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Ronzoni S, Boucoiran I, Yudin MH, Coolen J, Pylypjuk C, Melamed N, Holden AC, Smith G, Barrett J. Directive clinique n o 430 : Diagnostic et prise en charge de la rupture prématurée des membranes avant terme. JOURNAL OF OBSTETRICS AND GYNAECOLOGY CANADA 2022; 44:1209-1225.e1. [PMID: 36202728 DOI: 10.1016/j.jogc.2022.08.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIF Fournir des directives claires et concises pour le diagnostic et la prise en charge de la rupture prématurée des membranes avant terme (RPMAT). POPULATION CIBLE Toute patiente manifestant une rupture prématurée des membranes avant 37 semaines d'aménorrhée. BéNéFICES, RISQUES ET COûTS: La présente directive clinique vise à fournir les premières recommandations générales canadiennes sur la prise en charge de la rupture des membranes avant terme. Elle repose sur un examen complet et à jour des données probantes sur le diagnostic de la rupture et sur la prise en charge, le bon moment et les modes d'accouchement. DONNéES PROBANTES: Des recherches ont été effectuées dans PubMed-Medline et Cochrane en 2021 en utilisant les termes suivants : preterm premature rupture of membranes, PPROM, chorioamnionitis, Nitrazine test, ferning, commercial tests, PAMG-1, IGFBP-1 test, ultrasonography, PPROM/antenatal corticosteroids, PPROM/Magnesium sulphate, PPROM/antibiotic treatment, PPROM/tocolysis, PPROM/preterm labour, PPROM/neonatal outcomes, PPROM/mortality, PPROM/outpatient/inpatient, PPROM/cerclage, previable PPROM. Les articles retenus sont des essais cliniques randomisés, des méta-analyses, des revues systématiques, des directives cliniques et des études observationnelles. D'autres publications pertinentes ont été sélectionnées à partir des notices bibliographiques de ces articles. Seuls les articles en anglais ont été examinés. MéTHODES DE VALIDATION: Les auteurs ont évalué la qualité des données probantes et la force des recommandations en utilisant le cadre méthodologique GRADE (Grading of Recommendations, Assessment, Development, and Evaluation). Voir l'annexe A (tableau A1 pour les définitions et tableau A2 pour l'interprétation des recommandations fortes et faibles). PROFESSIONNELS CONCERNéS: Tous les fournisseurs de soins de santé prénatale ou périnatale. DÉCLARATIONS SOMMAIRES: RECOMMANDATIONS.
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Ronzoni S, Boucoiran I, Yudin MH, Coolen J, Pylypjuk C, Melamed N, Holden AC, Smith G, Barrett J. Guideline No. 430: Diagnosis and management of preterm prelabour rupture of membranes. JOURNAL OF OBSTETRICS AND GYNAECOLOGY CANADA 2022; 44:1193-1208.e1. [PMID: 36410937 DOI: 10.1016/j.jogc.2022.08.014] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVE To provide clear and concise guidelines for the diagnosis and management of preterm prelabour rupture of membranes (PPROM) TARGET POPULATION: All patients with PPROM <37 weeks gestation BENEFITS, HARMS, AND COSTS: This guideline aims to provide the first Canadian general guideline on the management of preterm membrane rupture. It includes a comprehensive and up-to-date review of the evidence on the diagnosis, management, timing and method of delivery. EVIDENCE The following search terms were entered into PubMed/Medline and Cochrane in 2021: preterm premature rupture of membranes, PPROM, chorioamnionitis, Nitrazine test, ferning, commercial tests, placental alpha microglobulin-1 (PAMG-1) test, insulin-like growth factor-binding protein-1 (IGFBP-1) test, ultrasonography, PPROM/antenatal corticosteroids, PPROM/Magnesium sulphate, PPROM/ antibiotic treatment, PPROM/tocolysis, PPROM/preterm labour, PPROM/Neonatal outcomes, PPROM/mortality, PPROM/outpatient/inpatient, PPROM/cerclage, previable PPROM. Articles included were randomized controlled trials, meta-analyses, systematic reviews, guidelines, and observational studies. Additional publications were identified from the bibliographies of these articles. Only English-language articles were reviewed. VALIDATION METHODS The authors rated the quality of evidence and strength of recommendations using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. See Appendix A (Tables A1 for definitions and A2 for interpretations of strong and weak recommendations). INTENDED AUDIENCE All prenatal and perinatal health care providers. SUMMARY STATEMENTS RECOMMENDATIONS.
