Preterm labor is characterized by a high abundance of amniotic fluid prostaglandins in patients with intra-amniotic infection or sterile intra-amniotic inflammation
Autor: | Nardhy Gomez-Lopez, Hassendrini N. Peiris, Sarah Reed, Roberto Romero, Eli Maymon, Adi L. Tarca, Murray D. Mitchell, Kanchan Vaswani, Dereje W. Gudicha, Offer Erez |
---|---|
Rok vydání: | 2019 |
Předmět: |
Amniotic fluid
Preterm labor Prostaglandin Inflammation Chorioamnionitis Article Andrology chemistry.chemical_compound Obstetric Labor Premature Pregnancy medicine Humans In patient business.industry Infant Newborn Obstetrics and Gynecology Interleukin Amniotic Fluid medicine.disease chemistry Intra-amniotic infection Pediatrics Perinatology and Child Health Prostaglandins lipids (amino acids peptides and proteins) Female medicine.symptom business |
Zdroj: | J Matern Fetal Neonatal Med |
ISSN: | 1476-4954 1476-7058 |
Popis: | Spontaneous preterm labor is one of the “great obstetrical syndromes” which may lead to preterm delivery, a leading cause for neonatal and infant death. Prostaglandins are considered universal mediators for the onset of spontaneous labor at term. This concept is largely based on the observations that amniotic fluid concentrations of prostaglandins are elevated prior to and during the onset of labor; however, these studies have largely been performed using immunoassays. Distinguishing prostaglandins from similarly structured molecules (i.e. prostamides) is difficult given the cross-reactivity of available antibodies and the chemical similarity of this family of compounds. Herein, this limitation was overcome by utilizing mass spectrometry to determine prostaglandin and prostamide concentrations in the amniotic fluid of women who had an episode of preterm labor with intact membranes. Patients were classified into the following groups: 1 subsequent delivery at term (n=23); 2) preterm delivery in the absence of intra-amniotic inflammation (n=51); 3) preterm delivery with sterile intra-amniotic inflammation (amniotic fluid interleukin (IL)-6 >2.6 ng/mL without detectable microorganisms) (n=35); and 4) preterm delivery with intra-amniotic infection [amniotic fluid IL-6 > 2.6 ng/mL with detectable microorganisms] (n=16). Amniotic fluid samples were analyzed by liquid chromatography-tandem mass spectrometry. We found that 1) both prostaglandins and prostamides were detectable and distinguishable in the amniotic fluid of women with preterm labor; 2) amniotic fluid concentrations of PGE(2), PGF(2α), and PGFM were higher in patients with intra-amniotic infection than in those without intra-amniotic inflammation; 3) amniotic fluid concentrations of PGE(2) and PGF(2α) were also greater in patients with intra-amniotic infection than in those with sterile intra-amniotic inflammation; 4) patients with sterile intra-amniotic inflammation had higher amniotic fluid concentrations of PGE(2) and PGFM than those without intra-amniotic inflammation who delivered at term; 5) amniotic fluid concentrations of PGFM were also greater in women with sterile intra-amniotic inflammation than in those without intra-amniotic inflammation who delivered preterm; 5) amniotic fluid concentrations of prostamides (PGE(2)-EA and PGF(2α)-EA) were not different among patients with preterm labor; 6) amniotic fluid concentrations of prostaglandins, but no prostamides, were higher in cases with intra-amniotic inflammation (interleukin-6 >2.6 ng/mL); and 7) the PGE(2):PGE(2)-EA and PGF(2α):PGF(2α)-EA ratios were higher in patients with intra-amniotic infection compared to those without inflammation. Mass spectrometric analysis of amniotic fluid indicated that amniotic fluid concentrations of PGE(2,) PGF(2α), and PGFM, but no prostamides, were significantly higher in women with preterm labor and intra-amniotic infection than in other patients with an episode of preterm labor. Yet, women with intra-amniotic infection had greater amniotic fluid concentrations of PGE(2,) and PGF(2α) than those with sterile intra-amniotic inflammation, suggesting that these two clinical conditions may be differentiated by using mass spectrometric analysis of amniotic fluid. |
Databáze: | OpenAIRE |
Externí odkaz: |