Summary
Concentration of amniotic fluid disaturated phosphatidylcholine (DSPC), factors related to cervical ripening, and histopathological evidence of chorioamnionitis were studied in 38 patients in preterm labour with intact membranes; all of them delivered spontaneously before 37 weeks. There was no correlation between the amniotic fluid DSPC level and gestational age at the time of amniocentesis. However, a significant inverse correlation was found between the amniotic fluid DSPC level and the interval between the onset of labour and delivery. The amniotic fluid DSPC level in cases with onset-delivery interval of <48h was significantly higher than that in cases with an onsetdelivery interval of 48h or more. The gestational age in the former group was significantly lower than in the latter (28.6 vs 32.0 weeks). The amniotic fluid DSPC level in the patients with chorioamnionitis was significantly higher than that in the patients without chorioamnionitis, although the gestational age did not differ between the two groups. All 3 infants with RDS were associated with cervical incompetence. Patients in preterm labour with chorioamnionitis may be refractory to tocolysis and have higher amniotic fluid surfactant levels.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Baumgarten K, Gruber W (1974) Tokolyseindex. In: Dudenhausen JW, Saling E (ed) Perinatale Medizin, Vol. 5. Thieme, Stuttgart, p 58
Benirschke K, Driscoll G (1967) The pathology of the human placenta. In: Lubarsch O, Henke F (ed) Handbuch der speziellen pathologischen Anatomie und Histologie, Bd. 7, Teil 5. Placenta. Springer, Berlin Heidelberg New York, p 98
Bishop EH (1964) Pelvic scoring for elective induction. Obstet Gynecol 24:266–268
Bejar R, Curbelo V, Davis C, Gluck L (1981) Premature labor II. Bacterial sources of phospholipase. Obstet Gynecol 57:479–482
Bennett PR, Rose MP, Myatt L, Elder MG (1987) Preterm labor: Stimulation of arachidonic acid metabolism in human amnion cell by bacterial products. Am J Obstet Gynecol 156:649–655
Blanc WA (1981) Pathology of the placenta, membranes, and umbilical cord in bacterial, fungal, and viral infections in man. In: Naeye RL, Kissane JM, Kaufman N (ed) International Academy of Pathology monographs, No. 22, Perinatal Diseases. Williams and Wilkins, Baltimore London, p 67
Bobitt JR, Hayslip CC, Damato JD (1981) Amniotic fluid infection as determined by transabdominal amniocentesis in patients with intact membranes in premature labor. Am J Obstet Gynecol 140:947–952
Gravett MG, Hummel D, Eschenbach DA, Holmes KK (1986) Preterm labor associated with subclinical amniotic fluid infection and with bacterial vaginosis. Obstet Gynecol 67:229–237
Hameed C, Tejani N, Verma UL, Archbald F (1984) Silent chorioamnionitis as a cause of preterm labor refractory to tocolytic therapy. Am J Obstet Gynecol 149:726–730
Higuchi M, Hirano H, Maki M (1980) Surfactant lipoprotein concentration in amniotic fluid of abnormal pregnancies and premature deliveries. Acta Obst Gynaec Jpn 32:1767–1774
Higuchi M, Hirano H, Maki M (1982) Effect of terbutaline on lung surfactant components in lung washings and amniotic fluid in pregnant rabbits. Asia-Oceania J Obstet Gynaecol 4:391–397
Higuchi M, Hirano H, Gotoh K, Otomo K, Maki M, Ikenoue T, Murakami N, Matumoto T (1988) The differences of disaturated phosphatidylcholine concentration in amniotic fluid and the comparison of its predictive accuracy for assessing fetal lung maturation in normal, abnormal and complicated pregnancies. J Jpn Soc Biol Interface 19:42–51
Higuchi M, Hirano H, Gotoh K, Otomo K, Maki M (1990) Comparison of amniotic fluid disaturated phosphatidylcholine, phosphatidylglycerol and lecithin/sphingomyelin ratio in predicting the risk of developing neonatal respiratory distress syndrome. Gynecol Obstet Invest 29:92–96
Kitterman JA, Liggins GC, Clements JA, Campos G, Lee CH, Ballard PL (1981) Inhibitors of prostaglandin synthesis, tracheal fluid, and surfactant in fetal lambs. J Appl Physiol 51:1562–1567
Lawson EE, Brown ER, Torday JS, Madansky DL, Taeusch HW (1978) The effect of epinephrine on tracheal fluid flow and surfactant efflux in fetal sheep. Am Rew Res Dis 118:1023–1026
Liggins GC (1968) Premature parturition after infusion of corticotrophin or cortisol into foetal lambs. J Endocr 42:323–329
Liggins GC, Howie RN (1972) A controlled trial of antepartum glucocorticoid treatment for prevention of the respiratory distress syndrome in premature infants. Pediatr 50:515–525
MacDonald PC, Porter JC, Shwarz BE, Johnston JM (1978) Initiation of labor in the human female. Sem Perinatol 2:273–286
Marino PA, Rooney SA (1980) Surfactant secretion in a newborn rabbit lung slice model. Biochim Biophys Acta 620:509–519
Miller JM, Pupkin MJ, Hill GB (1980) Bacterial colonization of amniotic fluid from intact fetal membranes. Am J Obstet Gynecol 136:796–804
Minkoff H (1983) Prematurity: infection as an etiologic factor. Obstet Gynecol 62:137–144
Naeye RL, Blanc WA (1970) Relation of poverty and race to antenatal infection. N Engl J Med 283:555–560
Nakayama M, Shimizu I (1988) Diagnosis of chorioamnionitis. Obstet Gynecol Therapy, Nagaishoten (Japan) 56:410–413
Okazaki T, Sagawa N, Okita JR, Bleasdale JE, MacDonald PC, Johnston JM (1981) Diacylglycerol metabolism and arachidonic acid release in human fetal membranes and decidua vera. J Biol Chem 256:7316–7321
Wahbeh CJ, Hill GB, Eden RD, Gall SA (1984) Intra-amniotic bacterial colonization in premature labor. Am J Obstet Gynecol 148:739–743
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Higuchi, M., Hirano, H., Gotoh, K. et al. The relation between amniotic fluid surfactant concentration in preterm labour and histological evidence of chorioamnionitis. Arch Gynecol Obstet 251, 35–44 (1992). https://doi.org/10.1007/BF02718276
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF02718276