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Prevalência de infecções urogenitais durante o trabalho de parto a termo e pré termo e associação com níveis de IgA secretora no colostro; Prevalence of urogenital infections during term and preterm labor and association with secretory IgA levels in colostrums

Edilson Dias de Araujo
Fonte: Biblioteca Digital da Unicamp Publicador: Biblioteca Digital da Unicamp
Tipo: Tese de Doutorado Formato: application/pdf
Publicado em 22/10/2010 PT
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56.47%
As infecções urogenitais (IUG) são muito prevalentes durante a gestação e são reconhecidamente uma das principais causa de trabalho de parto prematuro. Entretanto, a prevalência de IUG no período intraparto é pouco conhecida. Diversas variáveis podem alterar a concentração das imunoglobulinas no colostro. A prematuridade e as infecções urogenitais têm sido estudadas como um destes fatores. Objetivos: Avaliar a prevalência de infecções urogenitais em gestantes durante o trabalho de parto pré-termo e a termo; quantificar os níveis de IgA secretória no colostro de puérperas de parto pré-termo e a termo com e sem infecção urogenital e correlacionar os níveis de IgA secretória nos colostros das puérperas com a presença de infecções urogenitais. Metodologia: No per iodo de janei ro a junho de 2009, 94 gestantes em trabalho de parto, atendidas na Maternidade Escola Januário Cicco (MEJC) da Universidade Federal do Rio Grande do Norte (UFRN), foram alocadas em dois grupos, 49 gestantes em trabalho de parto pré-termo e 45 gestantes em trabalho de parto a termo, foram convidadas a participar do estudo. Para uma melhor homogeneização dos resultados, apenas 34 mães de recém nascidos pré-termo (RNPT) e 38 mães de recém nascidos a termo (RNT)...

Selective versus non-selective culture medium for group B streptococcus detection in pregnancies complicated by preterm labor or preterm-premature rupture of membranes

Nomura,Marcelo Luís; Passini Júnior,Renato; Oliveira,Ulysses Moraes
Fonte: Brazilian Society of Infectious Diseases Publicador: Brazilian Society of Infectious Diseases
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/08/2006 EN
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66.62%
The objective of this study was to identify group B streptococcus (GBS) colonization rates and compare detection efficiency of selective versus non-selective culture media and anorectal versus vaginal cultures in women with preterm labor and preterm-premature rupture of membranes (PROM). A prospective cohort study of 203 women was performed. Two vaginal and two anorectal samples from each woman were collected using sterile swabs. Two swabs (one anorectal and one vaginal) were placed separately in Stuart transport media and cultured in blood-agar plates for 48 hours; the other two swabs were inoculated separately in Todd-Hewitt selective media for 24 hours and then subcultured in blood-agar plates. Final GBS identification was made by the CAMP test. A hundred thrity-two cultures out of 812 were positive. The maternal colonization rate was 27.6%. Colonization rates were 30% for preterm PROM and 25.2% for preterm labor. Todd-Hewitt selective medium detected 87.5% and non-selective medium 60.7% GBS-positive women. Vaginal samples and anorectal samples had the same detection rate of 80.3%. Anorectal selective cultures detected 75% of carriers; 39% of GBS-positive women were detected only in selective medium. A combined vaginal-anorectal selective culture is appropriate for GBS screening in this population...

Amniotic fluid interleukin 6 in preterm labor. Association with infection.