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Breazzano MP, Day HR, Tanaka S, Tran U. CLEARED (Chemicals and Litmus testing with Effective Alkaline Range for Eye Damage): A Prospective, Interventional Study. Acad Emerg Med 2019; 26:796-802. [PMID: 30246924 DOI: 10.1111/acem.13622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2018] [Revised: 09/13/2018] [Accepted: 09/18/2018] [Indexed: 12/01/2022]
Abstract
OBJECTIVES While immediate diagnosis and irrigation is standard chemical eye burn practice, it is unknown to what extent specific pH measurements influence management, given the frequent clinical availability of narrow-spectrum nitrazine pH strips. We hypothesize that exclusive broad-spectrum pH strip implementation leads to more accurate measurement and expedited ophthalmologic consultation. METHODS At a Level I trauma center over 25 months, all emergent adult ophthalmology consultations for chemical burns were included in a pre-intervention (n = 22) and post-intervention (n = 20) study design. During this time, narrow-spectrum nitrazine pH strips available to non-obstetric emergency department (ED) staff were exclusively replaced by broad-spectrum strips. Causative chemical, time from triage to ophthalmology consultation, examination findings, ocular pH by ED and ophthalmology staff, and irrigation quantity were analyzed. RESULTS Most burns were alkaline. Time from triage (p = 0.043) and irrigation quantity following consultation (p = 0.047) each decreased following exclusive ED implementation of broad-spectrum pH strips. There was greater pH congruence between consulting and primary physicians after intervention (p = 0.03). CONCLUSIONS Exclusive non-obstetric implementation of broad-spectrum pH strips may allow greater accuracy and faster management of ocular chemical burns. Availability of narrow-spectrum pH strips may be dangerous clinically by falsely reassuring the examiner with inherent inaccuracy.
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Affiliation(s)
- Mark P. Breazzano
- Department of Ophthalmology & Visual Sciences Vanderbilt Eye Institute Vanderbilt University Medical Center Nashville TN
- Vanderbilt University School of Medicine Nashville TN
- Department of Ophthalmology Harkness Eye Institute Columbia University College of Physicians & Surgeons New York NY
| | | | - Sarah Tanaka
- Vanderbilt University School of Medicine Nashville TN
| | - Uyen Tran
- Department of Ophthalmology & Visual Sciences Vanderbilt Eye Institute Vanderbilt University Medical Center Nashville TN
- Vanderbilt University School of Medicine Nashville TN
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Galletta MAK, Bittar RE, Rodrigues AS, Francisco RPV, Zugaib M. Comparative analysis of Insulin-like growth factor binding protein-1, placental alpha-microglobulin-1, phenol and pH for the diagnosis of preterm premature rupture of membranes between 20 and 36 weeks. J Obstet Gynaecol Res 2019; 45:1448-1457. [PMID: 31099162 DOI: 10.1111/jog.13991] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2019] [Accepted: 04/14/2019] [Indexed: 11/27/2022]
Abstract
AIM Preterm premature rupture of membranes (PPROM) is responsible for approximately one-third of premature births worldwide, and although the diagnosis is often straightforward, this condition can still present difficulties. The purpose of this research was to compare the accuracy of several PPROM diagnostic tests. METHODS A total of 94 pregnant women with clinical suspicion of PPROM who were between 20 and 36 weeks of pregnancy were examined by vaginal speculum, and tests were performed for phenol, pH, insulin-like growth factor binding protein-1 (IGFBP-1) and placental alpha-microglobulin-1 (PAMG-1). All patients were followed up until the diagnosis was fully defined, and a diagnosis of PROM was confirmed by a definitive evolution of the clinical symptoms (visualization of vaginal amniotic fluid or persistence of oligohydramnios). RESULTS After excluding the cases that could not be definitively diagnosed, a good diagnostic performance of the immunochromatographic tests was observed that was superior to that of the clinical tests. Similar accuracies were observed for IGFBP-1 (98.7%) and PAMG-1 (93.9%). However, while the IGFBP-1 test differed from a vaginal pH ≥7 (88.9%) and the phenol test (85.7%), this did not occur for the PAMG-1 test. The performance of the tests was modified only by the presence of bleeding (with lower specificity rates for pH and phenol), without interference of gestational age or maternal morbidities. CONCLUSION Immunochromatographic tests are good tools but should be used sparingly in resource-poor settings because they are expensive, and there is no significant difference between PAMG-1 and traditional tests.
