Makino, I., Makino, Y., Yoshihara, F., Nishikimi, T., Kawarabayashi, T., Kangawa, K., & Shibata, K. (2003). Decreased mature adrenomedullin levels in feto-maternal tissues of pregnant women with histologic chorioamnionitis. Biochemical and biophysical research communications, 301(2), 437-442. https://doi.org/10.1016/s0006-291x(02)03059-0
Makino I, Makino Y, Yoshihara F, Nishikimi T, Kawarabayashi T, Kangawa K, et al. Decreased mature adrenomedullin levels in feto-maternal tissues of pregnant women with histologic chorioamnionitis. Biochem Biophys Res Commun. 2003;301(2):437-442. doi:10.1016/s0006-291x(02)03059-0
Makino, Ikuko, et al. "Decreased mature adrenomedullin levels in feto-maternal tissues of pregnant women with histologic chorioamnionitis." Biochemical and biophysical research communications, vol. 301, no. 2, 2003, pp. 437-442.
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Adrenomedullin (AM) gains its bioactivity by amidation at its C-terminal, forming "mature AM." The mature AM and the expression of AM receptor component mRNAs, receptor activity-modifying protein 2 and calcitonin receptor-like receptor, from feto-maternal tissues of normal pregnant women and women with histologic chorioamnionitis were examined to clarify the pathophysiological features of this intrauterine infection. Samples of the placenta and fetal membranes were obtained from 10 normal pregnant women and eight women with histologic chorioamnionitis under informed consent. Mature AM in the fetal membranes was significantly lower in patients with chorioamnionitis than in normal pregnant women. On the other hand, there were no differences in mature AM levels in the placenta between the two groups. The total AM levels as a sum of mature and immature AM were not significantly different between the two groups in either area. The ratio of mature AM/total AM was significantly decreased in the fetal membranes of the patients with chorioamnionitis compared with normal pregnancies, but not in the placenta. Also, levels of mature AM were negatively correlated with C-reactive protein concentrations. The present results thus suggested that mature AM may have some role in chorioamnionitis.
A group of 52 patients with premature rupture of the membranes (PROM) before 34 weeks' gestation were evaluated prospectively and managed expectantly. Of 42 patients who were delivered of their infants, 26 (61.9%) had significant chorioamnionitis on histopathology, and 18 had positive microbial cultures at delivery. However, only seven patients (16.7%) developed clinical signs of chorioamnionitis. There were no maternal deaths or perinatal deaths attributable to sepsis. Only two infants (less than 5%) had positive blood cultures. All patients were assessed daily for the development of chorioamnionitis. Amniocenteses were not routinely performed. White blood cell counts, band neutrophil counts, and erythrocyte sedimentation rate determinations were found to be unreliable. C-reactive protein determinations were found most reliable with a high sensitivity and specificity. Elevated C-reactive protein levels correlated better with pathologic confirmation of chorioamnionitis than with the clinical febrile morbidity. Clinical implications for the management of PROM are discussed.
Chaaban M et al., 1988·J Gynecol Obstet Biol Reprod (Paris)
We have retrospectively studied the changes in the level of C-reactive protein (CRP) and of white blood cells in 82 patients who had premature rupture of the membranes between the 20th and the 36th week of pregnancy in order to estimate the possibility of prenatal screening for amnion infections in early rupture of the membranes. The level of CRP was shown to be quickly and significantly raised in cases of clinical or histological chorioamnionitis, whereas the change in maternal leucocytes alters little and later. The level of CRP can be worked out as an early biological marker which is sensitive and cheap in the clinical supervision of cases with early rupture of the membranes.
To determine whether adrenomedullin levels in amniotic fluid were associated with preterm labor. We measured immunoreactive adrenomedullin in amniotic fluid collected by amniocentesis from 36 women with clinical diagnosis of preterm labor or preterm premature rupture of membranes (PROM) and from 18 normal pregnant women. Amniotic fluid from cases of PROM and failure to respond to tocolysis were associated significantly with higher amniotic fluid adrenomedullin concentrations (177.0 +/- 22.5 pg/mL and 182.7 +/- 22.0 pg/mL, respectively, P < .01) than that from uncomplicated pregnancies (101.2 +/- 28.1 pg/mL) or preterm labor responsive to tocolysis (102.3 +/- 26.8 pg/mL). Amniotic fluid adrenomedullin is higher than normal in cases of PROM and preterm labor unresponsive to tocolysis, perhaps indicating enhanced synthesis from placenta or fetal membranes being stimulated by bacterial products.
The purpose of this study was to determine the relationship between C-reactive protein (CRP) levels and intraamniotic infection in 48 women presenting with preterm labor and intact membranes. Blood samples for CRP tests were obtained immediately before the performance of transabdominal amniocentesis. The prevalence of amniotic fluid cultures positive for organisms was 14.6%. In 16 women (33.3%) positive CRP levels were obtained. There were no significant differences in the prematurity rate or the prevalence of microbial invasion of the amniotic cavity between women with positive CRP levels and women with negative levels. The sensitivity, specificity, and positive and negative predictive values for the detection of amniotic infection were 71.5%, 73.2%, 31.3% and 93.8%, respectively. Based on these results, we suggest that in women with preterm labor and negative CRP levels, routine amniocentesis may not be essential to the initial workup.
General Gynecology › Infections › Pelvic Inflammatory Disease
F Yoshihara, T Nishikimi, K Kangawa, K Shibata, T Kawarabayashi, I Makino, Y Makino
PMID 12565880 12565880 DOI 10.1016/s0006-291x(02)03059-0 10.1016/s0006-291x(02)03059-0 Makino et al. 2003, Makino 2003
Cite this article
Makino, I., Makino, Y., Yoshihara, F., Nishikimi, T., Kawarabayashi, T., Kangawa, K., & Shibata, K. (2003). Decreased mature adrenomedullin levels in feto-maternal tissues of pregnant women with histologic chorioamnionitis. Biochemical and biophysical research communications, 301(2), 437-442. https://doi.org/10.1016/s0006-291x(02)03059-0
Makino I, Makino Y, Yoshihara F, Nishikimi T, Kawarabayashi T, Kangawa K, et al. Decreased mature adrenomedullin levels in feto-maternal tissues of pregnant women with histologic chorioamnionitis. Biochem Biophys Res Commun. 2003;301(2):437-442. doi:10.1016/s0006-291x(02)03059-0
Makino, Ikuko, et al. "Decreased mature adrenomedullin levels in feto-maternal tissues of pregnant women with histologic chorioamnionitis." Biochemical and biophysical research communications, vol. 301, no. 2, 2003, pp. 437-442.