Romero, R; Avila, C; Santhanam, U; Sehgal, P B
Fonte: PubMed Publicador: PubMed
Tipo: Artigo de Revista Científica
Publicado em /05/1990 EN
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To evaluate whether IL-6 participates in the host response to intrauterine infection, we studied IL-6 bioactivity and isoforms in amniotic fluid (AF). Two different assays for IL-6 were used: the hepatocyte stimulating factor assay (in Hep3B2 cells) and the SDS-PAGE/immunoblot assay. IL-6 determinations were performed in 205 AF samples. Samples were obtained from patients in the midtrimester of pregnancy (n = 25), at term with no labor (n = 31), at term in active labor (n = 40), and from patients in preterm labor (n = 109). Higher AF IL-6 levels were observed in women in preterm labor with intraamniotic infection than in women in preterm labor without intraamniotic infection (median = 375 ng/ml, range = 30-5000 ng/ml vs. median = 1.5 ng/ml, range = 0-500, respectively, P less than 0.0001). The 23-25- and 28-30-kD IL-6 species could be readily detected in SDS-PAGE immunoblots performed directly on 10-microliters aliquots of AF from patients with intraamniotic infection. Among women in preterm labor with culture-negative AF, those who failed to respond to subsequent tocolytic treatment had higher AF IL-6 concentrations than those who responded to therapy (median = 50 ng/ml vs. median = 1.2 ng/ml, respectively, P less than 0.05). Only low levels of IL-6 were detected in AF obtained from normal women in the midtrimester and third trimester of pregnancy. Decidual tissue explants obtained from the placentas of women undergoing elective cesarean section at term without labor (n = 11) produced IL-6 in response to bacterial endotoxin. In a pilot study...

Bacterial isolates from patients with preterm labor with and without preterm rupture of the fetal membranes.

Mikamo, H; Sato, Y; Hayasaki, Y; Kawazoe, K; Hua, Y X; Tamaya, T
Fonte: PubMed Publicador: PubMed
Tipo: Artigo de Revista Científica
Publicado em //1999 EN
Relevância na Pesquisa
46.81%
OBJECTIVE: The aim of this study is to describe the bacterial flora of women in preterm labor with or without premature rupture of membranes. METHODS: Retrospective studies of 239 patients with preterm labor were performed. RESULTS: One hundred and twenty-three of 239 patients with preterm labor (51.5%) had bacterial vaginosis. Seventy of the 239 patients with preterm labor (29.3%) developed premature rupture of the membranes (preterm PROM). Of the 70 patients with preterm PROM, 51 (72.9%) had bacterial vaginosis. Therefore, 51 of the 123 patients with bacterial vaginosis (41.5%) developed preterm PROM. An increased number of organisms detected from the vaginal discharge in patients with preterm labor was associated with preterm PROM by Cochran-Armitage test. An increased number of organisms detected from the vaginal discharge in patients with preterm labor complicated with bacterial vaginosis was significantly associated with preterm PROM by Cochran-Armitage test. CONCLUSIONS: In preterm labor, the number of different species detected in the vagina provide sensitive and specific prediction of preterm PROM in patients with preterm labor.

Proteomic network analysis of human uterine smooth muscle in pregnancy, labor, and preterm labor

Ulrich, Craig; Quilici, David R.; Schlauch, Karen A.; Buxton, Iain L. O.
Fonte: PubMed Publicador: PubMed
Tipo: Artigo de Revista Científica
EN
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46.75%
The molecular mechanisms involved in human uterine quiescence during gestation and the induction of labor at term or preterm are not completely known. Preterm delivery is associated with major morbidity and mortality and current efforts to prevent delivery until term are largely ineffective. Identification and semi-quantification of proteomic changes in uterine smooth muscle during pregnancy will allow for targeted research into how quiescence is maintained and what changes are associated with induction of labor. Examining preterm labor in this context will provide potential therapeutic targets for the management of preterm labor. We have recently performed two dimensional liquid chromatography coupled with tandem mass spectrometry on myometrial proteins isolated from pregnant patients in labor, pregnant patients not in labor, and pregnant patients in labor preterm. Using a conservative false discovery rate of 1% we have identified 2132 protein groups using this method and semi-quantitative spectral counting shows 201 proteins that have disparate levels of expression in preterm laboring samples. To our knowledge this is the first large scale proteomic study examining human uterine smooth muscle and this initial work has provided a target list for future experiments that can address how changing protein levels are involved in the induction of labor at term and preterm.

