Intra-amniální zánět u předčasného odtoku plodové vody před termínem porodu je spojen se zvýšením hladin sCD93 v plodové vodě

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Autoři: R. Spacek ¹; M. Kacerovský ^2,3 ; C. Andrýs ⁴ ; O. Souček ⁴ ; R. Kukla ⁵ ; R. Bolehovská ⁵; I. Musilová ²
Působiště autorů: Department of Obstetrics and Gynecology, Faculty of Medicine, Ostrava University, University Hospital Ostrava ¹; Department of Obstetrics and Gynecology, Faculty of Medicine, Charles University, University Hospital Hradec Kralove ²; Biomedical Research Center, University Hospital Hradec Kralove ³; Department of Clinical Immunology and Allergy, Faculty of Medicine, Charles University, University Hospital Hradec Kralove ⁴; Institute of Clinical Biochemistry and Dia gnostics, Faculty of Medicine, Charles University, University Hospital Hradec Kralove ⁵
Vyšlo v časopise: Ceska Gynekol 2022; 87(6): 388-395
Kategorie: Původní práce
doi: https://doi.org/10.48095/cccg2022388

Souhrn

Cíl: Stanovit hladiny solubilní formy CD93 (sCD93) v plodové vodě u pacientek s předčasným odtokem plodové vody (PPROM –⁠ preterm prelabor rupture of membranes) s ohledem na přítomnost mikrobiální invaze do amniální dutiny (MIAC –⁠ microbial invasion of the amniotic cavity) a/nebo intraamniálního zánětu. Metody: Do studie bylo zahrnuto celkem144 žen s jednočetným těhotenstvím komplikovaným PPROM. Plodová voda byla získána amniocentézou. MIAC byla stanovena kultivačními a nekultivačními technikami. Intraamniální zánět byl stanoven hladinou interleukinu 6 ≥ 3 000 pg/ml v plodové vodě. Ženy byly rozděleny do následujících skupin: i) intraamniální infekce, ii) sterilní intraamniální zánět, iii) kolonizace a iv) negativní plodová voda. Hladiny sCD93 v plodové vodě byly stanoveny pomocí testu ELISA. Výsledky: Hladiny sCD93 v plodové vodě se lišily mezi skupinami žen s PPROM s intraamniální infekcí, sterilním intraamniálním zánětem, kolonizací a negativní plodovou vodou (intraamniální infekce: medián 22,3 ng/ml, sterilní intraamniální zánět: medián 21,0 ng/ml, kolonizace amniové dutiny: 8,7 ng/ml, negativní plodová voda: medián 8,7 ng/ml; p < 0,0001). Závěr: Intraamniální zánět u PPROM, bez ohledu na přítomnost, či chybení MIAC, je spojen se zvýšením hladin sCD93 v plodové vodě.

Klíčová slova:

předčasný porod – interleukin 6 – apoptóza – monocyt – neutrofil – receptor

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