Objective We investigated the poten tial roles of relaxin and subclinical intra -amniotic inflam mation by quantitating amniotic fluid relaxin and interleu kin -6concentrations for the prediction of outcome of rescue ...Objective We investigated the poten tial roles of relaxin and subclinical intra -amniotic inflam mation by quantitating amniotic fluid relaxin and interleu kin -6concentrations for the prediction of outcome of rescue c erclage in women with cervical incompetence.Study desig n Cervical incompe-tence was diagnosed when cervical di latation exceeded 2cm with intact but bulging membranes an d no detectable uter-ine activity.Each woman underwent a mniocentesis to fa-cilitate the performance of a rescue cerclage between 15and 27weeks of gestation(n =40women).Forty -five additional women who underwent amni ocentesis for chro-mosomal testing between 16and 27weeks of gestation served as a control group.All contro l patients were de-livered of chromosomally normal inf ants at>37weeks of gestation.All cases and control patients were singleton gestations.Interleukin -6and rela xin were determined in all amniotic fluid samples by enzyme -linked im-munosorbent assay.Results Amnioti c fluid interleukin -6levels were significantly higher in women with cervical incompetence than in control patien ts(control patients,50.4pg /mLrange,19.4-97.4pg /mLvs cervical incompetence patients,5459.1pg /m Lrange,1131.4-14425.7pg /mL;P <.001).In contrast to inter-leukin -6,relaxin levels did not dif fer between the 2groups(control patients,67.5pg /mLrange,35.1-153.5pg /mLvs cervical incompetence patients,45.6pg /mLrange,30.1-75.5pg /mL;P =.061).There was a significant difference i n interleukin -6lev-els in women with shorter latencies(P<.01for all latency intervals that were examined:delivery within 24hours,3days,7days,before 33and 37completed weeks of gestation).Linear regression analysis with th e use of the latency interval from cerclage to delivery as the depen-dent and with interleukin -6as the in dependent variable revealed a significant inverse rela tionship(r =-0.62;P<.001after log transformation of int erleukin -6).There was no relationship on regression analysis between relaxin and the latency interval.Co nclusion Amniotic fluid interleukin -6is increased in patie nts with cervical incom-petence,which suggests that subcli nical inflammation may contribute to cervical incompetence.Further,an elevated interleukin -6level predicts a cerc lage short -latency in-terval between cerclage and delivery.In contrast with inter-leukin -6,amniotic fluid relaxin does not appear to con-tribute to cervical incompetence -i nduced cervical dilation.展开更多
Objectives Mannose -binding lectin(MBL)is active in the innate immune defense against micro organisms.In this study,we determined whether vulvar vestibulitis syn-drome,a disorder of unknown etiolog y,was associated wi...Objectives Mannose -binding lectin(MBL)is active in the innate immune defense against micro organisms.In this study,we determined whether vulvar vestibulitis syn-drome,a disorder of unknown etiolog y,was associated with an altered distribution of MBL alleles.Study design Buccal swabs were obtained from women with v ulvar vestibulitis syndrome in New York(62)and from 2cities in Sweden(60),as well as control women in New York(48)and Sweden(51).DNA was tested for a single nucleotide polymorphism at codon 54in exon I by p olymerase chain reaction,endonuclease digestion,and gel electrophoresis.Blood samples were also obtained fro m the New York women and tested by ELISA for plasma MBL concentra-tions.The relationships between genotype,allele frequen-cies,blood MBL levels,and diagnosiswere analyzed by Fisher exact test and oneway analysis of variance.Results The variant MBL allele,MBLB,was detected in35.5%and 26.7%of vulvar vestibulit is patients from New York and Sweden,respectively.Only 12.5%of New York controls(P =.007)and 9.8%of Swedish controls(P =.01)were MBL2-positive.All women,with one exception,who were positive for MBLB were MBLA /MBLB heterozygotes.Women who carried MBLB had almost a 10-fold reduction in median plasma MBL con-centrations(278ng /mL),as opposed to women who were MBLA homozygotes(1980ng /mL)(P<.0001).Conclusion MBLB carriage and reduced plasma MBL levels are more common in women with v ulvar vestibulitis syndrome than in control patients,a nd may contribute to symptomatology in a subset of patien ts.展开更多
