title: Prelabor rupture of membranes between 34 and 37 weeks: the intraamniotic inflammatory response and neonatal outcomes.
abstract: OBJECTIVE
  We sought to determine the influence of microbial invasion of the amniotic cavity (MIAC) and acute histologic chorioamnionitis (HCA) on the intensity of the intraamniotic inflammatory response and neonatal morbidity in preterm prelabor rupture of membranes (PPROM) between 34-37 weeks.
  
  
  METHODS
  This study included 99 women with singleton pregnancies complicated by PPROM between the gestational ages of 34-37 weeks. Amniocenteses were performed at the time of admission, and MIAC and amniotic fluid interleukin-6 concentrations were determined. After delivery, the placenta was evaluated for the presence of HCA.
  
  
  RESULTS
  Women with both MIAC and HCA had the highest intraamniotic inflammatory response, which was mediated by interleukin-6 concentrations (both MIAC and HCA: median 2164.0 pg/mL; HCA alone: median 654.8 pg/mL; MIAC alone: median 784.1 pg/mL; neither MIAC nor HCA: median 383.0 pg/mL; P < .0001) and the highest incidence of newborns with early-onset sepsis (P = .02).
  
  
  CONCLUSIONS
  Both MIAC and HCA affect the intensity of the intraamniotic inflammatory response and the incidence of early-onset sepsis following PPROM between 34-37 weeks. The intensity of the intraamniotic inflammatory response should be considered in the clinical management of PPROM between 34-37 weeks.
authors.affiliation: Biomedical Research Center, University Hospital in Hradec Kralove, Hradec Kralove, Czech Republic; Department of Obstetrics and Gynecology, Charles University in Prague, Faculty of Medicine in Hradec Kralove, Hradec Kralove, Czech Republic. Electronic address: kacermar@fnhk.cz.
authors.forename: Marian
authors.initials: M
authors.lastname: Kacerovsky
authors.affiliation: Department of Obstetrics and Gynecology, Charles University in Prague, Faculty of Medicine in Hradec Kralove, Hradec Kralove, Czech Republic; Department of Obstetrics and Gynecology, University Hospital Pardubice, Pardubice, Czech Republic.
authors.forename: Ivana
authors.initials: I
authors.lastname: Musilova
authors.affiliation: Department of Clinical Immunology and Allergy, Charles University in Prague, Faculty of Medicine in Hradec Kralove, Hradec Kralove, Czech Republic.
authors.forename: Ctirad
authors.initials: C
authors.lastname: Andrys
authors.affiliation: Department of Pathology, Charles University in Prague, Faculty of Medicine in Hradec Kralove, Hradec Kralove, Czech Republic.
authors.forename: Helena
authors.initials: H
authors.lastname: Hornychova
authors.affiliation: Institute of Clinical Biochemistry and Diagnostics, Charles University in Prague, Faculty of Medicine in Hradec Kralove, Hradec Kralove, Czech Republic.
authors.forename: Lenka
authors.initials: L
authors.lastname: Pliskova
authors.affiliation: Department of Obstetrics and Gynecology, University Hospital Pardubice, Pardubice, Czech Republic.
authors.forename: Milan
authors.initials: M
authors.lastname: Kostal
authors.affiliation: Department of Obstetrics and Gynecology, Sahlgrenska University Hospital, Gothenburg, Sweden, and Department of Public Health, Oslo University, Oslo, Norway.
authors.forename: Bo
authors.initials: B
authors.lastname: Jacobsson
mesh_terms: D000328:Adult; D000649:Amniocentesis; D000653:Amniotic Fluid / Q000737:chemistry* / Q000382:microbiology*; D002821:Chorioamnionitis / Q000473:pathology*; D005260:Female; D005322:Premature Rupture of Fetal Membranes; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases / Q000175:diagnosis / Q000453:epidemiology; D015850:Interleukin-6 / Q000032:analysis*; D011237:Predictive Value of Tests; D011247:Pregnancy; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D018805:Sepsis / Q000175:diagnosis / Q000453:epidemiology*; D055815:Young Adult
chemical_list: D015850:Interleukin-6
keywords: amniotic fluid; gestational age; histologic chorioamnionitis; interleukin-6; microbial invasion of the amniotic cavity