Total and ionized serum magnesium and calcium levels during magnesium sulfate administration for preterm labor

OBJECTIVE: This study aimed to estimate the association between total and ionized magnesium, and the changes in serum magnesium and calcium levels in patients with preterm labor during magnesium sulfate (MgSO4) administration. METHODS: The study population included 64 women who were candidates for intravenous MgSO4 treatment for preterm labor. Serial blood samples were taken and measured total magnesium (T-Mg), ionized magnesium (I-Mg), total calcium (T-Ca), and ionized calcium (I-Ca) levels every one-week interval (1st, 2nd, 3rd). RESULTS: There was no significant difference in T-Mg and I-Mg levels during MgSO4 administration (P>0.05). There was no significant difference in T-Ca and I-Ca levels during MgSO4 administration (P>0.05). Compared before and after administration of MgSO4, T-Mg and I-Mg levels and T-Ca levels were changed allow statistically significant (P 0.05). There was significant correlation between levels of I-Mg and T-Mg (I-Mg=0.395×T-Mg+0.144, P < 0.01). CONCLUSION: There were no significant differences in serum Mg and Ca levels during MgSO4 administration for preterm labor. Compared to the before and after administration of MgSO4, only I-Ca levels were not substantially changed. There are significant correlations between I-Mg and T-Mg levels during administration of MgSO4 and I-Mg level seemed to have more correlation with adverse effect than T-Mg.

Impact of random urine proteinuria on maternal and fetal outcomes of pregnancy: a retrospective case-control study

BACKGROUND/AIMS: Proteinuria is associated with hypertension and preeclampsia in pregnancy. However, the impact of random urine proteinuria on fetal and maternal outcomes has not been established. We investigated the influence of random urine proteinuria on the clinical outcomes of pregnancy. METHODS: From January 2008 to December 2010, 2,822 patients were retrospectively studied. A total of 536 pregnant women with proteinuria in random urine and matched controls without proteinuria via propensity score matching were analyzed. Proteinuria was checked by the dipstick method. RESULTS: The patients’ mean age was 33.0 ± 4.7 years, and the mean gestational age was 235.6 ± 50.6 days on admission. The prevalence of hypertension and chronic kidney disease was 2.4% (n = 67) and 1.0% (n = 29), respectively. Women with random urine proteinuria showed higher blood urea nitrogen levels and a higher incidence of hematuria. These women also had a higher incidence of preeclampsia, preterm labor, premature rupture of membranes, and intrauterine growth restriction. Proteinuria was strongly correlated with preeclampsia in both propensity score matching (p < 0.001, r = 0.783) and unmatched whole samples (p < 0.001, r = 0.851). CONCLUSIONS: These findings suggest that random urine proteinuria is associated with preeclampsia, preterm labor, premature rupture of membrane, and intrauterine growth restriction.

Successful pregnancy and delivery of a patient with congenital adrenal hyperplasia

Congenital adrenal hyperplasia (CAH) during pregnancy is a rare condition. Only a few cases have been reported in the literature. CAH patients has lower pregnancy rate compared to normal women. A 27-year-old nulliparous woman, a diagnosed case of 21-hydroxylase deficient simple virilising form of classic CAH visited. She got pregnant spontaneously without any trial of assisted reproductive technology. At the age of 12, she underwent clitoral resection and vaginoplasty. She took dexamethasone or prednisolone after operation. She delivered healthy singleton female baby by cesarean section. Four years later, she delivered healthy singleton female baby by repeat cesarean section. Two female babies have shown normal external genitalia. Here, we report a case of successful pregnancy and delivery in a patient with CAH.

