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The American Journal of Case Reports Jun 2017BACKGROUND Capnocytophaga ochracea is a gram-negative anaerobic organism commonly found in human oral flora. It is characteristically sensitive to beta-lactams and...
BACKGROUND Capnocytophaga ochracea is a gram-negative anaerobic organism commonly found in human oral flora. It is characteristically sensitive to beta-lactams and resistant to aminoglycosides. CASE REPORT A 23-year-old woman presented with lower abdominal pain and was admitted for premature labor at 24-weeks of gestation. At presentation, the cervix was closed and the membrane was intact; however, contractions continued, the membrane subsequently ruptured before receiving any steroids or magnesium, and the mother gave birth to a 540-gram female baby. At birth, Apgar scores were 1 at 5 minutes, 1 at 10 minutes, and 2 at 15 minutes. On the fifth day of life, the blood culture grew Capnocytophaga species. Consequently, Cefotaxime was started and ampicillin continued for a total of 14 days; however, on the 6th day, the head ultrasound showed grade 4 intraventricular hemorrhage and a Do Not Resuscitate (DNR) order was placed in the chart. The patient's health continued to deteriorate, having multiple episodes of bradycardia and desaturation until cardiac arrest on the 17th day. CONCLUSIONS Capnocytophaga ochracea was isolated from the blood culture of a preterm neonate. It was thought to be the cause of the premature labor and subsequent neonatal septicemia. This case report suggests that the prevalence of Capnocytophaga infections is most likely underestimated and that additional premature labors and abortions could have been caused by Capnocytophaga infections that were never detected. Hence, more studies are needed to investigate the route of transmission.
Topics: Capnocytophaga; Cerebral Intraventricular Hemorrhage; Fatal Outcome; Female; Gram-Negative Bacterial Infections; Heart Arrest; Humans; Infant, Newborn; Infant, Premature, Diseases; Neonatal Sepsis; Obstetric Labor, Premature; Pregnancy
PubMed: 28620153
DOI: 10.12659/ajcr.903824 -
Sensors (Basel, Switzerland) Jun 2023Timely preterm labor prediction plays an important role for increasing the chance of neonate survival, the mother's mental health, and reducing financial burdens imposed...
Timely preterm labor prediction plays an important role for increasing the chance of neonate survival, the mother's mental health, and reducing financial burdens imposed on the family. The objective of this study is to propose a method for the reliable prediction of preterm labor from the electrohysterogram (EHG) signals based on different pregnancy weeks. In this paper, EHG signals recorded from 300 subjects were split into 2 groups: (I) those with preterm and term labor EHG data that were recorded prior to the 26th week of pregnancy (referred to as the PE-TE group), and (II) those with preterm and term labor EHG data that were recorded after the 26th week of pregnancy (referred to as the PL-TL group). After decomposing each EHG signal into four intrinsic mode functions (IMFs) by empirical mode decomposition (EMD), several linear and nonlinear features were extracted. Then, a self-adaptive synthetic over-sampling method was used to balance the feature vector for each group. Finally, a feature selection method was performed and the prominent ones were fed to different classifiers for discriminating between term and preterm labor. For both groups, the AdaBoost classifier achieved the best results with a mean accuracy, sensitivity, specificity, and area under the curve (AUC) of 95%, 92%, 97%, and 0.99 for the PE-TE group and a mean accuracy, sensitivity, specificity, and AUC of 93%, 90%, 94%, and 0.98 for the PL-TL group. The similarity between the obtained results indicates the feasibility of the proposed method for the prediction of preterm labor based on different pregnancy weeks.
Topics: Pregnancy; Female; Infant, Newborn; Humans; Uterine Contraction; Uterus; Electromyography; Obstetric Labor, Premature; Labor, Obstetric; Signal Processing, Computer-Assisted
PubMed: 37447815
DOI: 10.3390/s23135965 -
Seminars in Fetal & Neonatal Medicine Apr 2016Spontaneous preterm birth is a major public health problem, with a clear genetic component. Genetic association studies have evolved substantially in recent years,... (Review)
Review
Spontaneous preterm birth is a major public health problem, with a clear genetic component. Genetic association studies have evolved substantially in recent years, moving away from the traditional candidate gene analyses to newer approaches utilizing sophisticated analysis platforms to examine sequencing data, and shifting towards functional studies including methylation analysis. It is becoming increasingly evident that careful clinical phenotyping is crucial to high quality genetic association studies regardless of the assay or platform being used. Nonetheless, genetic studies of prematurity are hampered by numerous challenges including small sample sizes, incomplete phenotying, population stratification, and multiple comparisons. As the costs of sequencing and functional analyses continue to decrease, unbiased genome-wide assays will be more widely available. Researchers have met improved success recently when critically applying clinical phenotyping knowledge to group women prior to analyzing genotyping results. Eventually, as the analytic approaches evolve, it is likely that this methodology (combining precisely clinically phenotyped subjects with genome-wide data) will provide key information regarding the pathophysiology of prematurity, and provide potential new avenues for exploring innovative therapeutic strategies.
