns had HIE, 46 had available placentas and were matched with 92 controls...
February 15, 2019: Journal of Perinatology: Official Journal of the California Perinatal Association
Yaozhu Leng, Roberto Romero, Yi Xu, Jose Galaz, Rebecca Slutsky, Marcia Arenas-Hernandez, Valeria Garcia-Flores, Kenichiro Motomura, Sonia S Hassan, Andrea Reboldi, Nardhy Gomez-Lopez
PROBLEM: The immunophenotype of B cells at the maternal-fetal interface (decidua) in labor at term and preterm labor is poorly understood. METHOD OF STUDY: Decidual tissues were obtained from women with preterm or term labor and from non-labor gestational age-matched controls. Immunophenotyping of decidual B cells was performed using multi-color flow cytometry. RESULTS: 1) In the absence of acute or chronic chorioamnionitis, total B cells were more abundant in the decidua parietalis of women who delivered preterm than those who delivered at term, regardless of the presence of labor; 2) decidual transitional and naïve B cells were the most abundant B-cell subsets; 3) decidual B1 B cells were increased in women with labor at term or preterm labor and chronic chorioamnionitis compared to those without this placental lesion; 4) decidual transitional B cells were reduced in women with preterm labor compared to those without labor; 5) naïve, class-switched, and non-class-switched B cells in the decidual tissues underwent mild alterations with the process of preterm labor and/or placental inflammation; 6) decidual plasmablasts seemed to increase in women with labor at term or preterm labor with chronic chorioamnionitis; and 7) decidual B cells expressed high levels of interleukin (IL)-12, IL-6 and/or IL-35...
February 15, 2019: American Journal of Reproductive Immunology: AJRI
Sae Lin Oh, Tae Yeon Jeon, So-Young Yoo, Se In Sung, Hye Won Kim, Yun Sil Chang, Won Soon Park, Ji Hye Kim
OBJECTIVES: To investigate the incidence of, clinical outcome of, and risk factors for perirenal subcapsular fluid collections in extremely preterm infants with acute kidney injury (AKI). METHODS: Extremely preterm infants with AKI who underwent renal ultrasonography (US) during neonatal intensive care unit stay were classified into two groups according to the presence of a perirenal subcapsular fluid collection at US. Clinical outcome was compared, and relevant data were analysed, including demographics and comorbidities of the infants, as well as maternal demographics...
February 4, 2019: European Radiology
Tracy B Grossman, Debra S Heller, Rebecca N Baergen
OBJECTIVE: Acute funisitis (AF) is most commonly associated with acute chorioamnionitis (AC) and ascending infection. The significance of cases of AF without associated AC or isolated funisitis (IF) is unknown. Our objective was to evaluate clinical and pathologic features of IF and to determine its significance. STUDY DESIGN: This was a retrospective review of placentas of patients delivering at our institution from 1997 to 2017. Placentas with the diagnosis of IF comprised the study population and placentas without either AF or AC served as controls...
January 2019: Placenta
Gabriele Tonni, Gianpaolo Grisolia, Paolo Zampriolo, Federico Prefumo, Anna Fichera, Paola Bonasoni, Mathilde Lefebvre, Suonavy Khung-Savatovsky, Fabien Guimiot, Jonathan Rosenblatt, Edward Araujo Júnior
INTRODUCTION: Ablation of the acardiac twin umbilical cord in the TRAP protects the normal donor twin. MATERIALS AND METHODS: Two case descriptions, one of interstitial laser photocoagulation and one of laser umbilical cord occlusion (L-UCO) of the acardiac twin in monochorionic monoamniotic pregnancies are reported. RESULTS: L-UCO in two pregnancies with TRAP syndrome in the second trimester resulted in intrauterine fetal death in both cases after 1 month...
January 12, 2019: Fetal and Pediatric Pathology
M-J Allard, M-E Brochu, J D Bergeron, M Segura, G Sébire
Chorioamnionitis and intrauterine growth retardation (IUGR) are risk factors for cerebral palsy (CP). Common bacteria isolated in chorioamnionitis include group B Streptococcus (GBS) serotypes Ia and III. Little is known about the impact of placental inflammation induced by different bacteria, including different GBS strains. We aimed to test the impact of chorioamnionitis induced by two common GBS serotypes (GBSIa and GBSIII) on growth and neuromotor outcomes in the progeny. Dams were exposed at the end of gestation to either saline, inactivated GBSIa or GBSIII...
