Serial Ultrasonographic Examination of the Fetal Thymus in the Prediction of Early Neonatal Sepsis in Preterm Premature Rupture of Membranes

被引:19
作者
Cetin, Orkun [1 ]
Cetin, Lpek Dokurel [2 ]
Uludag, Seyfettin [3 ]
Sen, Cihat [3 ]
Verit, Fatma Ferda [4 ]
Guralp, Onur [5 ]
机构
[1] Yuzuncu Yuzyil Univ, Van, Turkey
[2] Istanbul Univ, Cerrahpasa Med Sch, Istanbul, Turkey
[3] Istanbul Univ, Cerrahpasa Med Sch, Div Maternal & Fetal Med Obstet & Gynecol, Istanbul, Turkey
[4] Suleymaniye Obstet & Gynecol Res & Training Hosp, Istanbul, Turkey
[5] Bozova State Hosp, Sanliurfa, Turkey
关键词
Preterm premature rupture of membranes; Fetal thymus transverse diameter; Early neonatal sepsis; Interleukin-6; Tumor necrosis factor-alpha; BLOOD-CELL COUNT; TRANSVERSE DIAMETER; MICROBIAL INVASION; GRAM STAIN; CHORIOAMNIONITIS; INTERLEUKIN-6; ULTRASOUND; PREGNANCIES; INFECTION; DELETION;
D O I
10.1159/000364871
中图分类号
R71 [妇产科学];
学科分类号
100211 [妇产科学];
摘要
Background/Aims: To evaluate the diagnostic accuracy of fetal thymus transverse diameter (FTTD) in predicting fetal infection in preterm premature rupture of membranes (PPROM) and compare its accuracy with cord blood tumor necrosis factor-a (TNF-alpha) and interleukin-6 (IL-6). Methods: Forty consecutive pregnancies complicated with PPROM between 26(1/7) and 36(6/7) gestational weeks were evaluated prospectively. Serial fetal ultrasonography follow-ups with 3-day intervals were performed beginning on the admission day. The FTTD was recorded on every ultrasonographic examination. Cord blood TNF-alpha and IL-6 values were measured after delivery. Results: FTTD was decreased below 5% according to nomograms compared to the initial measurement in 45% of all PPROM cases. Decreased FTTD had a sensitivity of 100%, specificity of 73%, positive predictive value of 55%, and negative predictive value of 100% in predicting early neonatal sepsis. Cord blood TNF-alpha had a sensitivity of 80% and specificity of 90%, whereas IL-6 had a sensitivity of 90% and specificity of 63.3% in predicting early neonatal sepsis. Conclusions: Assessment of the decrease in FTTD by serial ultrasonographic examinations is a promising 'prenatal' method for the early detection of early neonatal sepsis. (C) 2014 S. Karger AG, Basel
引用
收藏
页码:201 / 207
页数:7
相关论文
共 18 条
[1]
Fetal tyhmus size as a predictor of histological chorioamnionitis in preterm premature rupture of membranes [J].
Aksakal, Sezin Erturk ;
Kandemir, Omer ;
Altinbas, Sibel ;
Esin, Sertac ;
Muftuoglu, Kamil Hakan .
JOURNAL OF MATERNAL-FETAL & NEONATAL MEDICINE, 2014, 27 (11) :1118-1122
[2]
Assessment of the thymus at echocardiography in fetuses at risk for 22q11.2 deletion [J].
Barrea, C ;
Yoo, SJ ;
Chitayat, D ;
Valsangiacomo, E ;
Winsor, E ;
Smallhorn, JF ;
Hornberger, LK .
PRENATAL DIAGNOSIS, 2003, 23 (01) :9-15
[3]
Absent or hypoplastic thymus on ultrasound:: a marker for deletion 22q11.2 in fetal cardiac defects [J].
Chaoui, R ;
Kalache, KD ;
Heling, KS ;
Tennstedt, C ;
Bommer, C ;
Körner, H .
ULTRASOUND IN OBSTETRICS & GYNECOLOGY, 2002, 20 (06) :546-552
[4]
Diameter of the normal fetal thymus on ultrasound [J].
Cho, J. Y. ;
Min, J. Y. ;
Lee, Y.-H. ;
McCrindles, B. ;
Hornbergers, L. K. ;
Yoo, S.-J. .
ULTRASOUND IN OBSTETRICS & GYNECOLOGY, 2007, 29 (06) :634-638
[5]
EVALUATION OF RAPID DIAGNOSTIC-TESTS IN THE DETECTION OF MICROBIAL INVASION OF THE AMNIOTIC CAVITY [J].
COULTRIP, LL ;
GROSSMAN, JH .
AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY, 1992, 167 (05) :1231-1242
[6]
Small thymus in very low birth weight infants born to mothers with subclinical chorioamnionitis [J].
De Felice, C ;
Toti, P ;
Santopietro, R ;
Stumpo, M ;
Pecciarini, L ;
Bagnoli, F .
JOURNAL OF PEDIATRICS, 1999, 135 (03) :384-386
[7]
FELKER RE, 1989, J ULTRAS MED, V8, P669
[8]
Amniotic fluid matrix metalloproteinase-9 and interleukin-6 in predicting intra-amniotic infection [J].
Harirah, H ;
Donia, SE ;
Hsu, CD .
OBSTETRICS AND GYNECOLOGY, 2002, 99 (01) :80-84
[9]
Maternal serum interleukin-6 concentrations in patients with preterm premature rupture of membranes and evidence of infection [J].
Murtha, AP ;
Greig, PC ;
Jimmerson, CE ;
RoitmanJohnson, B ;
Allen, J ;
Herbert, WNP .
AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY, 1996, 175 (04) :966-969
[10]
Ultrasound measurement of the transverse diameter of the fetal thymus in pregnancies complicated by the preterm prelabor rupture of membranes [J].
Musilova, Ivana ;
Hornychova, Helena ;
Kostal, Milan ;
Jacobsson, Bo ;
Kacerovsky, Marian .
JOURNAL OF CLINICAL ULTRASOUND, 2013, 41 (05) :283-289