Treatment of preterm labor with the oxytocin antagonist atosiban: a double-bind, randomized, controlled comparison with salbutamol

Cabrol, D.; Gillett, J.; Madelenat, P.; Lansac, J.; Paniel, B.; Dellenbach, P.; Lemoine, J.; Bronstein, R.; Leng, J.; Laurent, M.C.; Mares, P.; Hedon, B.; Magnin, G.; Treisser, A.; Schumacher, J.; Grosieux, P.; Jacquetin, P.; Bruhat, M.; Segard, L.; Puech
Fonte: Elsevier Sci Ireland Ltd Publicador: Elsevier Sci Ireland Ltd
Tipo: Artigo de Revista Científica
Publicado em //2001 EN
Relevância na Pesquisa
66.63%
Objective: To compare the efficacy and safety of atosiban and salbutamol in the treatment of preterm labor. Study design: A multicenter, double-blind, double-placebo, randomized, controlled trial. Women (n=241) diagnosed with preterm labor at 23–33 gestational weeks were enrolled and received either atosiban (n=119) or salbutamol (n=122). At randomization, women were stratified by gestational age (≤28 weeks and >28 weeks). Atosiban (i.v. bolus dose of 6.75 mg, then 300 μg/min for 3 h and 100 μg/min for up to 48 h) and salbutamol (2.5–45 μg/min) were administered by i.v. infusion for up to 48 h. Retreatment with study drug or an alternative tocolytic agent was allowed. Main outcome measures included tocolytic effectiveness which was assessed in terms of the number of women undelivered after 48 h and 7 days. Tocolytic efficacy and tolerability were assessed in terms of the proportion of women undelivered and who did not require alternative tocolytic therapy at 48 h and 7 days of starting treatment. Safety was assessed in terms of maternal side effects and neonatal morbidity. Results: Tocolytic effectiveness at 48 h was 93.3 versus 95.0% (P=0.67) and after 7 days was 89.9 versus 90.1% (P=0.93) in the atosiban and salbutamol groups...

Essential role for IL-10 in resistance to lipopolysaccharide-induced preterm labor in mice

Robertson, S.; Skinner, R.; Care, A.
Fonte: Amer Assoc Immunologists Publicador: Amer Assoc Immunologists
Tipo: Artigo de Revista Científica
Publicado em //2006 EN
Relevância na Pesquisa
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IL-10 is highly expressed in the uterus and placenta and is implicated in controlling inflammation-induced pathologies of pregnancy. To investigate the role of IL-10 in regulating preterm labor, the response of IL-10 null mutant mice to low-dose LPS in late gestation was evaluated. When IL-10 null mutant C57BL/6 (IL-10–/–) and control (IL-10+/+) mice were administered LPS on day 17 of pregnancy, the dose of LPS required to elicit 50% preterm fetal loss was 10-fold lower in IL-10–/– mice than in IL-10+/+ mice. Surviving fetuses in IL-10–/– mice exhibited fetal growth restriction at lower doses of LPS than IL-10+/+ mice. Marked elevation of LPS-induced immunoactive TNF- and IL-6 was evident in the serum, uterus, and placenta of IL-10–/– mice, and TNF- and IL-6 mRNA expression was elevated in the uterus and placenta, but not the fetus. Serum IL-1, IFN-, and IL-12p40 were increased and soluble TNFRII was diminished in the absence of IL-10, with these changes also reflected in the gestational tissues. Administration of rIL-10 to IL-10–/– mice attenuated proinflammatory cytokine synthesis and alleviated their increased susceptibility to preterm loss. Exogenous IL-10 also protected IL-10+/+ mice from fetal loss. These data show that IL-10 modulates resistance to inflammatory stimuli by down-regulating proinflammatory cytokines in the uterus and placenta. Abundance of endogenous IL-10 in gestational tissues is therefore identified as a critical determinant of resistance to preterm labor...

