losartan-potassium and Fetal-Membranes--Premature-Rupture

The aim of this study is to examine the hypothesis that prolonged rupture of membranes (PROM) is associated with increased cord blood erythropoietin (EPO) concentrations, proportional to the duration of ruptured membranes.. This study is a prospective, cross-sectional, observational (noninterventional) cohort study of mother-infant pairs. Criteria for inclusion were as follows: active labor with or without ruptured membranes and vaginally delivered neonates. Excluded were infants with major factors known to be associated with a potential increase in fetal erythropoiesis.. A total of 40 mother-infant pairs were recruited. EPO was not influenced by duration of ruptured membranes and significantly correlated only with maternal body mass index.. Cord blood concentrations of EPO do not appear to be significantly affected by the duration of ruptured membranes. We speculate that erythropoiesis is upregulated in PROM by mechanisms that involve the production of cytokines and are not EPO driven.

Topics: Adult; Body Mass Index; Cross-Sectional Studies; Erythrocyte Count; Erythropoietin; Female; Fetal Blood; Fetal Membranes, Premature Rupture; Gestational Age; Humans; Infant, Newborn; Pregnancy; Prospective Studies; Young Adult

The aim of this study was to compare the neonatal nucleated red blood cell counts in preterm infants in the presence and absence of clinical and histologic chorioamnionitis while controlling for gestational age and birth weight percentile.. Nucleated red blood cell counts were obtained from preterm infants delivered after preterm labor or preterm premature rupture of membranes. Patients were divided on the basis of clinical and histologic chorioamnionitis. Nucleated red blood cell counts between groups were compared, and regression analysis controlling for gestational age and birth weight percentile was performed.. Of 359 patients, both measures of infection status were significantly associated with increased nucleated red blood cell counts. In the regression analysis histologic chorioamnionitis retained significance, whereas clinical chorioamnionitis did not.. Histologic chorioamnionitis produces an erythropoietic response in the fetus. Whether fetal erythropoiesis is a direct response to mediators of inflammation or whether it is the result of a rise in erythropoietin is unknown.

Topics: Birth Weight; Chorioamnionitis; Erythrocyte Count; Erythropoiesis; Erythropoietin; Female; Fetal Blood; Fetal Membranes, Premature Rupture; Gestational Age; Humans; Infant, Newborn; Infant, Premature; Obstetric Labor, Premature; Pregnancy; Regression Analysis

To investigate the concentrations of amniotic fluid erythropoietin in normal and risk pregnancies.. The concentrations of erythropoietin were measured in 150 samples of amniotic fluid. The samples were obtained by amniocentesis and amniotomia and were analysed using an enzyme-linked immunosorbent assay (ELISA). Results were available within 6 hours. The intra-assay variation was 6.4%, the inter-assay variation 7.2%.. The range of erythropoietin concentration in all samples was between 0.23 and 80 U/L and in a defined group of normal pregnancies between 1.20 and 6.53 U/L (10%-90% percentile). Correlation was found between the concentration of erythropoietin and maternal hypertension (p = 0.0159), amnion infection syndrome in combination with premature birth (p = 0.0593), fetal growth retardation (p = 0.784), and base-excess (p = 0.0487). Elevated erythropoietin concentrations were found in a defined risk group with Apgar scores below 7 after 1 minute (p = 0.072) and after 5 minutes (p = 0.0037). There is a connection between postpartal transfer to the intensive-care unit and elevated erythropoietin concentrations (p = 0.073). No influence is exercised by the child's sex on the concentration of erythropoietin. No significant connection was found between the level of erythropoietin and smoking during pregnancy, volume of amniotic fluid and maturity at birth. A critical erythropoietin concentration could be postulated at 12 U/L. Children with higher levels showed heavy and severe disorders.. Elevated erythropoietin levels in amniotic fluid indicate prolonged fetal hypoxaemia. Using the ELISA-technique a rapid prepartal determination of such situations is possible and might be helpful in the clinical procedure.

Topics: Adolescent; Adult; Amniocentesis; Amniotic Fluid; Enzyme-Linked Immunosorbent Assay; Erythropoietin; Female; Fetal Growth Retardation; Fetal Hypoxia; Fetal Membranes, Premature Rupture; Humans; Infant, Newborn; Obstetric Labor, Premature; Pre-Eclampsia; Pregnancy; Pregnancy, High-Risk; Reference Values