Topics: Abruptio Placentae; Female; Fetal Membranes, Premature Rupture; Genetic Association Studies; Genetic Predisposition to Disease; Genetic Variation; Humans; Obstetric Labor, Premature; Pregnancy; Premature Birth; Uterine Cervical Incompetence
PubMed: 26851828
DOI: 10.1016/j.siny.2016.01.001 -
Journal of Immunology Research 2019Successful pregnancy requires a tightly-regulated equilibrium of immune cell interactions at the maternal-fetal interface (i.e., the decidual tissues), which plays a...
Successful pregnancy requires a tightly-regulated equilibrium of immune cell interactions at the maternal-fetal interface (i.e., the decidual tissues), which plays a central role in the inflammatory process of labor. Most of the innate immune cells in this compartment have been well characterized; however, adaptive immune cells are still under investigation. Herein, we performed immunophenotyping of the decidua basalis and decidua parietalis to determine whether exhausted and senescent T cells are present at the maternal-fetal interface and whether the presence of pathological (i.e., preterm) or physiological (i.e., term) labor and/or placental inflammation alter such adaptive immune cells. In addition, decidual exhausted T cells were sorted to test their functional status. We found that (1) exhausted and senescent T cells were present at the maternal-fetal interface and predominantly expressed an effector memory phenotype, (2) exhausted CD4 T cells increased in the decidua parietalis as gestational age progressed, (3) exhausted CD4 and CD8 T cells decreased in the decidua basalis of women who underwent labor at term compared to those without labor, (4) exhausted CD4 T cells declined with the presence of placental inflammation in the decidua basalis of women with preterm labor, (5) exhausted CD8 T cells decreased with the presence of placental inflammation in the decidua basalis of women who underwent labor at term, (6) both senescent CD4 and CD8 T cells declined with the presence of placental inflammation in the decidua basalis of women who underwent preterm labor, and (7) decidual exhausted T cells produced IFN and TNF upon stimulation. Collectively, these findings indicate that exhausted and senescent T cells are present at the human maternal-fetal interface and undergo alterations in a subset of women either with labor at term or preterm labor and placental inflammation. Importantly, decidual T cell function can be restored upon stimulation.
Topics: Adult; Biomarkers; Cellular Senescence; Decidua; Female; Humans; Immunophenotyping; Labor, Obstetric; Leukocytes; Lymphocyte Count; Maternal-Fetal Exchange; Obstetric Labor, Premature; Placenta; Pregnancy; T-Lymphocyte Subsets; T-Lymphocytes; Young Adult
PubMed: 31263712
DOI: 10.1155/2019/3128010 -
Infectious Diseases in Obstetrics and... 2017chorioamnionitis is rare but can lead to neonatal infection, high mortality, and neurodevelopmental impairment. We aimed to investigate maternal clinical features and... (Review)
Review
chorioamnionitis is rare but can lead to neonatal infection, high mortality, and neurodevelopmental impairment. We aimed to investigate maternal clinical features and perinatal outcomes and discuss future management strategies. We reviewed the medical records of women with chorioamnionitis at our hospital over a 10-year period ( = 9) and previous published case reports and case series. The most prevalent species was (71.3% of the all cases). The most prevalent predisposing condition was preterm premature rupture of membranes (31/123, 25.2%), followed by pregnancy with a retained intrauterine contraceptive device (26/123, 21.1%) and pregnancy after in vitro fertilization (25/123, 20.3%). Preterm labor was the most common symptom (52/123, 42.3%), and only 13% of cases involved fever. Of the infants, 27% of the singletons and 23.8% of the twins were born before 22 gestational weeks, while 60% of the singletons and 76.2% of the twins were born at 22-36 weeks. The median birth weight of the babies born after 22 weeks was 1230 g. The mortality rates of the singletons and twins born after 22 weeks of gestation in the year 2000 or later were 28.6% and 52.4%, respectively. Antenatal treatment for chorioamnionitis has not been established.