Measures to address obstetrically underserved areas: limitations and future directions

Since 2015, the Support Project for Obstetrically Underserved Areas has been operating a total of 31 obstetric clinics, including 12 delivery clinics, 14 outpatient clinics, and 31 mobile clinics. However, the effectiveness of the project is being questioned due to the low birth rate in some of the hospitals that received delivery clinics through the project. Despite the support project, the number of obstetrically underserved areas is increasing as clinics ceasing their business or at least give up maternal care. This has led to the need for a discussion regarding the limits of obstetrics clinics in underserved areas that are operated by the support project itself and the direction of future improvements. The increasing number of obstetrically underserved areas that lack delivery clinics within a one-hour drive range can have grave consequences, which are not limited to maternal medical systems alone, but also towards the general deterioration of the community. Thus, it has been determined that existing problems should be addressed and the project should continue operating with the Support Project for Obstetrically Underserved Areas Act as the foundation and minimal measures for strengthening the social security system, which is essential. Additionally, aggressive policymaking by the government is thought to be needed for the sake of expanding the extremely weakened obstetric infrastructure.

Practice patterns in the management of threatened preterm labor in Korea: A multicenter retrospective study

OBJECTIVE: This study aimed to examine clinical practice patterns in the management of pregnant women admitted with threatened preterm labor (TPL) in Korea. METHODS: Data from women admitted with a diagnosis of TPL were collected from 22 hospitals. TPL was defined as regular uterine contractions with or without other symptoms such as pelvic pressure, backache, increased vaginal discharge, menstrual-like cramps, bleeding/show and cervical changes. Data on general patient information, clinical characteristics at admission, use of tocolytics, antibiotics, and corticosteroids, and pregnancy outcomes were collected using an online data collections system. RESULTS: A total of 947 women with TPL were enrolled. First-line tocolysis was administered to 822 (86.8%) patients. As a first-line tocolysis, beta-agonists were used most frequently (510/822, 62.0%), followed by magnesium sulfate (183/822, 22.3%), calcium channel blockers (91/822, 11.1%), and atosiban (38/822, 4.6%). Of the 822 women with first-line tocolysis, second-line tocolysis were required in 364 (44.3%). Of 364 with second-line, 199 had third-line tocolysis (37.4%). Antibiotics were administered to 29.9% of patients (284/947) with single (215, 22.7%), dual (26, 2.7%), and triple combinations (43, 4.5%). Corticosteroids were administered to 420 (44.4%) patients. Betamethasone was administered to 298 patients (71.0%), and dexamethasone was administered to 122 patients (29.0%). CONCLUSION: Practice patterns in the management of TPL in Korea were quite various. It is needed to develop standardized practice guidelines for TPL management.

Oxidative Stress Markers in the Venous Plasma of Women with Preterm Labor and Preterm Premature Rupture of Membranes / 대한주산의학회잡지

PURPOSE: This study was performed to investigate the oxidation and antioxidation capacity in the maternal venous plasma of preterm labor with intact membranes, and premature rupture of membranes (PPROM), and also to evaluate their roles in the pathophysiology of PPROM. METHODS: Seventy five women in the following categories had venous blood retrieved: (1) Group A, normal pregnancy (n=24). (2) Group B, preterm labor with intact membranes (n=25). (3) Group C, preterm premature rupture of membranes (n=26). Malondialdehyde (MDA) levels as a marker of lipid peroxidation by thiobarbituric acid reaction, protein carbonyl content by 2,4-dinitrophenylhydrazine reaction, and total antioxidant capacity by oxygen radical absorbance capacity assay (ORAC) were measured. Mann-Whitney U test, Kruskal-Wallis test were used for statistical analysis. RESULTS: Lipid peroxide levels in the venous plasma of group B and C were significantly higher than those of group A (group B: 4.59+/-0.30, group C: 5.40+/-0.22 vs. group A: 3.90+/-0.26 nmol/mg protein, P<0.05). Lipid peroxide levels in the venous plasma of group C were significantly higher than those of group B (P<0.05). Protein carbonyl levels in the venous plasma of group C were significantly higher than those of group A (group C: 5.68+/-0.42 vs. group A: 5.43+/-0.41 nmol/mg protein, P<0.05). There was no significant difference of protein carbonyl levels in the venous plasma between group A and B. ORAC levels in the venous plasma of group B and C were significantly lower than those of group A (group B: 117.90+/-0.48, group C: 111.68+/-1.23 vs. group A: 119.14+/-1.12 mM/mL, P<0.05). ORAC levels in the venous plasma of group C were significantly lower than those of group B (P<0.05). CONCLUSION: In the blood of the women with preterm premature rupture of membranes, the lipid peroxidation was increased and the antioxidant capacity was decreased compared to women with normal pregnancy and preterm labor with intact membranes. These results suggest that oxidative stress was increased in preterm premature rupture of membranes.

