			Home About us Contact

Spontaneous Preterm Delivery (spontaneous + preterm_delivery)

Distribution by Scientific Domains

Medical Sciences	50%

Selected Abstracts

The proform of eosinophil major basic protein: a new maternal serum marker for adverse pregnancy outcome

PRENATAL DIAGNOSIS, Issue 11 2009
Kasper Pihl
Abstract Objective To establish the first trimester serum levels of the proform of eosinophil major basic protein (proMBP) in pregnancies with adverse outcome. Furthermore, to determine the screening performance using proMBP alone and in combination with other first trimester markers. Methods A case-control study was conducted in a primary hospital setting. The proMBP concentration was measured in cases with small-for-gestational age (SGA) (n = 150), spontaneous preterm delivery (n = 88), preeclampsia (n = 40), gestational hypertension (n = 10) and in controls (n = 500). Concentrations were converted to multiples of the median (MoM) in controls and groups were compared using Mann,Whitney U -test. Logistic regression analysis was used to determine significant factors for predicting adverse pregnancy outcome. Screening performance was assessed using receiver operating characteristic curves. Results The proMBP median was significantly reduced in pregnancies with SGA (0.81 MoM), spontaneous preterm delivery (0.83 MoM), preeclampsia (0.88 MoM) and gestational hypertension (0.60 MoM). The best screening performance was found for preeclampsia including the covariates proMBP and nulliparity yielding an area under the curve equal to 0.737 (p < 0.0005) and a 75% detection rate for a 30% false positive rate. Conclusion The proMBP is a novel first trimester serum marker for adverse pregnancy outcome. Copyright © 2009 John Wiley & Sons, Ltd. [source]

First-trimester maternal serum matrix metalloproteinase-9 (MMP-9) and adverse pregnancy outcome

PRENATAL DIAGNOSIS, Issue 6 2009
Leona C. Y. Poon
Abstract Objective To investigate the potential value of maternal serum matrix metalloproteinase-9 (MMP-9) in first-trimester screening for preeclampsia and spontaneous early preterm delivery. Methods The concentrations of MMP-9, tumour necrosis factor soluble receptor-1 (TNF-R1), pregnancy-associated plasma protein-A (PAPP-A) and uterine artery pulsatility index (UA-PI) were measured at 11+0 , 13+6 weeks in cases of preeclampsia (n = 128), gestational hypertension (n = 88), small for gestational age (n = 296), spontaneous early preterm delivery (n = 57) and controls (n = 569). The distributions of measured metabolites and UA-PI in the control and adverse outcome groups were compared. Logistic regression analysis was used to determine the significant contributors in the prediction of adverse outcomes. Results The median MMP-9 was higher than controls in the preeclampsia (1.190 MoM) and preterm delivery (1.187 MoM) groups. In the preeclampsia group there was a significant association between serum MMP-9 and TNF-R1 (r = 0.523, P < 0.0001). Significant prediction of preeclampsia was provided by history and UA-PI, and prediction of preterm delivery was provided by history and neither was improved by the addition of MMP-9. Conclusion In pregnancies developing preeclampsia, the increased level of MMP-9 and the good correlation with TNF-R1 suggest the presence of an underlying inflammatory process. In the pregnancies resulting in spontaneous preterm delivery the small increase in MMP-9 is not useful in the prediction of preterm delivery. Copyright © 2009 John Wiley & Sons, Ltd. [source]

Mid-trimester amniotic fluid C-reactive protein, ferritin and lactate dehydrogenase concentrations and subsequent risk of spontaneous preterm labour

AUSTRALIAN AND NEW ZEALAND JOURNAL OF OBSTETRICS AND GYNAECOLOGY, Issue 4 2009
Sedigheh BORNA
Background: Preterm delivery is a serious problem in obstetrics. A pre-existing inflammation in the first half of gestation has been proposed as a possible condition that leads to preterm delivery. Aim: Our aim was to compare C-reactive protein (CRP), ferritin and lactate dehydrogenase (LDH) concentrations in mid-trimester amniotic fluid of patients with preterm and term deliveries and to found out their predictive values for preterm delivery. Methods: The study was conducted on 90 pregnant women who underwent genetic amniocentesis between the 15th and the 20th weeks of gestation. The samples were carried immediately to the laboratory for cytogenetic and biochemical examination. Non-parametric tests and receiver-operating characteristic curve analysis were used for statistical purpose. Results: This study showed women with preterm delivery at < 37 weeks (n = 17) had a higher median of amniotic fluid LDH concentration than those women who delivered at term (n = 73) (P = 0.003). Amniotic fluid LDH concentration of > 120 IU/L had a sensitivity of 59% and a specificity of 81% in the prediction of spontaneous preterm delivery at < 37 weeks. Maternal serum alpha-fetoprotein levels were higher in patients delivered preterm compared with term deliveries (P = 0.036). Conclusion: Mid-trimester LDH is found to be quite effective in the prediction of preterm delivery. Pre-existing intrauterine inflammatory process early in gestation may be an important risk factor for preterm delivery. [source]

First trimester maternal serum free , human chorionic gonadotrophin and pregnancy associated plasma protein A as predictors of pregnancy complications

BJOG : AN INTERNATIONAL JOURNAL OF OBSTETRICS & GYNAECOLOGY, Issue 10 2000
Charas Y. T. Ong Research Fellow (Fetal Medicine)
Objective To examine the value of first trimester maternal serum free , human chorionic gonadotrophin (, hCG) and pregnancy associated plasma protein A (PAPP-A) as predictors of pregnancy complications. Design Screening study. Setting Antenatal clinics. Population Singleton pregnancies at 10,14 weeks of gestation. Methods Maternal serum free , hCG and PAPP-A were measured at 10,14 weeks of gestation in 5584 singleton pregnancies. In the 5297 (94.9%) pregnancies with complete follow up free , hCG and PAPP-A were compared between those with normal outcome and those resulting in miscarriage, spontaneous preterm delivery, pregnancy induced hypertension or fetal growth restriction and in those with pre-existing or gestational diabetes. Results Maternal serum PAPP-A increased and , hCG decreased with gestation. The multiple of median maternal serum PAPP-A was significantly lower in those pregnancies resulting in miscarriage, pregnancy induced hypertension, growth restriction and in those with pre-existing or gestational diabetes mellitus, but not in those complicated by spontaneous preterm delivery. The level was < 10th centile of the reference range in about 20% of the pregnancies that subsequently resulted in miscarriage or developed pregnancy induced hypertension or growth restriction, and in 27% of those that developed gestational diabetes. Maternal serum free , hCG was < 10th centile of the reference range in about 15% of the pregnancies that subsequently resulted in miscarriage or developed pregnancy induced hypertension or growth restriction, and in 20% of those that developed gestational diabetes. Conclusion Low maternal serum PAPP-A or , hCG at 10,14 weeks of gestation are associated with subsequent development of pregnancy complications. [source]