Two hundred forty pregnant women pre sented with first-trimester threatened abortion were examined by transvaginal ultrasound.Women with a slow fetal heart rate of less than120beats per minute may eventually b e at in...Two hundred forty pregnant women pre sented with first-trimester threatened abortion were examined by transvaginal ultrasound.Women with a slow fetal heart rate of less than120beats per minute may eventually b e at increased risk for pregnancy loss.展开更多
文摘Objective We investigated the poten tial roles of relaxin and subclinical intra -amniotic inflam mation by quantitating amniotic fluid relaxin and interleu kin -6concentrations for the prediction of outcome of rescue c erclage in women with cervical incompetence.Study desig n Cervical incompe-tence was diagnosed when cervical di latation exceeded 2cm with intact but bulging membranes an d no detectable uter-ine activity.Each woman underwent a mniocentesis to fa-cilitate the performance of a rescue cerclage between 15and 27weeks of gestation(n =40women).Forty -five additional women who underwent amni ocentesis for chro-mosomal testing between 16and 27weeks of gestation served as a control group.All contro l patients were de-livered of chromosomally normal inf ants at>37weeks of gestation.All cases and control patients were singleton gestations.Interleukin -6and rela xin were determined in all amniotic fluid samples by enzyme -linked im-munosorbent assay.Results Amnioti c fluid interleukin -6levels were significantly higher in women with cervical incompetence than in control patien ts(control patients,50.4pg /mLrange,19.4-97.4pg /mLvs cervical incompetence patients,5459.1pg /m Lrange,1131.4-14425.7pg /mL;P <.001).In contrast to inter-leukin -6,relaxin levels did not dif fer between the 2groups(control patients,67.5pg /mLrange,35.1-153.5pg /mLvs cervical incompetence patients,45.6pg /mLrange,30.1-75.5pg /mL;P =.061).There was a significant difference i n interleukin -6lev-els in women with shorter latencies(P<.01for all latency intervals that were examined:delivery within 24hours,3days,7days,before 33and 37completed weeks of gestation).Linear regression analysis with th e use of the latency interval from cerclage to delivery as the depen-dent and with interleukin -6as the in dependent variable revealed a significant inverse rela tionship(r =-0.62;P<.001after log transformation of int erleukin -6).There was no relationship on regression analysis between relaxin and the latency interval.Co nclusion Amniotic fluid interleukin -6is increased in patie nts with cervical incom-petence,which suggests that subcli nical inflammation may contribute to cervical incompetence.Further,an elevated interleukin -6level predicts a cerc lage short -latency in-terval between cerclage and delivery.In contrast with inter-leukin -6,amniotic fluid relaxin does not appear to con-tribute to cervical incompetence -i nduced cervical dilation.
文摘Objectives Mannose -binding lectin(MBL)is active in the innate immune defense against micro organisms.In this study,we determined whether vulvar vestibulitis syn-drome,a disorder of unknown etiolog y,was associated with an altered distribution of MBL alleles.Study design Buccal swabs were obtained from women with v ulvar vestibulitis syndrome in New York(62)and from 2cities in Sweden(60),as well as control women in New York(48)and Sweden(51).DNA was tested for a single nucleotide polymorphism at codon 54in exon I by p olymerase chain reaction,endonuclease digestion,and gel electrophoresis.Blood samples were also obtained fro m the New York women and tested by ELISA for plasma MBL concentra-tions.The relationships between genotype,allele frequen-cies,blood MBL levels,and diagnosiswere analyzed by Fisher exact test and oneway analysis of variance.Results The variant MBL allele,MBLB,was detected in35.5%and 26.7%of vulvar vestibulit is patients from New York and Sweden,respectively.Only 12.5%of New York controls(P =.007)and 9.8%of Swedish controls(P =.01)were MBL2-positive.All women,with one exception,who were positive for MBLB were MBLA /MBLB heterozygotes.Women who carried MBLB had almost a 10-fold reduction in median plasma MBL con-centrations(278ng /mL),as opposed to women who were MBLA homozygotes(1980ng /mL)(P<.0001).Conclusion MBLB carriage and reduced plasma MBL levels are more common in women with v ulvar vestibulitis syndrome than in control patients,a nd may contribute to symptomatology in a subset of patien ts.
文摘Two hundred forty pregnant women pre sented with first-trimester threatened abortion were examined by transvaginal ultrasound.Women with a slow fetal heart rate of less than120beats per minute may eventually b e at increased risk for pregnancy loss.