Incidentally detected ganglioneuroma during pregnancy: A case report

Retroperitoneal ganglioneuroma is a rare benign tumor, which is included in the neuroblastomas group. It can occur anywhere along the peripheral autonomic ganglion sites, and the tumor is often incidentally detected in asymptomatic patients or may produce symptoms related to the slow growing tumor. Surgical excision is the treatment of choice and the prognosis is good. We report a case of retroperitoneal ganglioneuroma, which was incidentally detected in the first trimester of pregnancy in a 29-year-old woman. Surgical resection of the ganglioneuroma was done at the time of cesarean section at full term without complications.

Comparison of oxidative stress markers in umbilical cord blood after vaginal and cesarean delivery

OBJECTIVE: The purpose of our study was to investigate the effect of the mode of delivery on the oxidant and antioxidant system in umbilical cord blood. METHODS: We performed gas analysis of umbilical venous blood and umbilical arterial blood immediately after delivery in 38 women; eighteen women had a vaginal delivery while 20 women delivered via cesarean section at over 37 weeks gestation. We examined lipid peroxide concentration by thiobarbituric acid reaction, protein carbonyl content by 2,4-dinitrophenylhydrazine reaction, and total antioxidant capacity by oxygen radical absorbance capacity assay. RESULTS: Lipid peroxide levels in umbilical venous blood were significantly higher in patients delivering by planned cesarean section (1.81 +/- 0.06 nmol/mg protein) than those with vaginal delivery (1.24 +/- 0.05 nmol/mg protein) (P < 0.05). Antioxidant capacity in umbilical venous blood was significantly higher in patients delivering by planned cesarean section (119.70 +/- 0.13 microM/microL) than those with a vaginal delivery (118.70 +/- 0.29 microM/microL) (P < 0.05). There was no significant difference in the carbonyl content of umbilical venous blood or in the lipid peroxide, carbonyl content, and total antioxidant capacity of umbilical arterial blood. CONCLUSION: Lipid peroxidation levels and antioxidant capacity in umbilical venous blood were higher in patients delivering by planned cesarean section than those with a vaginal delivery. Therefore, we propose that both the mother and neonate are exposed to higher oxidative stress during cesarean section delivery.

Significance of Gray-Level Histogram of the Uterine Cervix as a Predictor of Preterm Birth in Pregnant Women with Preterm Labor / 대한주산의학회잡지

PURPOSE: The aim of this study was to determine the value of a gray-level histogram of the cervix as a predictor of preterm birth in women who admitted for preterm labor. METHODS: Ninety-seven women who admitted Chonnam national university for preterm labor were enrolled in this prospective study. A transvaginal ultrasonography for measurement of cervical length (CL), gray-scale histogram and cervical volume was performed when patients were admitted. Anterior and posterior cervical walls and AP (anterior and posterior) difference in MGL (mean gray level between anterior and posterior) were checked. And we analyzed the relationship between the value and preterm birth. RESULTS: The overall rate of preterm birth before 37 weeks was 53.6% and after 37 weeks was 46.4%, respectively. Logistic regression analysis demonstrated that not only cervix length (P=0.003; odds ratio [OR], 0.189; 95% confidence interval [CI], 0.064-0.560) but also anterior histogram (P=0.028; OR, 0.319; 95% CI, 0.115-0.884) was independent predictor of preterm birth before 37 weeks. The receiver operator characteristics (ROC) curves were analyzed for the anterior histogram, a value of 85.9 was the best cut-off value to determine the preterm birth. The areas under the ROC curve indicate that the variable provides a prognostic value for the prediction for preterm birth. To predict a preterm birth, anterior histogram had 78.8% sensitivity and 46.7% specificity. CONCLUSION: Gray-level histogram of the uterine cervix may predict the preterm birth in pregnant women with preterm labor.

