Journal ArticleDOI
Silent chorioamnionitis and associated pregnancy outcomes: a review of clinical data gathered over a 16-year period.
TLDR
The study findings support the association between intra-amniotic infections and preterm delivery and the lower the birth-weight or gestational age, the higher the frequency of silent infections in the uterine cavity.Abstract:
OBJECTIVE To assess neonatal outcomes and associated findings in pregnant women identified after delivery as having had underlying subclinical chorioamnionitis by either histology or bacterial culture. METHODS In 16 years, 8974 clinical, histological, and bacterial culture data were obtained retrospectively. RESULTS Placental histology was analyzed in 4237 pregnancies (2785 term and 1452 preterm) and 4737 amniotic cavity cultures were obtained during 5446 cesarean deliveries (3268 term and 1469 preterm). Histological results and bacterial cultures were both available in 1270 of the preterm deliveries. Histology revealed inflammation, suggestive of infection, in 13.6% of placentas. Subclinical acute chorioamnionic inflammation was confirmed in 142 out of 2785 term pregnancies (5.1%) and in 436 out of 1452 preterm pregnancies (30.0%, P<0.001). Bacteriological culture of the intrauterine cavity was obtained from the lower uterine segment of the uterus during cesarean section. A positive culture was found in 19.9% of all cases (941/4737), this proportion was significantly higher in preterm deliveries (343/1273, 26.9%) than in term (17.3%, P<0.001). The lower the birth-weight or gestational age, the higher the frequency of silent infections in the uterine cavity. CONCLUSIONS Our study findings support the association between intra-amniotic infections and preterm delivery.read more
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Journal ArticleDOI
Clinical chorioamnionitis at term I: microbiology of the amniotic cavity using cultivation and molecular techniques.
Roberto Romero,Jezid Miranda,Juan Pedro Kusanovic,Tinnakorn Chaiworapongsa,Piya Chaemsaithong,Piya Chaemsaithong,A Martínez,Francesca Gotsch,Zhong Dong,Ahmed I. Ahmed,Majid Shaman,Kia Lannaman,Bo Hyun Yoon,Sonia S. Hassan,Sonia S. Hassan,Chong J. Kim,Steven J. Korzeniewski,Steven J. Korzeniewski,Lami Yeo,Lami Yeo,Yeon Mee Kim +20 more
TL;DR: The amniotic fluid (AF) microbiology of patients with the diagnosis of clinical chorioamnionitis at term was determined using both cultivation and molecular techniques and the relationship between intra-amniotic inflammation with and without microorganisms and placental lesions consistent with acute AF infection was examined.
Journal ArticleDOI
The Human Ureaplasma Species as Causative Agents of Chorioamnionitis
TL;DR: The information presented within this review confirms that Ureaplasma spp.
Journal ArticleDOI
Vaginal progesterone, but not 17α-hydroxyprogesterone caproate, has antiinflammatory effects at the murine maternal-fetal interface
Amy Eunice Furcron,Roberto Romero,Roberto Romero,Olesya Plazyo,Ronald Unkel,Yi Xu,Sonia S. Hassan,Sonia S. Hassan,Piya Chaemsaithong,Piya Chaemsaithong,Arushi Mahajan,Nardhy Gomez-Lopez,Nardhy Gomez-Lopez +12 more
TL;DR: Vaginal progesterone, but not 17OHP-C, has local antiinflammatory effects at the maternal-fetal interface and the cervix and protects against endotoxin-induced PTB.
The human Ureaplasma species as causative agents of chorioamnionitis
TL;DR: In this article, the authors provide evidence that Ureaplasma spp. are associated with diseases of pregnancy and discuss recent findings, which demonstrate that the presence of these microorganisms is associated with chorioamnionitis, regardless of gestational age at the time of delivery.
Journal ArticleDOI
Clinical chorioamnionitis at term V: umbilical cord plasma cytokine profile in the context of a systemic maternal inflammatory response
Roberto Romero,Piya Chaemsaithong,Piya Chaemsaithong,Nikolina Docheva,Steven J. Korzeniewski,Steven J. Korzeniewski,Steven J. Korzeniewski,Adi L. Tarca,Adi L. Tarca,Gaurav Bhatti,Zhonghui Xu,Juan Pedro Kusanovic,Noppadol Chaiyasit,Zhong Dong,Bo Hyun Yoon,Sonia S. Hassan,Sonia S. Hassan,Tinnakorn Chaiworapongsa,Lami Yeo,Lami Yeo,Yeon Mee Kim +20 more
TL;DR: The umbilical cord plasma cytokine profile in neonates born to mothers with clinical chorioamnionitis at term was characterized, suggesting that maternal fever in the absence of intra-amniotic inflammation leads to a change in the fetal cytokine network.
References
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Journal ArticleDOI
The preterm parturition syndrome
Roberto Romero,Jimmy Espinoza,Juan Pedro Kusanovic,Francesca Gotsch,Sonia S. Hassan,Offer Erez,Tinnakorn Chaiworapongsa,Moshe Mazor +7 more
TL;DR: The evidence indicating that the pathological processes implicated in the preterm parturition syndrome include: intrauterine infection/inflammation; uterine ischaemia; (3) uterine overdistension; (4) abnormal allograft reaction; (5) allergy; (6) cervical insufficiency; and (7) hormonal disorders (progesterone related and corticotrophin‐releasing factor related).
Journal ArticleDOI
A review of premature birth and subclinical infection
TL;DR: Results support the hypothesis that premature birth results in part from infection caused by genital tract bacteria, and research efforts must be prioritized to determine the role of infection and the appropriate prevention of this cause of prematurity.
Journal ArticleDOI
Microbial Prevalence, Diversity and Abundance in Amniotic Fluid During Preterm Labor: A Molecular and Culture-Based Investigation
Daniel B. DiGiulio,Daniel B. DiGiulio,Roberto Romero,Roberto Romero,Harold P. Amogan,Juan Pedro Kusanovic,Juan Pedro Kusanovic,Elisabeth M. Bik,Elisabeth M. Bik,Francesca Gotsch,Chong Jai Kim,Chong Jai Kim,Offer Erez,Offer Erez,Sam Edwin,David A. Relman,David A. Relman +16 more
TL;DR: The amniotic cavity of women in preterm labor harbors DNA from a greater diversity of microbes than previously suspected, including as-yet uncultivated, previously-uncharacterized taxa.