January 10, 2019: Journal of Developmental Origins of Health and Disease
Rehan Rais, Roman Starikov, Wu Robert, Phinnara Has, Mai He
Studies have demonstrated an association between pregestational diabetes (preGDM) and a higher prevalence of large-for-gestational age placentas (LGA). However, frequency of placental pathologies and perinatal outcomes in LGA placentas is lacking. We aimed to determine differences in perinatal outcome or placental pathology between LGA placentas and appropriate-for-gestational age (AGA) placentas from pregnancies complicated by preGDM. We found LGA placentas are associated with significantly higher neonatal weight but lower fetal-to-placental weight ratio (f/p) for both T1DM and T2DM...
December 26, 2018: Pathology, Research and Practice
Stefania Ronzoni, Valerie Steckle, Rohan D'Souza, Kellie E Murphy, Stephen Lye, Oksana Shynlova
Premature prelabor rupture of the membranes (PPROM) causes one-third of preterm births worldwide and is most likely caused by subclinical intrauterine infection and/or inflammation. We proposed that women with systemic inflammation at the time of PPROM would have shorter latency. Peripheral blood samples were collected from 20 singleton pregnant women with PPROM between 23 ± 1 and 33 ± 6 weeks. The first sample was drawn within 48 hours of admission, followed by weekly blood draws until delivery. Pregnancies complicated with acute chorioamnionitis, preeclampsia, intrauterine growth restriction, obesity, substance abuse, and chronic maternal disease were excluded...
December 12, 2018: Reproductive Sciences
Anne Marie Singh, Michael G Sherenian, Kwang-Youn Kim, Kristin A Erickson, Amy Yang, Karen Mestan, Linda M Ernst, Rajesh Kumar
Background: Chorioamnionitis is a risk factor for future asthma development. Animal models of chorioamnionitis demonstrate increased TH 17-to-Treg ratios associated with proinflammatory cytokine elevations. The association of chorioamnionitis on human neonatal immune cells systemically and within tissues is not known. Methods: We enrolled two cohorts to evaluate TH 17 and regulatory T cell (Treg ) phenotypic markers in chorioamnionitis. From a cohort of 19 live birth infants, we collected cord blood and placenta samples to evaluate for signs of acute and chronic histologic inflammation and cell phenotype characterization...
2018: Allergy, Asthma, and Clinical Immunology
Nardhy Gomez-Lopez, Roberto Romero, Eli Maymon, Juan Pedro Kusanovic, Bogdan Panaitescu, Derek Miller, Percy Pacora, Adi L Tarca, Kenichiro Motomura, Offer Erez, Eunjung Jung, Sonia S Hassan, Chaur-Dong Hsu
Background The inflammasome has been implicated in the mechanisms that lead to spontaneous labor at term. However, whether the inflammasome is activated in the amniotic cavity of women with clinical chorioamnionitis at term is unknown. Herein, by measuring extracellular ASC [apoptosis-associated speck-like protein containing a C-terminal caspase recruitment domain (CARD)], we investigated whether there is in vivo inflammasome activation in amniotic fluid of patients with clinical chorioamnionitis at term with sterile intra-amniotic inflammation and in those with intra-amniotic infection...
November 9, 2018: Journal of Perinatal Medicine
Chaini Konwar, E Magda Price, Li Qing Wang, Samantha L Wilson, Jefferson Terry, Wendy P Robinson
BACKGROUND: Placental inflammation, often presenting as acute chorioamnionitis (aCA), is commonly associated with preterm birth. Preterm birth can have both immediate and long-term adverse effects on the health of the baby. Developing biomarkers of inflammation in the placenta can help to understand its effects and potentially lead to new approaches for rapid prenatal diagnosis of aCA. We aimed to characterize epigenetic variation associated with aCA in placenta (chorionic villi) and fetal membranes (chorion and amnion) to better understand how aCA may impact processes that lead to preterm birth...
October 29, 2018: Epigenetics & Chromatin
Nikos Papadogiannakis, Maaike Joerink, Erika Rindsjö, Annika Scheynius, Johan Alm
AIM: To investigate (i) whether maternal sensitisation to allergens, and lifestyle can influence the risk of acute and chronic inflammation of the placenta, in the forms of chorioamnionitis and villitis, respectively, and (ii) whether these placental inflammations are associated with the outcome of sensitisation for the child during preschool age. METHODS: Placentas from term uncomplicated pregnancies (n = 275) in the assessment of lifestyle and allergic disease during infancy study were analysed for the presence of acute chorioamnionitis and chronic villitis...
October 18, 2018: Acta Paediatrica
Pawel T Schubert, Deidre Mason, Roosacelis Martines, Marlene Deleon-Carnes, Sherif R Zaki, Drucilla J Roberts
Fetal bacterial infections are a common cause of fetal/neonatal morbidity and mortality. The pathologic correlates of congenital bacterial infection include acute chorioamnionitis, acute villitis, and acute intervillositis. The strength of the association of congenital bacterial infection differs among these pathologies. Acute chorioamnionitis results usually from an ascending infection, and damage to the fetus is thought to be cytokine driven rather than damage secondary to bacteremia. Acute villitis is strongly associated with fetal sepsis due to congenital infections...