Complications Following Outside-in and Inside-out Transobturator-Tape Procedures with Concomitant Gynecologic Operations / 전남의대학술지

This study was undertaken to compare the complications of outside-in transobturator tape procedures (TOT) and inside-out transobturator tape procedures (TVT-O) with concomitant gynecologic surgery for the treatment of female stress urinary incontinence (SUI). A retrospective review of 206 consecutive patients who underwent either TOT or TVT-O with concomitant gynecologic operations between March 2008 and February 2011 was conducted. The incidence of perioperative complications was compared. For statistical analysis, chi-squared tests were used. There were no reports of intraoperative complications such as vaginal injury or bladder perforation. Postoperative complications were noted in 23 procedures (11.2%). These included 6 cases of urinary retention (2.9%), 2 cases of vulva hematoma (1.0%), 7 cases of urinary tract infection (3.4%), 4 cases of de novo urgency (2.9%), and 4 cases of vaginal erosion (2.9%). There were no significant differences in complication rates between the two groups. Our results suggest that inside-out and outside-in procedures are simple and safe techniques that may have a low rate of complications when used with a concomitant gynecologic operation.

Complications Following Outside-in and Inside-out Transobturator-Tape Procedures with Concomitant Gynecologic Operations / 전남의대학술지

This study was undertaken to compare the complications of outside-in transobturator tape procedures (TOT) and inside-out transobturator tape procedures (TVT-O) with concomitant gynecologic surgery for the treatment of female stress urinary incontinence (SUI). A retrospective review of 206 consecutive patients who underwent either TOT or TVT-O with concomitant gynecologic operations between March 2008 and February 2011 was conducted. The incidence of perioperative complications was compared. For statistical analysis, chi-squared tests were used. There were no reports of intraoperative complications such as vaginal injury or bladder perforation. Postoperative complications were noted in 23 procedures (11.2%). These included 6 cases of urinary retention (2.9%), 2 cases of vulva hematoma (1.0%), 7 cases of urinary tract infection (3.4%), 4 cases of de novo urgency (2.9%), and 4 cases of vaginal erosion (2.9%). There were no significant differences in complication rates between the two groups. Our results suggest that inside-out and outside-in procedures are simple and safe techniques that may have a low rate of complications when used with a concomitant gynecologic operation.

A Study of Maternal and Perinatal Risk Factors on Intrauterine Fetal Death / 대한주산의학회잡지

PURPOSE: The purpose of this study was to identify the risk factors for intrauterine fetal death (IUFD). METHODS: We carried out a case control retrospective study, at the Chonnam National University Hospital, Korea. We included all pregnant women diagnosed as singleton IUFD in pregnancies of 28 weeks of gestation or more, admitted to the hospital from Jan 2003 to Dec 2007. There were 53 cases of singleton IUFD and 3,298 cases of singleton live birth during that period. The incidence, age distribution, and prevalent gestational weeks were analysed. The risk factors were analyzed by using odds ratio, student's t test, and Chisquare test. Logistic regression analysis was applied to determine independent risk factors. RESULTS: The overall incidence of IUFD was 1.6%. The age distribution of mother with IUFD was highest in the age group of 20 year old or less (5.3%). IUFD was the most prevalent at 28-32 weeks of gestation (41.5%). Significant risk factors were maternal body weight just before delivery, weight gain during pregnancy, and abruptio placentae. The independent risk factors were weight gain during pregnancy (beta=0.002, P=0.000) and abruptio placentae (beta=-0.067, P=0.000). CONCLUSION: Lower maternal body weight just before delivery, lower weight gain during pregnancy, and abruptio placentae are factors significantly associated with IUFD. Further investigations are needed to understand the complex etiology of stillbirth.