Topics: Adult; Birth Weight; Candida; Candida albicans; Candidiasis; Chorioamnionitis; Female; Humans; Infant, Newborn; Obstetric Labor, Premature; Perinatal Death; Pregnancy; Premature Birth
PubMed: 29180840
DOI: 10.1155/2017/9060138 -
Circulation Feb 2018Cardiovascular disease (CVD) risk factors are well established. However, little is known about a woman's cardiovascular response to pregnancy, which appears to be an... (Review)
Review
Cardiovascular disease (CVD) risk factors are well established. However, little is known about a woman's cardiovascular response to pregnancy, which appears to be an early marker of future maternal CVD risk. Spontaneous preterm delivery (sPTD) has been associated with a ≤3-fold increased risk of maternal CVD death later in life compared with having a term delivery. This review focuses on 3 key areas to critically assess the association of sPTD and future maternal CVD risk: (1) CVD risk factors, (2) inflammatory biomarkers of interest, and (3) specific forms of vascular dysfunction, such as endothelial function and arterial stiffness, and mechanisms by which each may be linked to sPTD. The association of sPTD with subsequent future maternal CVD risk suggests that a woman's abnormal response to pregnancy may serve as her first physiological stress test. These findings suggest that future research is needed to understand why women with sPTD may be at risk for CVD to implement effective interventions earlier in a woman's life.
Topics: Endothelium, Vascular; Female; Humans; Obstetric Labor, Premature; Pregnancy; Pregnancy Complications, Cardiovascular; Risk Factors; Vascular Stiffness
PubMed: 29459472
DOI: 10.1161/CIRCULATIONAHA.117.031403 -
Acta Obstetricia Et Gynecologica... Dec 2022Our objective was to compare the vaginal microbiome in low-risk and high-risk pregnant women and to explore a potential association between vaginal microbiome and...
INTRODUCTION
Our objective was to compare the vaginal microbiome in low-risk and high-risk pregnant women and to explore a potential association between vaginal microbiome and preterm birth.
MATERIAL AND METHODS
A pilot, consecutive, longitudinal, multicenter study was conducted in pregnant women at 18-22 weeks of gestation. Participants were assigned to one of three groups: control (normal cervix), pessary (cervical length ≤25 mm) and cerclage (cervical length ≤25 mm or history of preterm birth). Analysis and comparison of vaginal microbiota as a primary outcome was performed at inclusion and at 30 weeks of gestation, along with a follow-up of pregnancy and perinatal outcomes. We assessed the vaginal microbiome of pregnant women presenting a short cervix with that of pregnant women having a normal cervix, and compared the vaginal microbiome of women with a short cervix before and after placement of a cervical pessary or a cervical cerclage.
RESULTS
The microbiome of our control cohort was dominated by Lactobacillus crispatus and inners. Five community state types were identified and microbiome diversity did not change significantly over 10 weeks in controls. On the other hand, a short cervix was associated with a lower microbial load and higher microbial richness, and was not correlated with Lactobacillus relative abundance. After intervention, the cerclage group (n = 19) had a significant increase in microbial richness and a shift towards community state types driven by various bacterial species, including Lactobacillus mulieris, unidentified Bifidobacterium or Enterococcus. These changes were not significantly observed in the pessary (n = 26) and control (n = 35) groups. The cerclage group had more threatened preterm labor episodes and poorer outcomes than the control and pessary groups.
CONCLUSIONS
These findings indicate that a short cervix is associated with an altered vaginal microbiome community structure. The use of a cerclage for preterm birth prevention, as compared with a pessary, was associated with a microbial community harboring a relatively low abundance of Lactobacillus, with more threatened preterm labor episodes, and with poorer clinical outcomes.
Topics: Female; Infant, Newborn; Pregnancy; Humans; Pessaries; Premature Birth; Cervix Uteri; Cervical Length Measurement; Obstetric Labor, Premature; Microbiota
PubMed: 36168933
DOI: 10.1111/aogs.14460 -
Ginekologia Polska 2016The aim of the study was to analyze a possible correlation between personality traits and the level of stress experienced by women after premature labor.
OBJECTIVES
The aim of the study was to analyze a possible correlation between personality traits and the level of stress experienced by women after premature labor.
MATERIAL AND METHODS
The analysis was carried out on the basis of a study conducted in 96 women after premature labor. The following tools were used: Personality Inventory NEO-FFI, Parental Stressor Scale: NICU (SSR:OITN), and personal data questionnaire. It was an exploratory study since the SSR:OITN method is only applied to find out the characteristic features of stress induced by prematurity, and, therefore, it cannot be applied to study the control sample (i.e. women who delivered at term).
RESULTS
The obtained results revealed significant correlations between the level and structure of stress connected with premature labor and personality traits. The general level of stress and all its components (infant's clinical characteristics and medical procedures, personal and interpersonal problems as well as parental competence) correlated positively with Neuroticism. Negative correlations between the general level of stress together with its parental competence factor and Extraversion and Openness to experience were found. Agreeableness correlated negatively with parental competence stress. No correlation between the level of stress and Conscientiousness was observed.