Nifedipine pharmacokinetics and plasma levels in the management of preterm labor

Papatsonis, D.; Bos, J.; van Geijn, H.; Lok, C.; Dekker, G.
Fonte: Lippincott Williams & Wilkins Publicador: Lippincott Williams & Wilkins
Tipo: Artigo de Revista Científica
Publicado em //2007 EN
Relevância na Pesquisa
56.6%
The aim of this study was to determine if the dose regimen of nifedipine used for tocolysis was effective to achieve uterine quietness, and at which plasma concentration levels this tocolysis was achieved to optimize our dose regimen of nifedipine. In women with preterm labor, nifedipine was administered orally to achieve uterine quietness to prevent preterm birth. Patients (n = 5) were administered 10 mg nifedipine capsules (Adalat capsules, Bayer AG) orally every 15 minutes up to 40 mg in the first hour, and were subsequently given 1 tablet of 20 mg nifedipine slow release (Adalat retard, Bayer AG) t = 90 min. Plasma levels of nifedipine were measured at regular intervals during the first 4 hours after starting tocolysis. In all 5 patients tocolysis was achieved with nifedipine. Peak plasma concentration of nifedipine was 127.2 +/- 44 ng/mL at 1.2 +/- 0.1 hours. Mean plasma concentrations of nifedipine was 67.4 +/- 28.4 ng/mL. In all patients, tocolysis was achieved during the 4 hours of blood sampling. There were no adverse hemodynamic side effects seen before and after starting tocolysis with nifedipine. Initial dose regimen of 4 times 10 mg nifedipine capsule orally in the first hour, followed by 20 mg slow release nifedipine at t = 90 min is effective in achieving tocolysis in women with preterm labor. In steady state...

Effect of maintenance tocolysis with nifedipine in threatened preterm labor on perinatal outcomes: a randomized controlled trial

Roos, C.; Spaanderman, M.; Schuit, E.; Bloemenkamp, K.; Bolte, A.; Cornette, J.; Duvekot, J.; van Eyck, J.; Franssen, M.; de Groot, C.; Kok, J.; Kwee, A.; Merien, A.; Bijivank, B.; Opmeer, B.; Oudijk, M.; van Pampus, M.; Papatsonis, D.; Porath, M.; Scheep
Fonte: American Medical Association Publicador: American Medical Association
Tipo: Artigo de Revista Científica
Publicado em //2013 EN
Relevância na Pesquisa
56.59%
IMPORTANCE In threatened preterm labor, maintenance tocolysis with nifedipine, after an initial course of tocolysis and corticosteroids for 48 hours, may improve perinatal outcome. OBJECTIVE To determine whether maintenance tocolysis with nifedipine will reduce adverse perinatal outcomes due to premature birth. DESIGN, SETTING, AND PARTICIPANTS APOSTEL-II (Assessment of Perinatal Outcome with Sustained Tocolysis in Early Labor) is a double-blind, placebo-controlled trial performed in 11 perinatal units including all tertiary centers in the Netherlands. From June 2008 to February 2010, women with threatened preterm labor between 26 weeks (plus 0 days) and 32 weeks (plus 2 days) gestation, who had not delivered after 48 hours of tocolysis and a completed course of corticosteroids, were enrolled. Surviving infants were followed up until 6 months after birth (ended August 2010). INTERVENTION Randomization assigned 406 women to maintenance tocolysis with nifedipine orally (80 mg/d; n = 201) or placebo (n = 205) for 12 days. Assigned treatment was masked from investigators, participants, clinicians, and research nurses. MAIN OUTCOME MEASURES Primary outcome was a composite of adverse perinatal outcomes (perinatal death, chronic lung disease...

Risk stratification with cervical length and fetal fibronectin in women with threatened preterm labor before 34 weeks and not delivering within 7 days

Hermans, F.J.R.; Bruijn, M.M.C.; Vis, J.Y.; Wilms, F.F.; Oudijk, M.A.; Porath, M.M.; Scheepers, H.C.J.; Bloemenkamp, K.W.M.; Bax, C.J.; Cornette, J.M.J.; Nij Bijvanck, B.W.A.; Franssen, M.T.M.; Vandenbussche, F.P.H.A.; Kok, M.; Grobman, W.A.; Van Der Post
Fonte: Wiley Publicador: Wiley
Tipo: Artigo de Revista Científica
Publicado em //2015 EN
Relevância na Pesquisa
66.72%
OBJECTIVE: To stratify the risk of spontaneous preterm delivery using cervical length (CL) and fetal fibronectin (fFN) in women with threatened preterm labor who remained pregnant after 7 days. DESIGN: Prospective observational study. SETTING: Nationwide cohort of women with threatened preterm labor from the Netherlands. POPULATION: Women with threatened preterm labor between 24 and 34 weeks with a valid CL and fFN measurement and remaining pregnant 7 days after admission. METHODS: Kaplan-Meier and Cox proportional hazards models were used to estimate cumulative percentages and hazard ratios (HR) for spontaneous delivery. MAIN OUTCOME MEASURES: Spontaneous delivery between 7 and 14 days after initial presentation and spontaneous preterm delivery before 34 weeks. RESULTS: The risk of delivery between 7 and 14 days was significantly increased for women with a CL < 15 mm or a CL ≥15 to <30 mm and a positive fFN, compared with women with a CL ≥30 mm: HR 22.3 [95% confidence interval (CI) 2.6-191] and 14 (95% CI 1.8-118), respectively. For spontaneous preterm delivery before 34 weeks the risk was increased for women with a CL < 15 mm [HR 6.3 (95% CI 2.6-15)] or with a CL ≥15 to <30 mm with either positive fFN [HR 3.6 (95% CI 1.5-8.7)] or negative fFN [HR 3.0 (95% CI 1.2-7.1)] compared with women with a CL ≥ 30 mm. CONCLUSIONS: In women remaining pregnant 7 days after threatened preterm labor...