Evaluation of length, volume and gray-scale histogram of the cervix as predictors of successful induction / 대한산부인과학회지

OBJECTIVE: The aim of this study was to evaluate whether the Bishop score, length, volume and gray-scale histogram of the cervix has a predictive value of assessing the rate of success in trial of induction. METHODS: Forty-one nulliparous patients with its Bishop score six or less were enrolled for this prospective study. All were on prostaglandin E2 (PGE2, Propess(R); Controlled Therapeutics Ltd) pessary. Three-dimensional transvaginal ultrasound scans of the cervix were performed on the ACCUVIX XQ (Medison) to measure length, volume, and gray-scale histogram. Bishop score was determined by digital examination. The successful induction was defined as the ability to achieve the active phase of labor corresponding to a cervical dilatation of > or =4 cm within 12 hours of removing the PGE2 pessary. The receiver operating characteristics (ROC) curves were also used to estimate an optimal cutoff point for the Bishop score, length, volume, and gray-scale histogram of the cervix. Logistic regression analysis was used for statistical analyses. RESULTS: The overall successful rate of labor induction was 73.2% (30/41). Multiple logistic regression analyses demonstrated that the value of anterior lip histogram was significantly associated with the successful labor induction. ROC curve for anterior lip histogram value in predicting success of induction indicated a significant relationship with successful induction. The best cutoff value was 69.4. CONCLUSION: The value of anterior lip histogram associates significantly with the prediction of successful induction in nulliparous women. But, Bishop score and other sonographic measurement of cervical length, volume, and posterior lip histogram have no predictive values for successful induction.

Changes of antioxidant levels in the uterine venous plasma amniotic fluid, and chorioamnion after maternal supplementation with vitamin C and vitamin E / 대한주산의학회잡지

PURPOSE:To investigate the change in the antioxidant vitamin levels in maternal uterine venous plasma (MUVP), amniotic fluid (AF), and chorioamnion after vitamin C and E supplementation during pregnancy. METHODS:Thirty pregnant women who were scheduled for elective cesarean section between 37 and 39 gestational weeks were randomized in this study. Fifteen women were given a daily oral dose of vitamin C 1,000 mg and vitamin E 400 IU from 33~34 gestational weeks to delivery. The other fifteen women were not given, as a control group. Maternal uterine venous blood, AF, and chorioamnion were obtained after cesarean section. Lipid peroxides and oxygen-radical absorbance capacity value were measured by thiobarbituric acid reaction and Cao's method respectively. Ascorbic acid, uric acid, beta-carotene, retinol, alpha-tocopherol, and gamma-tocopherol were measured by high performance liquid chromatography. The tissue sections of chorioamnion were stained with hematoxylin-eosin and Masson-trichrome stain, and immunohistochemical stain for collagen type IV was also performed. RESULTS:The lipid peroxide levels in MUVP of the study group were significantly lower than those of the control group but in contrast, ORAC (Oxygen-radical absorbance capacity) values were lower in the control group. The alpha-tocopherol levels in MUVP, AF, and chorioamnion study group were significantly higher than those of the control group. Amniotic membrane and subepithelial stromal tissue in the study group were thicker than those in the control group. And subchorionic type IV collagen of placenta tissue in the study group was more stained than that of the control group. CONCLUSION:Maternal vitamin C and E supplementation may be beneficial in the prevention of diseases caused by oxidative stress such as preeclampsia and PROM and in increasing fibrin and type IV collagen in chorioamnion.

