title: Amniotic fluid prostaglandin F2 increases even in sterile amniotic fluid and is an independent predictor of impending delivery in preterm premature rupture of membranes.
abstract: OBJECTIVE
  To determine whether amniotic fluid (AF) concentration of prostaglandins (PGs) increases in patients with intra-amniotic inflammation and/or proven AF infection in preterm PROM, and can predict impending delivery.
  
  
  METHODS
  AF PGF2a concentrations were determined by ELISA in 140 singleton pregnancies with preterm premature rupture of membranes (PROM) (< or =35 weeks). AF was cultured for aerobic and anaerobic bacteria, and genital mycoplasmas. Intra-amniotic inflammation was defined as an elevated AF matrix metalloproteinase-8 concentration (>23 ng/ml). Results. (1) Patients with intra-amniotic inflammation and a negative AF culture had a significantly higher median AF PGF2a than those without intra-amniotic inflammation and with a negative culture (p < 0.001); (2) However, there was no difference in the median AF PGF2a between patients with intra-amniotic inflammation with a negative culture and those with culture-proven AF infection (p > 0.1); (3) Patients with an elevated AF PGF2a had a significantly shorter interval-to-delivery than those with a low AF PGF2a (< or =170 pg/mL) (p < 0.001); (4) An elevated AF PGF2a (< or =170 pg/mL) concentration was a significant predictor of the duration of pregnancy after adjusting for gestational age and AF inflammation/infection (p < 0.005). Conclusions. AF PGF2a (> or =170 pg/mL) concentration increased in patients with intra-amniotic inflammation regardless of AF culture results. Moreover, an elevated AF PGF2a concentration was an independent predictor of impending delivery in preterm PROM.
authors: Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul 110-744, Republic of Korea.
authors: Si Eun
authors: SE
authors: Lee
authors: In-Sook
authors: IS
authors: Park
authors: Roberto
authors: R
authors: Romero
authors: Bo Hyun
authors: BH
authors: Yoon
mesh_terms: D000328:Adult; D000649:Amniocentesis; D000653:Amniotic Fluid / Q000737:chemistry / Q000378:metabolism* / Q000382:microbiology*; D001431:Bacteriological Techniques; D002821:Chorioamnionitis / Q000378:metabolism; D036861:Delivery, Obstetric; D015237:Dinoprost / Q000032:analysis / Q000378:metabolism*; D005260:Female; D005322:Premature Rupture of Fetal Membranes / Q000175:diagnosis* / Q000378:metabolism / Q000382:microbiology; D006801:Humans; D008875:Middle Aged; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000175:diagnosis / Q000378:metabolism / Q000382:microbiology; D011379:Prognosis; D013997:Time Factors; D015854:Up-Regulation; D055815:Young Adult
chemical_list: D015237:Dinoprost