Risk factors for preterm labor.; Factores de risco para trabalho de parto pré-termo.

Rodrigues, T; Serviço de Higiene e Epidemiologia, Faculdade de Medicina do Porto.; Barros, H
Fonte: Ordem dos Médicos Publicador: Ordem dos Médicos
Tipo: info:eu-repo/semantics/article; article; article; info:eu-repo/semantics/publishedVersion Formato: application/pdf
Publicado em 30/10/1998 POR
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Most studies investigating preterm risk factors include medically induced preterm labor due to fetal or maternal complications and do not distinguish preterm labor from preterm premature rupture of membranes. Thus, the objective of this study was to determine the proportion of the three types of preterm birth and identify risk factors for spontaneous preterm labor in a sample of pregnant women who delivered at two level III units.From January to October 1996, we interviewed 385 women with live preterm newborns and, as controls, 357 mothers of term newborns. Preterm births were classified as preterm labor, preterm premature rupture of membranes and iathrogenic preterm. Independent associations between maternal sociodemographic, constitutional, nutritional and obstetric characteristics and preterm labor were identified using logistic regression analysis.In this sample of preterm births, 29% corresponded to preterm labor, 49% to preterm premature rupture of the membranes and 22% were iathrogenic preterm. The identified risk factors for preterm labor were multiple gestation, no paid work during pregnancy, less than six prenatal care visits, arm circumference less than 26 cm and previous preterm or low birth-weight. Gestational bleeding during the first or third trimester was significantly associated with preterm labor.As previously recognized...

Additional effects of the cervical length measurement in women with preterm contractions: a systematic review

Vis, J.; Kuin, R.; Grobman, W.; Mol, B.; Bossuyt, P.; Opmeer, B.
Fonte: Springer-Verlag Publicador: Springer-Verlag
Tipo: Artigo de Revista Científica
Publicado em //2011 EN
Relevância na Pesquisa
56.66%
Purpose: Transvaginal cervical length measurement in women with symptoms of preterm labor has been used to decide if treatment is necessary. Cervical length measurement may also have additional effects on patients, such as providing reassurance, although the evidence to support this is unclear. We explored and summarized to what extent additional effects of cervical length measurement in women with threatened preterm labor have been reported in the clinical literature and what the magnitude of these effects was. Methods We performed a systematic review of the literature to identify articles reporting on cervical length measurements in women with symptoms of preterm labor. We assessed whether these articles reported patient outcomes other than preterm delivery. Results: The electronic and hand search resulted in 764 articles, of which 172 met initial criteria for further eligibility assessment. We found 12 articles that reported additional effects of cervical length measurement in symptomatic women, such as the reassurance or the sensory consequences related to the transvaginal procedure. None of the articles quantified such additional effects. Conclusions There appears to be a gap between the presumed effects of cervical length measurement on patient outcomes...