Effect of vitamin C and E on the lipid peroxide, antioxidant ability, and antioxidant vitamin levels in maternal and umbilical venous plasma / 대한산부인과학회지

OBJECTIVE: This controlled trial investigated the effect of supplementation with vitamins C and E on the lipid peroxide, antioxidant ability, and antioxidant vitamin levels in full term maternal and umbilical venous plasma. METHODS: Forty pregnant women were randomized in this study. They were nulliparous or multiparous women with history of preeclampsia or preterm premature rupture of membranes (PPROM). Twenty women were given vitamin C (1,000 mg/day) and vitamin E (400 IU/day) from 15~20 gestational weeks to delivery. The others were not given, as a control group. Maternal venous blood was obtained before vitamin supplementation and just before delivery. Umbilical venous blood was obtained after delivery. Lipid peroxide level and oxygen-radical absorbance capacity (ORAC) were measured by thiobarbituric acid reaction and Cao's method, respectively. Ascorbic acid, uric acid, beta-carotene, retinol, alpha-tocopherol, and gamma-tocopherol were measured by high performance liquid chromatography. Results: Supplementation with vitamins C and E was associated with decrease in lipid peroxide levels and increase in ORAC values and alpha-tocopherol levels in maternal venous plasma. And it was also associated with decrease in lipid peroxide levels and increase in ORAC values and alpha-tocopherol levels in umbilical venous plasma. CONCLUSION: Supplementation with vitamins C and E may be beneficial in the prevention of oxidant-antioxidant imbalance origin diseases such as preeclampsia, PPROM. And it also may affect antioxidant ability of the fetus.

Successful full-term delivery after abdominal radical trachelectomy and concurrent cervicoisthmic cerclage for early stage cervical cancer: Two cases / 대한산부인과학회지

Since the screening tool was introduced, the incidence and mortality of cervical carcinoma has decreased. However, the incidence of early stage cervical cancer is increasing in young women who want to preserve their fertility. The risk of preterm delivery after trachelectomy is high and remains problematic. Herein we report two patients who had successful full-term delivery after abdominal radical trachelectomy and concurrent cervicoisthmic cerclage for early stage cervical cancer.

A case of ureterouterine fistula as a complication of cesarean section / 대한산부인과학회지

Ureteral injury is usually iatrogenic in origin, in particular as a result of laparoscopic or gynecological surgery. Ureterouterine fistula constitute a rare subset of iatrogenic genitourinary fistulas. The most common presentation of ureterouterine fistula is in women who have had a cesarean section. The management options include conservative therapy (spontaneous healing), endourologic (stented repair) or open surgical operation (ureteroneocystostomy or ureteroureterostomy). Herein, we report on a case of ureterouterine fistula in a 33-year-old woman who underwent a cesarean section. The 17th day after the operation, she complained watery vaginal discharge. Clinical and urographic assessments revealed an iatrogenic ureterouterine fistula and an ureteroneocystostomy was performed after 3 months.

Morning Sickness of Pregnancy / 대한주산의학회잡지

Morning sickness is a common condition in early pregnancy, and it affects the health of both the pregnant woman and fetus. It can decrease the woman's quality of life and also contribute significantly to health care costs and time off work. In most women the condition is mild and self limiting, but a small percentage of women experience severe form being hyperemesis gravidarum. Once symptoms progress, treatment can become more difficult. So, the treatment in the early stages is important to prevent more serious complications, including hospitalization. Once pathologic causes have been ruled out, treatment is individualized. Initial treatment should be conservative and should involve dietary and lifestyle changes. But, severe or prolonged cases may need hospitalization and pharmacologic therapy.

