| Premature rupture of membranes (PROM) is defined as rupture that occurs prior to labor, regardless of the gestational age. The frequency of PROM in pregnancy is 2.7-17%. It is also a major clinical problem, and one of its causes is intrau-amniotic infection. Intrau-amniotic infection as a pregnancy-dependant disease is a common problem and difficult to diagnose and to cure before delivery. But in the early time, there is no clinical evidence of infection in most patients with sub-clinical chorioamnionitis. Therefore, it continues to be a leading cause of neonatal and maternal morbidity and mortality. Complications associated with premature rupture of fetal membranes include preterm labor, maternal and fetal infections, asphyxia .Once the diagnosis of Premature rupture of fetal membranes is established , patients are often managed expectantly with hospitalization and bed rest until there is clinical evidence of infection or documentation of fetal lung maturity . Clinical signs of infection are subtle and usually not present in early chorioamnionitis. Currently there are no reliable clinical signs to adequately indicate impending intrauterine infection in these patients.C-reaction protein (CRP) now is the main marker to detect intra-amniotic infection. Although it has certain specificity, it lacks sufficient sensitivity and negative predictive value for detecting intrauterine infection. So we should find a highersensitivity marker to improve the ability of diagnosis.Granulocyte colony-stimulating factor (G-CSF), an 18-kd glycoprotein produced by a variety of cells, including monocytes-macrophages and decidual cells. This cytokine is a physiologic upword regulator of neutrophil production and neutrophil antibacterial function. Animal experiments show that G-CSF can sensitive reflect the bacterial infection in the body. Some researches about the relationship between G-CSF and intrauterine infection were reported in foreign journals. But scarcely is reported about the relationship between G-CSF and sub- chorioamniomitis in the patients of PROM..So this investigation was designed to evaluate the clinical usefulness of maternal serum and cord serum G-CSF concentrations in patients with PROM. Specifically, in the present study, we are to determine whether maternal serum and cord serum G-CSF concentrations are elevated in patients with PROM, no signs of clinical infection, with and without histologic evidence of chorioamnioitis . The aim of the study is to determine the early diagnostic value of serum G-CSF of women in the sub-clinical infection. The ability to reliably diagnose pre-clinical or early infection could lead to early intervention and improve the ability of the intervention and a subsequent decrease in perinatal morbidity and mortality. At the same time, detection of G-CSF concentrations in serum is helpful to pre-diagnose neonatal morbidity in PROM.Method: Subjects were divided two groups: 1. The PROM group (n=50,age of 24-35 years). According to the diagnostic standard (OBSTETRICS AND GYNECOLOGY edited by Lejie, the Fifth edition). All the patients had no other complications of pregnancy , such as Pregnancy-induced Hypertension(PIH), primaryhypertension and renal disorders; 2.The normal group (n=30 age of 24-33 years).Placental tissue of normal pregnancy and PROM were immediately obtained after delivery of placentas and determined whether there be existed chorioamnionitis with HE staining .At the same time , by use of a sensitive enzyme-linked immunosorbent assay maternal serum and cord serum G-CSF and CRP concentrations were measured in 80 samples from patients with the infected controls (n=30),and PROM(n=50)beforethe urinary constriction .Descriptive data are given as mean ?standard deviation(SD).All experimental data in the maternal serum and cord serum study were analyzed using Chi-square test and ANOVA or Nonparametric test and t or t' student test and processed by spss 10.0. There was a statistical significance when P<0.05.Results: 1. There was no significa... |