Cost-effectiveness analysis of cervical length measurement and fibronectin testing in women with threatened preterm labor

van Baaren, G.J.; Vis, J.; Grobman, W.; Bossuyt, P.; Opmeer, B.; Mol, B.
Fonte: Mosby Publicador: Mosby
Tipo: Artigo de Revista Científica
Publicado em //2013 EN
Relevância na Pesquisa
66.6%
OBJECTIVE: The objective of the study was to evaluate the cost-effectiveness of risk stratification with cervical length (CL) measurement and/or fetal fibronectin (fFN) tests in women with threatened preterm labor between 24 and 34 weeks' gestation. STUDY DESIGN: We performed a model-based cost-effectiveness analysis to evaluate 7 test-treatment strategies in women with threatened preterm labor from a health care system perspective. Estimates on disease prevalence, costs, and test accuracy were based on medical literature. RESULTS: We found that additional fFN testing in the case of a CL between 10 and 30 mm is cost saving without compromising neonatal health outcomes, compared with a treat-all strategy or single CL testing. Implementing this strategy could lead to an annual cost saving between €2.8 million and €14.4 million in The Netherlands, a country with about 180,000 deliveries annually. CONCLUSION: In women with threatened preterm labor between 24 and 34 weeks of gestation, the most cost-effective test strategy uses a combination of CL and fFN testing.; Gert-Jan van Baaren, Jolande Y. Vis, William A. Grobman, Patrick M. Bossuyt, Brent C. Opmeer, Ben W. Mol

Tratamento do trabalho de parto prematuro; Management of preterm labor

BITTAR, Roberto Eduardo; ZUGAIB, Marcelo
Fonte: Federação Brasileira das Sociedades de Ginecologia e Obstetrícia Publicador: Federação Brasileira das Sociedades de Ginecologia e Obstetrícia
Tipo: Artigo de Revista Científica
POR
Relevância na Pesquisa
56.57%
O objetivo principal para o uso de uterolíticos no trabalho de parto prematuro é prolongar suficientemente a gestação para a administração materna de glicocorticoides e/ou realizar a transferência materna para um centro hospitalar terciário. As decisões sobre o uso e a escolha de uterolítico requerem o diagnóstico correto do trabalho de parto prematuro, o conhecimento da idade gestacional, das condições médicas materno-fetais, da eficácia, dos efeitos colaterais e do custo do medicamento. Todos os uterolíticos possuem efeitos colaterais e alguns deles são potencialmente letais. Os estudos sugerem que os agonistas de receptores beta-adrenérgicos, os bloqueadores de cálcio e os antagonistas de receptor de ocitocina são eficazes para prolongar a gestação por pelo menos 48 horas. Dos três agentes, o atosiban (antagonista de receptor de ocitocina) possui maior segurança, embora o custo seja elevado. O sulfato de magnésio não é eficaz para prolongar a gestação e apresenta efeitos colaterais importantes. Os inibidores da ciclooxigenase também apresentam efeitos colaterais significativos. Até o momento, não há evidências suficientes para se recomendar o uso de doadores de óxido nítrico para inibir o trabalho de parto prematuro. Não existem fundamentos para o emprego de antibióticos para evitar a prematuridade diante do trabalho de parto prematuro.; The main purpose of using uterulytic in preterm delivery is to prolong gestation in order to allow the administration of glucocorticoid to the mother and/or to accomplish the mother's transference to a tertiary hospital center. Decisions on uterolytic use and choice require correct diagnosis of preterm delivery...

Risco de parto prematuro e qualidade de vida durante a gestação; Risk of preterm birth and quality of life during pregnancy

Helga Geremias Gouveia
Fonte: Biblioteca Digital da Unicamp Publicador: Biblioteca Digital da Unicamp
Tipo: Tese de Doutorado Formato: application/pdf
Publicado em 26/10/2010 PT
Relevância na Pesquisa
56.72%
Introdução: A prematuridade é definida como o nascimento que ocorre antes da 37º semana de gestação, sendo responsável por 75% da morbidade e mortalidade no período neonatal. Situações de risco para o desfecho da gestação influenciam de modo negativo a percepção de uma mulher sobre a qualidade de vida. Objetivo: Avaliar a qualidade de vida durante a gestação associada ao risco para parto prematuro. Método: revisão de literatura, seguida de estudo de corte transversal e comparativo, com três grupos de 54 gestantes (Grupo 1: sem risco atual para parto prematuro; Grupo 2: com fatores de risco para parto prematuro; Grupo 3: com trabalho de parto prematuro), totalizando 162 mulheres, realizado entre abril de 2008 a agosto de 2009 em maternidade de alto risco e unidade básica de saúde da cidade de Campinas (SP). Após assinatura de Termo de Consentimento Livre e Esclarecido foram verificadas informações sociodemográficas e obstétricas das mulheres e para avaliação da qualidade de vida foi aplicado o instrumento MOS-SF 36. Os dados foram analisados utilizando frequências, média e desvio-padrão. A homogeneidade entre os grupos foi avaliada pelos testes qui-quadrado de Pearson e exato de Fisher, para as variáveis categóricas e Kruskall-Wallis...

