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1.
Eur J Obstet Gynecol Reprod Biol ; 297: 65-71, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38581887

RESUMO

OBJECTIVE: We aimed to determine whether the semi-quantitative metalloproteinase-8 (MMP-8) bedside test is a worthwhile indicator in reflecting the severity of of intra-amniotic inflammation (IAI) and in predicting adverse pregnancy outcomes. STUDY DESIGN: This retrospective cohort study comprised 76 singleton-pregnant women admitted to the Seoul National University Bundang Hospital with a diagnosis of preterm premature rupture of membranes (preterm PROM) between 20 weeks 0 days and 33 weeks 6 days of gestation who underwent trans-abdominal amniocentesis to confirm intra-amniotic infection by positive results for aerobic/anaerobic bacteria, fungi, and genital mycoplasma and evaluate lung maturity. The semi-quantitative MMP-8 rapid test kit employs a colourimetric assay to quantify MMP-8 levels in amniotic fluid (AF), expressing results from 0 to 100 percent. Participants were divided into three groups: group 1, including negative MMP-8 test with colour scale of 0 % (negative, n = 17); group 2, including positive MMP-8 test with colour scale < 51 % (weak positive, n = 21); and group 3, including positive MMP-8 test with colour scale of 51 %-100 % (strong positive, n = 38). RESULTS: Approximately 78 % (59/76) of the participants showed a positive MMP-8 test result; all culture-proven AF samples (33.3 % [25/75]) yielded positive MMP-8 test, categorizing these patients into either group 2 or group 3. A significant trend was observed where the rate of positive culture-proven samples increased with the progression from group 1 (negative) to group 3 (strong positive). Both white blood cell counts in AF and maternal serum C-reactive protein levels were found to escalate with the progression of test results from negative to strong positive. This progression was associated with an increased risk of spontaneous preterm birth within 48 h, 7 days, and 14 days from amniocentesis and within 34 weeks of gestation. CONCLUSION: The more the test results progress from negative to strong positive, the shorter the interval from amniocentesis to delivery becomes, and the higher the risk of intra-amniotic infection, spontaneous preterm delivery, and other perinatal complications. This relationship highlights the critical value of the semi-quantitative MMP-8 rapid test in predicting adverse pregnancy outcomes in patients with preterm PROM.


Assuntos
Líquido Amniótico , Ruptura Prematura de Membranas Fetais , Metaloproteinase 8 da Matriz , Humanos , Feminino , Gravidez , Ruptura Prematura de Membranas Fetais/diagnóstico , Metaloproteinase 8 da Matriz/análise , Metaloproteinase 8 da Matriz/metabolismo , Estudos Retrospectivos , Adulto , Líquido Amniótico/microbiologia , Resultado da Gravidez , Corioamnionite/diagnóstico , Amniocentese , Valor Preditivo dos Testes , Biomarcadores/análise , Nascimento Prematuro/diagnóstico
2.
Taiwan J Obstet Gynecol ; 61(3): 441-446, 2022 May.
Artigo em Inglês | MEDLINE | ID: mdl-35595435

RESUMO

OBJECTIVE: To evaluate the effects of pre-pregnancy maternal body mass index (BMI) to pregnancy outcomes in patients diagnosed as preeclampsia. MATERIALS AND METHODS: This was a retrospectively study on women who had been diagnosed as preeclampsia and delivered at Seoul National University Bundang Hospital between June 2017 and March 2020. Multifetal gestation, major fetal anomaly, and fetal death in utero were excluded. A total of 150 singleton pregnancies were included and divided into four groups according to the pre-pregnancy BMI classification: underweight (<18.5 kg/m2, n = 6), normal (18.5-22.9 kg/m2, n = 66), overweight (23.0-24.9 kg/m2, n = 26), and obese (≥25.0 kg/m2, n = 52). Pregnancy outcomes including gestational age at delivery, birthweight, and delivery modes were reviewed. RESULTS: The rates of preterm birth before 34 weeks of gestation were 67%, 49%, 35%, and 27% for underweight group, normal BMI group, overweight group, and obese group, respectively (p-trend = 0.006). The birthweight of newborn increased significantly as pre-pregnancy BMI increased (p-trend<0.001). The proportions of small for gestational age (SGA) were highest in underweight group and decreased as pre-pregnancy BMI increased (67%, 41%, 42%, and 10% for each group, respectively, p-trend<0.001). CONCLUSION: The rates of preterm birth before 34 weeks and SGA increased as pre-pregnancy BMI decreased in patients with preeclampsia. IMPLICATIONS FOR PRACTICE: Women with underweight before pregnancy are at the highest risk for preterm birth and SGA, therefore they need to be monitored more intensively when diagnosed as preeclampsia.


Assuntos
Pré-Eclâmpsia , Nascimento Prematuro , Peso ao Nascer , Índice de Massa Corporal , Feminino , Retardo do Crescimento Fetal , Humanos , Recém-Nascido , Obesidade/complicações , Sobrepeso/complicações , Pré-Eclâmpsia/epidemiologia , Gravidez , Resultado da Gravidez , Nascimento Prematuro/epidemiologia , Nascimento Prematuro/etiologia , Estudos Retrospectivos , Fatores de Risco , Magreza/complicações
3.
J Cosmet Dermatol ; 21(4): 1471-1476, 2022 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-34008912

RESUMO

BACKGROUND: Recently, pulsed dye laser (PDL) combined with triamcinolone intralesional injection (TAILI) has been introduced for surgical scar prevention. However, little is known about this procedure's effectiveness in preventing hypertrophic scar following surgical scar removal. OBJECTIVES: This study aimed to evaluate the outcome of early intervention using PDL combined with TAILI after surgical removal of hypertrophic cesarean section (CS) scars. METHODS: The medical records of 35 patients who underwent early intervention using PDL and TAILI after removal of hypertrophic CS scars were retrospectively reviewed. The scars' average Vancouver Scar Scale (VSS) scores before scar removal and 3 months after the final treatment were compared. RESULTS: The patients received 4.23 treatments on average and were followed up for a mean period of 7.74 months. The mean final VSS was 3.11 ± 1.52 and was significantly lower than that of the previous VSS (9.29 ± 1.74, p = 0.000). VSS of the previous CS scar, and the presence or absence of keloid formation in other areas, was associated with treatment outcome (p = 0.003 and 0.008, respectively). CONCLUSIONS: Early intervention using PDL combined with TAILI could prevent the recurrence or progression of hypertrophic CS scarring after surgical scar removal.


Assuntos
Cicatriz Hipertrófica , Queloide , Lasers de Corante , Terapia com Luz de Baixa Intensidade , Cesárea/efeitos adversos , Cicatriz Hipertrófica/etiologia , Cicatriz Hipertrófica/prevenção & controle , Feminino , Humanos , Injeções Intralesionais , Queloide/etiologia , Queloide/patologia , Queloide/terapia , Lasers de Corante/efeitos adversos , Gravidez , Estudos Retrospectivos , Resultado do Tratamento , Triancinolona
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