Background: Considering the effect of preterm delivery in morbidity and mortality of newborns, its precaution and prevention is so important.

Objective: To investigate the association between second trimester maternal serum biomarkers (Human Chorionic Gonadotropin, Alpha-fetoprotein, Non-conjugated estrogen, Inhibin A) and pre-term delivery.

Materials and Methods: This is a historical cohort study that has been performed for 700 pregnant women, clients of Nilou Lab in the second trimester of pregnancy to take the Quad Marker test between March to September 2008. The information of mothers having required conditions to enter to study has been registered and after delivery, they called again to be interviewed. These data sets using statistical tests: chi-square test and Roc Curve was analysis.

Results: There is a direct relationship between preterm delivery and increase of Alpha-fetoprotein (p=0.011) and inhibin A (p=0.03) serum level and. Also, there is an inverse relationship between the non-conjugated estrogen (p=0.002) serum level and preterm delivery. Moreover, there is not any relationship between the increase human chorionic gonadotropin (p=0.68) serum level and preterm delivery.

Conclusion: The increase in the Alpha-fetoprotein and Inhibin A and decrease in Non-conjugated estrogen serum levels in the second trimester of pregnancy lead to enhance the probability of preterm delivery. Moreover, if the current study is done with higher samples and different sampling environment, it may have different results.

https://tspace.library.utoronto.ca/bitstream/1807/62307/1/rm13017.pdf

Investigating association between second trimester maternal serum biomarkers and pre-term delivery

Background: Preterm birth is a common problem in obstetrics. Objective: To measure maternal serum interlukin-6 in mothers with preterm uterine contractions and compare it with cervicovaginal interlukin-6 in the same women. Methods: In this cross-sectional study, we measured interlukin-6 in the sera and cervicovaginal fluids of 86 women with preterm uterine contractions. All participants had an intact membrane. Interlukin-6 was measured by using ELISA method. Statistical analysis was done using U-Mann Whitney, Chi-Square and Kendall’s tests. Results: The mean and median (Quartile25, Quartile75) of interlukin-6 in cervicovaginal fluid was higher than maternal serum interlukin-6. There was a statically significant difference in the median of interlukin-6 in sera and cervicovaginal fluid (P<0.0001).  There was no significant correlation between serum and cervicovaginal interlukin-6 (r=0.048, p=0.548). Conclusion: There was no significant correlation between serum and cervicovaginal interlukin-6 (r=0.048, p=0.548). Conclusion: We found no relationship between serum interlukin-6 and preterm labor and the maternal serum Interlukin-6 does not seem to be a suitable biomarker for predicting preterm delivery.

Maternal Serum and Cervicovaginal IL-6 in Patients with Symptoms of Preterm Labor

Introduction: Four tests are performed on the 20th to 15th week of gestation  These tests include Triple Markers and Inhibin A Markers Research has shown that abnormal levels of quadruple markers are useful in predicting side effects of pregnancy, and several studies have shown that there is a significant relationship between abnormal levels of four tests and preterm delivery, preeclampsia, pregnancy pressure, intrauterine growth restriction, and premature rupture of fetal curves There are few previously published large studies that evaluated combination of quad screen markers,the aim of this study was to predict the predictive value of quadruple tests in the second trimester of pregnancy in the diagnosis of complications, especially the prediction of fetal death and abortion at birth Method: This is a longitudinal study All pregnant women in their second trimester who referred to Zabol city labaratory in 1995 and 1996 for Quad Marker testing were included The exclusion criteria were: mothers over 35 years of age, mothers with a history of preterm labor, gestational hypertention and Down syndrome Results: 240 pregnant women participated in this study 292% of them were in the age group of 15 to 25 years old and 413% were in the age group of 31 to 35 years old The results showed that only the surface area below the UE3 curve is statistically significant (AUC=0144, p=0007) The best UE3 value for detecting fetal death with a sensitivity of 100% and a 8% attribute equals 0265 and the best AFP value for diagnosis of abortion with a sensitivity of 86% and 78% is 1,765 Discussion: In our study, although the underlying curve for Inhibin was higher than other markers, but the overlap between the confidence intervals for the surface under the curve of the three markers of Inhibin, Alfus, Protein and HCG indicated no significant difference in the level below the curve of the three markers In a study by Duric et al, which was done by cohort method, 2384 pregnant women were evaluated in Croatia The results of this study indicate that the increase in AFP was significantly associated with intrauterine growth retardation and spontaneous abortion, and the increase in HCG levels in the second trimester of pregnancy was associated with preterm delivery and intrauterine fetal death, as well as a decrease in the serum levels of 3 US Mother in the second trimester of pregnancy is associated with preterm labor and restriction of uterine infertility

/pdf/the-predictive-value-of-quadruple-tests-in-the-second-49h6l50ajq.pdf

The Predictive Value of Quadruple Tests in the Second Trimester of Pregnancy in Identifying Pregnancy Complications

/pdf/relationship-between-maternal-serum-biomarkers-hcg-afp-ue3-3kjvnlsyq1.pdf

Relationship between Maternal Serum Biomarkers (HCG, AFP, UE3, and Inhibin A) in the Second Trimester of Pregnancy and Preterm Labor

Studying the combination of cervical interleukins-6 and -8 with cervical dilatation in predicting preterm labor

Background: According to the text book of obstetrics and Gynecology,
prematurity is the first cause of perinatal mortality. Therefore
postponing delivery will become mandatory to prevent complications of
prematurity. Parental MgSO4 is one of the most common and the safest
medications for this purpose. Case report: We present a primigravida
patient with multiple uterine myoma who had premature labor and
received intravenous MgSO4 for 58 days in order to postpone her
delivery while having a cervical dilation of 4-5 cm. The patient
underwent C/S at the gestational age of 34 weeks because of reducing
fetal movements and Breech presentation. Conclusion: Because of many
side effects of long term management with MgSO4 and bed rest, this
protocol isn't recommended for all patients.

/pdf/long-term-management-of-preterm-labor-with-mgso4-in-104z4l2maa.pdf

Ghasemi Mozhdeh

Papers

Studying the combination of cervical interleukins-6 and -8 with cervical dilatation in predicting preterm labor

Long term management of preterm labor with mgso4 in myomatous uterus