Lipid peroxidation and total antioxidant ability in venous plasma and amniotic fluid of pregnant women with preterm premature rupture of membranes / 대한산부인과학회지

OBJECTIVE: To evaluate their roles in the pathophysiology of preterm premature rupture of membranes (PPROM), we checked interleukin (IL)-6, lipid peroxide, oxygen-radical absorbance capacity (ORAC) and antioxidant vitamin in the venous plasma and amniotic fluid of women with PPROM. METHODS: Venous plasma and amniotic fluid was taken from 20 normal pregnant women and 20 PPROM pregnancy women. IL-6 levels was determined by enzyme-linked immunosorbent assay. Lipid peroxide levels were measured by thiobarbituric acid reaction. The ORAC levels and the antioxidant levels were measured by Cao's method and by high performance liquid chromatography. RESULTS: The IL-6 levels in the venous plasma and amniotic fluid of PPROM pregnancy women were significantly higher than normal pregancy (P<0.01, P<0.01). The lipid peroxide levels in the venous plasma and amniotic fluid of PPROM pregnancy women were significantly higher than normal pregancy (P<0.01, P<0.01). The ORAC values in the venous plasma and amniotic fluid of PPROM pregnancy women were significantly higher than normal pregancy (P<0.01, P<0.01). The ORAC values/lipid peroxide levels in the venous plasma and amniotic fluid of PPROM pregnancy women were significantly higher than normal pregancy (P<0.01, P<0.01). The ascorbic acid levels in the venous plasma and amniotic fluid of PPROM pregnancy women were significantly higher than normal pregancy (P<0.05, P<0.01). CONCLUSION: This result suggest that the increased inflammatory bioactivity, increased lipid peroxidation and decreased antioxidant activity may be involved in the pathophysiology of PPROM. Low levels of ascorbic acid appears to be an important determinant of PPROM.

Changes of lipid peroxide levels and prooxidative activity stimulating the protein carbonyl formation in the amniotic fluid of women with preterm premature rupture of membranes / 대한산부인과학회지

OBJECTIVE: To investigate the lipid peroxide levels and protein carbonyls levels in the amniotic fluid of pregnant women with preterm premature rupture of membranes (PPROM). METHODS: The lipid peroxide levels in the amniotic fluid of normal pregnancy (n=20) and pregnant women with PPROM (n=20) were measured by thiobarbituric acid reaction. The protein carbonyl contents in the amniotic fluid of normal pregnancy (n=20) and pregnant women with PPROM (n=20) were determined by the 2,4-dinitrophenylhydrazine method. After amniotic fluid of them were mixed and incubated up to 5 hours with 0.2 mL of 1mM moxalactam, cefodizime, amoxacillin, erythromycin, the lipid peroxide levels and protein carbonyl contents in them were measured. RESULTS: 1. The lipid peroxide levels in the amniotic fluid of pregnant women with PPROM was significantly higher than that of normal pregnancy (9.74+/-0.48 vs. 7.20+/-0.38 nmol/mg protein, P<0.01). 2. The protein carbonyl levels in the amniotic fluid of pregnant women with PPROM was significantly higher than that of normal pregnancy (13.0+/-0.33 vs. 11.27+/-0.17 nmol/mg protein P<0.01). 3. The lipid peroxide levels and protein carbonyls formation by moxalactam in the amniotic fluid of pregnant women with PPROM was significantly higher than basal level (12.08+/-0.81 vs. 9.74+/-0.48 nmol/mg protein, 20.08+/-0.66 vs. 13.0+/-0.33 nmol/mg protein, P<0.01). 4. The lipid peroxide levels and protein carbonyls formation by cefodizime in the amniotic fluid of pregnant women with PPROM was significantly lower than basal level (5.04+/-0.33 vs. 9.74+/-0.48 nmol/mg protein, 9.76+/-0.35 vs. 13.0+/-0.33 nmol/mg protein, P<0.01). 5. There were no significant differences in the levels of lipid peroxide and protein carbonyls by amoxacillin and erythromycin in the amniotic fluid of pregnant women with PPROM between antibiotics-induced and basal levels. CONCLUSION: The lipid peroxidation and the protein carbonyls formation were increased in the amniotic fluid of pregnant women with PPROM. Antibiotics-induced lipid peroxide and protein carbonyl levels were changed in the amniotic fluid of pregnant women with PPROM. Further studies on our results may be beneficial in the selection of antibiotics for pregnant women with PPROM.