October 18, 2018: Pediatric and Developmental Pathology
Duc Ninh Nguyen, Thomas Thymann, Sandra K Goericke-Pesch, Shuqiang Ren, Wei Wei, Kerstin Skovgaard, Peter Damborg, Anders Brunse, Charlotte van Gorp, Boris W Kramer, Tim G Wolfs, Per T Sangild
Prenatal inflammation is a major risk for preterm birth and neonatal morbidity, but its effects on postnatal immunity and organ functions remain unclear. Using preterm pigs as a model for preterm infants, we investigated whether prenatal intra-amniotic (IA) inflammation modulates postnatal systemic immune status and organ functions. Preterm pigs exposed to IA lipopolysaccharide (LPS) for 3 days were compared with controls at birth and postnatal day 5 after formula feeding. IA LPS induced mild chorioamnionitis but extensive intra-amniotic inflammation...
November 2018: American Journal of Pathology
S Yousuf, N Akhter, S Arzoo, B Ferdous
Misoprostol has been widely used in Obstetrics and Gynecology for cervical priming, medical abortion and induction of labour. The purpose of the present study was to evaluate the efficacy and safety of intravaginal misoprostol in mid-trimester medical termination of pregnancy. This non-randomized clinical trial was carried out in the Department of Obstetrics and Gynecology at Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh from July 2007 to June 2008 for a period of one year. Primi- or multigravid women with 13 to 28 weeks of singleton pregnancy, fetal congenital malformation and missed abortion who were selected for medical termination of pregnancy were included in this study...
July 2018: Mymensingh Medical Journal: MMJ
Yi Liao, Ya-Nan Zhang, Xing-Lou Liu, Yuan-Yuan Lu, Lin-Lin Zhang, Ting Xi, Sai-Nan Shu, Feng Fang
Increasing evidence has revealed that maternal cytomegalovirus (CMV) infection may be associated with neurodevelopmental disorders in offspring. Potential relevance between the placental inflammation and CMV-related autism has been reported by clinical observation. Meanwhile, abnormal expression of Toll-like receptor 2 (TLR2) and TLR4 in placenta of patients with chorioamnionitis was observed in multiple studies. IL-6 and IL-10 are two important maternal inflammatory mediators involved in neurodevelopmental disorders...
August 2018: Current Medical Science
Tuija Hautakangas, Outi Palomäki, Karoliina Eidstø, Heini Huhtala, Jukka Uotila
BACKGROUND: Purpose of this study was to investigate differences between primiparous term pregnancies, one leading to vaginal delivery (VD) and the other to acute cesarean section (CS) due to labor dystocia in the first stage of labor. We particularly wanted to assess the influence of body mass index (BMI) on CS risk. METHODS: A retrospective case-control study in a tertiary delivery unit with 5200 deliveries annually. Cases were 296 term primiparous women whose intended vaginal labor ended in acute CS because of dystocia...
July 18, 2018: BMC Pregnancy and Childbirth
Hyo Kyozuka, Syun Yasuda, Tsuyoshi Hiraiwa, Yasuhisa Nomura, Keiya Fujimori
OBJECTIVE: Histological chorioamnionitis (CAM) is related to neonatal mortality and morbidity. However, identifying intrauterine inflammation before delivery is challenging. The aim of this study was to investigate the changes in fetal heart rate (FHR) short-term variability (STV) during the course of histological CAM. STUDY DESIGN: Changes in STV were measured in 7 chronically instrumented fetal sheep at 111-120 days of gestation. Lipopolysaccharide (LPS) was infused into the amniotic cavity for 2 days following the 4th postoperative day to develop histological CAM...
September 2018: European Journal of Obstetrics, Gynecology, and Reproductive Biology
Lai-Man Chan, Ho-Hsiung Lin, Sheng-Mou Hsiao
OBJECTIVE: To report detailed clinical history and management of maternal listeria infection in the first trimester. CASE REPORT: A 34-year-old woman at 11 gestational weeks was infected by Listeria monocytogenes with clinical symptoms of acute onset of a fever with subsequent headache and neck stiffness, and was treated with intravenous ampicillin at 2 g every 4 h for 3 weeks. A healthy, unaffected male baby was delivered at term. Histopathologic examination of the placenta did not reveal any chorioamnionitis, granulomas, microabscesses or vasculitis...
June 2018: Taiwanese Journal of Obstetrics & Gynecology
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