The effect of antenatal intravenous immunoglobulin on ascending intrauterine infection after preterm premature rupture of the membranes: a pilot study.
Ascending infection is a serious threat in pregnancies complicated by preterm premature rupture of the membranes (PROM). In a controlled randomized prospective pilot study (n = 18) we have evaluated the effect of intravenous IgM enriched immunoglobulin given to the mothers 24-48 hours after preterm PROM in reducing ascending infection. Using a validated infection score from laboratory and clinical data at birth, we found a significant reduction of probable infection in the neonates of the treatment group compared to the control group (p = 0.0022). Histopathological investigation of the placentas, membranes and umbilical cords revealed significantly lower stages and grades of chorioamnionitis in the treatment group (p = 0.036). From these preliminary results we conclude, that intravenous broad spectrum immunoglobulin given antenatally to patients with preterm PROM may reduce ascending infection. However, studies with a much larger cohort of patients are necessary to confirm these preliminary results and to detect potential clinical benefits from this treatment mode.
Höckel
M
M
Department of Obstetrics and Gynecology, University of Mainz, Fed. Rep. of Germany.
Queisser-Luft
A
A
Beck
T
T
Zielberg
R
R
Stopfkuchen
H
H
Lissner
R
R
D000328:Adult; D001424:Bacterial Infections / Q000517:prevention & control*; D005260:Female; D005322:Premature Rupture of Fetal Membranes / Q000150:complications*; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use*; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases / Q000517:prevention & control*; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000628:therapy*; D011446:Prospective Studies; D014591:Uterine Diseases / Q000517:prevention & control*
D016756:Immunoglobulins, Intravenous