CONCLUSIONS
Our findings shed new light on how women after premature labor experience stress, and suggested an ef-fective medical-psychological-therapeutic support aiming at reducing the level of trauma. The SSR:OITN Scale is proposed as one of the basic methods used to diagnose difficulties experienced by the investigated women.
Topics: Adaptation, Psychological; Adult; Female; Humans; Obstetric Labor, Premature; Personality; Personality Assessment; Personality Inventory; Pregnancy; Psychological Techniques; Stress, Psychological
PubMed: 27304651
DOI: 10.5603/GP.2016.0004 -
JCI Insight Jun 2021Clinical phenotyping of term and preterm labor is imprecise, and disagreement persists on categorization relative to underlying pathobiology, which remains poorly...
Clinical phenotyping of term and preterm labor is imprecise, and disagreement persists on categorization relative to underlying pathobiology, which remains poorly understood. We performed RNA sequencing (RNA-seq) of 31 specimens of human uterine myometrium from 10 term and 21 preterm cesarean deliveries with rich clinical context information. A molecular signature of 4814 transcripts stratified myometrial samples into quiescent (Q) and nonquiescent (NQ) phenotypes, independent of gestational age and incision site. Similar stratifications were achieved using expressed genes in Ca2+ signaling and TGF-β pathways. For maximal parsimony, we evaluated the expression of just 2 Ca2+ transporter genes, ATP2B4 (encoding PMCA4) and ATP2A2 (coding for SERCA2), and we found that their ratio reliably distinguished NQ and Q specimens in the current study, and also in 2 publicly available RNA-seq data sets (GSE50599 and GSE80172), with an overall AUC of 0.94. Cross-validation of the ATP2B4/ATP2A2 ratio by quantitative PCR in an expanded cohort (by 11 additional specimens) achieved complete separation (AUC of 1.00) of NQ versus Q specimens. While providing additional insight into the associations between clinical features of term and preterm labor and myometrial gene expression, our study also offers a practical algorithm for unbiased classification of myometrial biopsies by their overall contractile program.
Topics: Adult; Cesarean Section; Female; Fetal Membranes, Premature Rupture; Gene Expression Profiling; Gestational Age; Humans; Labor Stage, First; Labor, Obstetric; Myometrium; Obstetric Labor, Premature; Plasma Membrane Calcium-Transporting ATPases; Pregnancy; Premature Birth; Sarcoplasmic Reticulum Calcium-Transporting ATPases; Term Birth; Transcriptome; Uterine Contraction; Young Adult
PubMed: 33945511
DOI: 10.1172/jci.insight.148425 -
European Review For Medical and... Nov 2023The predictive values of cervix length (CL) measurement based on transvaginal ultrasonography (TVUS) and pathological examination of placenta for premature delivery...
Predictive values of cervix length measurement based on transvaginal ultrasonography combined with pathological examination of placenta for premature delivery and correlation between premature delivery and infection.
OBJECTIVE
The predictive values of cervix length (CL) measurement based on transvaginal ultrasonography (TVUS) and pathological examination of placenta for premature delivery (PTD) were investigated, and the correlation between PTD and infection was analyzed.
PATIENTS AND METHODS
A total of 120 pregnant women with PTD or high-risk factors for PTD admitted to Hengyang Maternal and Child Health Hospital, between February 2020 and March 2022 were included in this retrospective study. There were 36 subjects in the PTD group and 84 in the normal delivery group (control group). They underwent pathological examination of the placenta and TVUS for CL measurement. The final gestational age was set as the standard for the evaluation of the predictive values of pathological examination of the placenta and TVUS. Moreover, a pathological examination of the placenta was used to analyze the correlation between PTD and infection.
RESULTS
The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of joint inspection were remarkably superior to those of single CL or pathological examination of the placenta (p<0.05). The proportion of pregnant women with CL ≤30 mm and positive placental pathology was higher than that of pregnant women with CL >30 mm and negative placental pathology (p<0.05). In addition, the incidence of Ureaplasma urealyticum (UU), Chlamydia trachomatis (CT), and chorioamnionitis (CA) in the vaginal discharge of the PTD group was markedly superior to that of the control group (p<0.05).
CONCLUSIONS
The combination of CL ≤30 mm and positive placental pathology could effectively predict PTD, and placental infection was notably correlated with the occurrence of PTD.
Topics: Child; Female; Pregnancy; Humans; Obstetric Labor, Premature; Placenta; Retrospective Studies; Cervix Uteri; Premature Birth; Cervical Length Measurement; Predictive Value of Tests
PubMed: 37975346
DOI: 10.26355/eurrev_202311_34297