A Ghidini1, C M Salafia, V Kirn, V Doria, C Y Spong. 1. Department of Obstetrics and Gynecology, Georgetown University Medical Center, Washington, DC 20007, USA. ghidina@gusun.georgetown.edu
Abstract
OBJECTIVE: To assess the performance of the biophysical profile (BPP) and its components within 24 hours of delivery in predicting histopathologic evidence of severe acute placental inflammation in women with premature rupture of membranes (PROM) before 32 weeks' gestation. METHODS: We examined placentas from a series of consecutive, nonanomalous, live-born, singleton infants delivered before 32 weeks' gestation after PROM. In 166 cases, biophysical profiles (BPP) were done within 24 hours of birth. Histologic evidence of acute inflammation was assessed in the maternal (amnion) and fetal (chorionic and umbilical cord vessels) compartments, and scored on a severity scale of 0-4 by a single pathologist masked to clinical data. The presence and severity of acute inflammation was related to BPP results and its individual components. RESULTS: The overall prevalence of severe acute inflammation, ie, a score of 3 or 4, was 59% (98 of 166). In 30 (18%) cases it was present in the amnion, in 49 (30%) cases in chorionic or umbilical cord vessels, and in 19 (11%) cases in maternal and fetal compartments. There was no association between abnormal BPP score and presence or absence of severe acute placental inflammation (48% versus 46%, P =.7). Our study had a 90% power to detect a 0.26 difference between them. When rates of abnormal BPP scores were compared in cases with different degrees of acute inflammation in the maternal, fetal, or both compartments, no association was found. When the individual components of the BPP were analyzed in relation to site and severity of acute inflammation, no association was detected. CONCLUSION: We did not find evidence of a dose-response relationship between acute placental inflammation and BPP score or its individual components in cases of PROM with infants delivered before 32 weeks. Mediators other than infection might affect BPP in preterm PROM.
OBJECTIVE: To assess the performance of the biophysical profile (BPP) and its components within 24 hours of delivery in predicting histopathologic evidence of severe acute placental inflammation in women with premature rupture of membranes (PROM) before 32 weeks' gestation. METHODS: We examined placentas from a series of consecutive, nonanomalous, live-born, singleton infants delivered before 32 weeks' gestation after PROM. In 166 cases, biophysical profiles (BPP) were done within 24 hours of birth. Histologic evidence of acute inflammation was assessed in the maternal (amnion) and fetal (chorionic and umbilical cord vessels) compartments, and scored on a severity scale of 0-4 by a single pathologist masked to clinical data. The presence and severity of acute inflammation was related to BPP results and its individual components. RESULTS: The overall prevalence of severe acute inflammation, ie, a score of 3 or 4, was 59% (98 of 166). In 30 (18%) cases it was present in the amnion, in 49 (30%) cases in chorionic or umbilical cord vessels, and in 19 (11%) cases in maternal and fetal compartments. There was no association between abnormal BPP score and presence or absence of severe acute placental inflammation (48% versus 46%, P =.7). Our study had a 90% power to detect a 0.26 difference between them. When rates of abnormal BPP scores were compared in cases with different degrees of acute inflammation in the maternal, fetal, or both compartments, no association was found. When the individual components of the BPP were analyzed in relation to site and severity of acute inflammation, no association was detected. CONCLUSION: We did not find evidence of a dose-response relationship between acute placental inflammation and BPP score or its individual components in cases of PROM with infants delivered before 32 weeks. Mediators other than infection might affect BPP in preterm PROM.
Authors: Megan E McCarthy; Catalin S Buhimschi; John T Hardy; Antonette T Dulay; Christine A Laky; Mert-Ozan Bahtyiar; Ramesha Papanna; Guomao Zhao; Irina A Buhimschi Journal: Placenta Date: 2017-12-24 Impact factor: 3.481
Authors: John T Hardy; Irina A Buhimschi; Megan E McCarthy; Guomao Zhao; Christine A Laky; Lydia L Shook; Catalin S Buhimschi Journal: J Clin Endocrinol Metab Date: 2016-05-09 Impact factor: 5.958
Authors: Kara M Rood; Catalin S Buhimschi; Guomao Zhao; Emily A Oliver; Taryn Summerfield; Mert Ozan Bahtiyar; Irina A Buhimschi Journal: Biol Reprod Date: 2019-03-01 Impact factor: 4.285
Authors: Margaret A Baumbusch; Catalin S Buhimschi; Emily A Oliver; Guomao Zhao; Stephen Thung; Kara Rood; Irina A Buhimschi Journal: Cytokine Date: 2016-03-05 Impact factor: 3.861
Authors: Catalin S Buhimschi; Vineet Bhandari; Yiping W Han; Antonette T Dulay; Margaret A Baumbusch; Joseph A Madri; Irina A Buhimschi Journal: Curr Opin Infect Dis Date: 2009-06 Impact factor: 4.915
Authors: C S Buhimschi; A T Dulay; S Abdel-Razeq; G Zhao; S Lee; E J Hodgson; V Bhandari; I A Buhimschi Journal: BJOG Date: 2008-10-08 Impact factor: 6.531
Authors: Catalin S Buhimschi; Margaret A Baumbusch; Antonette T Dulay; Emily A Oliver; Sarah Lee; Guomao Zhao; Vineet Bhandari; Richard A Ehrenkranz; Carl P Weiner; Joseph A Madri; Irina A Buhimschi Journal: Am J Pathol Date: 2009-08-13 Impact factor: 4.307