Human cervicovaginal fluid biomarkers to predict term and preterm labor

Heng, Yujing J.; Liong, Stella; Permezel, Michael; Rice, Gregory E.; Di Quinzio, Megan K. W.; Georgiou, Harry M.
Fonte: Frontiers Media S.A. Publicador: Frontiers Media S.A.
Tipo: Artigo de Revista Científica
EN_US
Relevância na Pesquisa
66.68%
Preterm birth (PTB; birth before 37 completed weeks of gestation) remains the major cause of neonatal morbidity and mortality. The current generation of biomarkers predictive of PTB have limited utility. In pregnancy, the human cervicovaginal fluid (CVF) proteome is a reflection of the local biochemical milieu and is influenced by the physical changes occurring in the vagina, cervix and adjacent overlying fetal membranes. Term and preterm labor (PTL) share common pathways of cervical ripening, myometrial activation and fetal membranes rupture leading to birth. We therefore hypothesize that CVF biomarkers predictive of labor may be similar in both the term and preterm labor setting. In this review, we summarize some of the existing published literature as well as our team's breadth of work utilizing the CVF for the discovery and validation of putative CVF biomarkers predictive of human labor. Our team established an efficient method for collecting serial CVF samples for optimal 2-dimensional gel electrophoresis resolution and analysis. We first embarked on CVF biomarker discovery for the prediction of spontaneous onset of term labor using 2D-electrophoresis and solution array multiple analyte profiling. 2D-electrophoretic analyses were subsequently performed on CVF samples associated with PTB. Several proteins have been successfully validated and demonstrate that these biomarkers are associated with term and PTL and may be predictive of both term and PTL. In addition...

Immune cells in term and preterm labor

Gomez-Lopez, Nardhy; StLouis, Derek; Lehr, Marcus A; Sanchez-Rodriguez, Elly N; Arenas-Hernandez, Marcia
Fonte: Nature Publishing Group Publicador: Nature Publishing Group
Tipo: Artigo de Revista Científica
EN
Relevância na Pesquisa
46.77%
Labor resembles an inflammatory response that includes secretion of cytokines/chemokines by resident and infiltrating immune cells into reproductive tissues and the maternal/fetal interface. Untimely activation of these inflammatory pathways leads to preterm labor, which can result in preterm birth. Preterm birth is a major determinant of neonatal mortality and morbidity; therefore, the elucidation of the process of labor at a cellular and molecular level is essential for understanding the pathophysiology of preterm labor. Here, we summarize the role of innate and adaptive immune cells in the physiological or pathological activation of labor. We review published literature regarding the role of innate and adaptive immune cells in the cervix, myometrium, fetal membranes, decidua and the fetus in late pregnancy and labor at term and preterm. Accumulating evidence suggests that innate immune cells (neutrophils, macrophages and mast cells) mediate the process of labor by releasing pro-inflammatory factors such as cytokines, chemokines and matrix metalloproteinases. Adaptive immune cells (T-cell subsets and B cells) participate in the maintenance of fetomaternal tolerance during pregnancy, and an alteration in their function or abundance may lead to labor at term or preterm. Also...

What is the risk of preterm delivery after arrested preterm labor?

