Showing papers by "Roberto Romero published in 1990"

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

Abstract: 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, AF IL-6 was determined in 56 consecutive women admitted with preterm labor. All patients (n = 10) with elevated AF IL-6 (cutoff = 46 ng/ml) delivered a premature neonate. 4 of these 10 patients had positive AF cultures for microorganisms. These studies implicate IL-6 in the host response to intrauterine infection and suggest that evaluation of AF IL-6 levels may have diagnostic and prognostic value in the management of women in preterm labor.

Prostaglandin biosynthesis by human decidual cells: effects of inflammatory mediators.

Abstract: There is substantial evidence that decidual activation, in association with infection, is linked with the onset of both preterm and term labor We therefore undertook the present study to evaluate prostaglandin production and its potential regulation by inflammatory mediators in human decidual cells in primary monolayer culture Upon attaining confluence, the cells were incubated with endotoxin, interleukin 1α (IL1α), interleukin 1β (IL1β); or tumor necrosis factor (TNF) Production of prostaglandin (PG) E 2 and PGF 2α was determined using specific radioimmunoassays Endotoxin and these cytokines all induced significant concentration-dependent increases in PGE 2 and PGF 2α production Our results suggest that term human decidual cells are responsive to endotoxin and cytokines and that generation of these substances in the decidua or nearby (eg in response to infection) will lead to increased prostaglandin production and uterine contractions

Amniotic fluid interleukin-1 in spontaneous labor at term.

Abstract: The regulatory signals responsible for the increased biosynthesis of prostaglandins during parturition have not been established. Interleukin-1 (IL-1) is capable of stimulating prostaglandin production by intrauterine tissues and is an inflammation mediator. It has been postulated as a signal for the onset of labor in the setting of intrauterine infection. A study was designed to determine if spontaneous labor at term was associated with changes in IL-1 activity in amniotic fluid. Such fluid was retrieved from 41 women in labor and from 39 women who were not in labor at term. Immunodetectable IL-1 beta was present in 22 of the 41 women in labor but in only 8 of the 39 women without labor. IL-1-like bioactivity was not different between the two groups at a dilution of 1:4, but at dilutions of 1:12, 1:36 and 1:108, amniotic fluid from women in labor had significantly higher bioactivity than that from women not in labor. A significant correlation was found between the bioassay and immunoassay results. Our data show that inhibitors of IL-1 bioactivity are present in amniotic fluid and suggest that in a subset of laboring women at term, an inflammatory reaction may play a role in triggering the onset of parturition.

Umbilical cord hemangioma. Prenatal identification and review of the literature.

Abstract: Hemangioma of the umbilical cord is a tumor arising from endothelial cells ofthe umbilical vessels. It has also been referred to as angiomyxoma of the umbilical cord, cavernous hemangioma, myxoangioma, hemangiofibromyxoma, or telangiectatic myxosarcoma. A total of 22 cases have been reported in the world literature.1 -6 In four cases the lesions were prenatally identified,2-6 the earliest being done at 17 weeks gestation.' We present our case and review the other prenatal diagnoses, discuss the differential diagnosis and prognosis of this condition, and stress which common elements may help the sonographer to direct the diagnosis.

Prenatal diagnoses in unilateral empty renal fossa.

Abstract: Six cases of unilateral empty renal fossa diagnosed by obstetric sonography are described. The anomalies reported (ectopic kidney, cross-fused ectopic kidney, and unilateral renal agenesis) have not yet been described in the prenatal literature, to our knowledge, in fetuses that are otherwise normal. The study also demonstrates that, in spite of their nonvital in utero role, single kidneys may show compensatory hypertrophy.

Isolated fetal ascites: prenatal diagnosis and management.

Abstract: The perinatal outcomes of four patients with isolated fetal ascites were evaluated. The ascites disappeared prior to delivery in 50% of the cases and was resolved shortly after delivery in the remainder. Excellent neonatal outcomes were observed. Thus, isolated fetal ascites may represent a separate condition that significantly differs from the general category of nonimmune hydrops in both perinatal courses and prognoses. The prenatal diagnosis and management of this condition are discussed.

A monokine stimulates prostaglandin-E2 production by human amnion

Abstract: The studies reported in this communication were designed to test the hypothesis that products of mononuclear cells are capable of stimulating prostaglandin E2 production by human amnion. Conditioned media obtained from peripheral blood mononuclear cells were incubated with amnion cells in primary culture. A dose dependent increase in PGE2 biosynthesis was observed in response to increasing amounts of the conditioned media. These observations suggest that mononuclear cells produce a factor(s) capable of stimulating prostaglandin production by amnion cells. The signal responsible for the increased biosynthesis of prostaglandins by human amnion associated with parturition in the setting of intraamniotic infection may be of host origin.