title: The fetal splenic vein flow pattern and fetal inflammatory response in the preterm prelabor rupture of membranes.
abstract: OBJECTIVE
  To evaluate the intensity of the fetal inflammatory response, characterized by umbilical cord blood IL-6 levels, and neonatal outcome in the preterm prelabor rupture of membranes (PPROM) pregnancies using the pulsatile fetal splenic vein flow pattern.
  
  
  METHODS
  Women with singleton pregnancies complicated by PPROM at a gestational age between 24 + 0 and 36 + 6 weeks were included in the study. Doppler evaluation of the fetal splenic vein flow was performed. The flow-velocity waveform pattern was evaluated qualitatively as continuous or pulsatile. The umbilical cord blood interleukin-6 (IL-6) levels were evaluated after delivery. The fetal inflammatory response was defined as IL-6 >11 pg/mL.
  
  
  RESULTS
  In total, 129 women were included. The fetuses with pulsatile splenic vein flow exhibited higher IL-6 levels in umbilical cord blood (median: 56.7 pg/mL versus 5.6 pg/mL; p < 0.0001) and had a higher rate of fetal inflammatory response syndrome (71% versus 35%; p = 0.0005) than fetuses with continuous flow. The pulsatile flow pattern was related to a higher rate of early onset neonatal sepsis (odds ratio 4.2; 95% confidence interval: 1.3-13.5).
  
  
  CONCLUSIONS
  The presence of pulsatile fetal splenic vein flow in PPROM pregnancies is associated with fetal inflammatory response and neonatal morbidity.
authors.affiliation: Faculty of Health Studies, University Pardubice , Hradec Kralove , Czech Republic .
authors.forename: Ivana
authors.initials: I
authors.lastname: Musilova
authors.forename: Marian
authors.initials: M
authors.lastname: Kacerovsky
authors.forename: Ctirad
authors.initials: C
authors.lastname: Andrys
authors.forename: Milan
authors.initials: M
authors.lastname: Kostal
authors.forename: Katarina
authors.initials: K
authors.lastname: Slaba
authors.forename: Bo
authors.initials: B
authors.lastname: Jacobsson
mesh_terms: D000328:Adult; D002821:Chorioamnionitis / Q000097:blood* / Q000453:epidemiology / Q000503:physiopathology; D005260:Female; D005312:Fetal Blood / Q000737:chemistry / Q000378:metabolism; D005322:Premature Rupture of Fetal Membranes / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology; D005333:Fetus / Q000098:blood supply* / Q000276:immunology; D006801:Humans; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology; D007249:Inflammation / Q000097:blood / Q000453:epidemiology / Q000503:physiopathology; D015850:Interleukin-6 / Q000032:analysis / Q000097:blood*; D011247:Pregnancy; D011256:Pregnancy Outcome / Q000453:epidemiology; D011379:Prognosis; D012039:Regional Blood Flow; D012189:Retrospective Studies; D013162:Splenic Vein / Q000502:physiology*; D055815:Young Adult
chemical_list: D015850:Interleukin-6