Wilms, F.F.; Vis, J.Y.; de Wit-Zuurendonk, L.; Porath, M.M.; Mol, B.W.I.J.
Fonte: Georg Thieme Verlag Publicador: Georg Thieme Verlag
Tipo: Artigo de Revista Científica
Publicado em //2015 EN
Relevância na Pesquisa
66.55%
OBJECTIVE: The aim of this study is to assess if women with arrested preterm labor (PTL) have an increased risk of preterm delivery (PTD) compared with healthy pregnant women, and if digital examination, fetal fibronectin (fFn) and cervical length (CL) are prognostic markers for PTD after arrested PTL. STUDY DESIGN: Prospective-matched cohort study among women with arrested PTL (cases) and healthy pregnant women (controls). RESULTS: We included 74 index cases and 74 controls. PTD occurred in 20 (27%) index cases and in 5 (7%) controls (hazard ratio [HR], 4.5; 95% confidence interval [CI], 1.7-12). A dilatation of the cervix ≥ 1 cm (HR, 9.1 [95% CI, 3.3-25], an fFn positive status (HR, 13 [95% CI, 4.3-40]), and a CL < 15 mm (HR, 11 [95% CI, 3.1-38]) increased this risk in cases compared with controls. Knowledge of the fFn result had additional value over the cervical dilatation or CL in the prediction of persistent PTD, with an increased risk in case of a positive fFn test. CONCLUSION: Women stay at increased risk for PTD after arrested PTL. This risk further increased in case of ≥ 1 cm cervical dilatation, CL < 15 mm and/or a positive fFn status.; Femke F. Wilms, Jolande Y. Vis, Laura de Wit-Zuurendonk, Martina M. Porath...

Preterm labor: current pharmacotherapy options for tocolysis

van Vliet, E.O.G.; Boormans, E.M.; de Lange, T.S.; Mol, B.W.; Oudijk, M.A.
Fonte: Taylor & Francis Publicador: Taylor & Francis
Tipo: Artigo de Revista Científica
Publicado em //2014 EN
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INTRODUCTION: In the developed world, preterm birth is in quantity and in severity the most important issue in obstetric care. Adverse neonatal outcome is strongly related to gestational age at delivery. Since the pathophysiological mechanism of preterm birth is not yet completely unraveled, the development of successful preventive strategies is hampered. When preterm labor is actually threatening, current pharmacological therapies focus on inhibition of preterm contractions. This allows for transportation of the mother to a center with a neonatal intensive care unit and administration of corticosteroids to enhance fetal lung maturation. Globally, however, large practice variation exists. AREAS COVERED: The aim of this review is to provide an overview of current pharmacological therapies for preterm labor. EXPERT OPINION: For the initial tocolysis, the use of atosiban or nifedipine for 48 h is recommended based on the largest effectiveness and most favorable side effect profile. However, since data that convincingly indicate the beneficial effect of tocolytics on neonatal outcome are lacking, it might well be that tocolytics are ineffective. The role of progesterone in treatment of acute tocolysis is limited, but it might play a role in the prevention of preterm labor or as sensitizer for other tocolytic agents.; Elvira OG van Vliet...

Prevalence and correlates of preterm labor among young parturient women attending public hospitals in Brazil

Miranda,Angélica E.; Pinto,Valdir M.; Szwarcwald,Célia L.; Golub,Elizabeth T.
Fonte: Organización Panamericana de la Salud Publicador: Organización Panamericana de la Salud
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/11/2012 EN
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OBJECTIVE: To determine the prevalence of and risk factors for preterm labor (< 37 weeks of gestation) among young pregnant women in Brazil. METHODS: A national cross-sectional study was conducted among parturient women aged 15-24 years attending Brazilian public maternities in 2009. Questionnaires were administered by interviewers during parturient admission to the maternity clinic (or soon after delivery, if survey participants were in too much pain to respond during labor). The questionnaires collected demographic, behavioral, and clinical data. RESULTS: A total of 2 071 (86.3%) of the 2 400 parturient women invited to participate were included in the study. Mean age was 20.2 years (standard deviation [SD]: 2.7) and mean years of formal education was 8 (SD: 2.4). Preterm labor occurred in 450 women (21.7%). The highest proportion of premature labor (36.1%) was found in the North region and the lowest proportion (6.9%) was found in the South region. In the final multivariate logistic regression model, living in the North region (odds ratio [OR]: 1.43, 95% confidence interval [CI]: 1.28-1.59); having monthly income less than twice the Brazilian minimum wage (OR: 1.27, 95% CI: 1.01-1.60); having suffered domestic violence (OR: 2.27...