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Affiliation(s)
- Marco A K Galletta
- Disciplina de Obstetricia, Departamento de Obstetricia e Ginecologia, Faculdade de Medicina, Universidade de Sao Paulo (FMUSP), Sao Paulo, Brazil
| | - Roberto E Bittar
- Disciplina de Obstetricia, Departamento de Obstetricia e Ginecologia, Faculdade de Medicina, Universidade de Sao Paulo (FMUSP), Sao Paulo, Brazil
| | - Agatha S Rodrigues
- Disciplina de Obstetricia, Departamento de Obstetricia e Ginecologia, Faculdade de Medicina, Universidade de Sao Paulo (FMUSP), Sao Paulo, Brazil
| | - Rossana P V Francisco
- Disciplina de Obstetricia, Departamento de Obstetricia e Ginecologia, Faculdade de Medicina, Universidade de Sao Paulo (FMUSP), Sao Paulo, Brazil
| | - Marcelo Zugaib
- Disciplina de Obstetricia, Departamento de Obstetricia e Ginecologia, Faculdade de Medicina, Universidade de Sao Paulo (FMUSP), Sao Paulo, Brazil
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Eleje GU, Ezugwu EC, Ezebialu IU, Ojiegbe NO, Egeonu RO, Obiora CC, Okafor CG, Ikechebelu JI, Eke AC. Performance indices of AmnioQuick Duo+ versus placental α-microglobulin-1 tests for women with prolonged premature rupture of membranes. Int J Gynaecol Obstet 2018; 144:180-186. [PMID: 30387138 DOI: 10.1002/ijgo.12703] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2018] [Revised: 08/17/2018] [Accepted: 10/31/2018] [Indexed: 11/07/2022]
Abstract
OBJECTIVE To compare AmnioQuick Duo+ versus the placental α-microglobulin-1 (PAMG-1) test for diagnosis of prolonged premature rupture of membranes (PROM). METHODS A multicenter prospective cohort study included women with suspected PROM at six tertiary institutions in southern Nigeria between January 1 and December 31, 2015. The inclusion criteria were features of PROM lasting at least 24 hours and a pregnancy duration of more than 24 weeks. AmnioQuick Duo+ (Biosynex, Strasbourg, France) and PAMG-1 (AmniSure International, Boston, USA) tests were used to diagnose PROM, which was confirmed after delivery by any two of the following criteria: delivery within 48 hours to 7 days, chorioamnionitis, membranes perceptibly ruptured at delivery, and adverse perinatal outcomes considerably associated with prolonged PROM. RESULTS Of 100 women assessed for eligibility, 99 were included. Sensitivity, specificity, and accuracy were, respectively, 97.3%, 100%, and 95.9% for AmnioQuick Duo+, and 93.2%, 100%, and 90.4% for PAMG-1. The differences were not significant and the diagnostic discordant rate between the two tests was 3.1%. In equivocal cases (i.e., negative pooling test result), AmnioQuick Duo+ and PAMG-1 performed equally (diagnostic accuracy, 100% vs 97.7%; P>0.99). CONCLUSION For diagnosis of PROM, AmnioQuick Duo+ was found to be non-inferior and comparable in accuracy to the PAMG-1 test, with a diagnostic discordance rate of 3.1%.
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Affiliation(s)
- George U Eleje
- Effective Care Research Unit, Department of Obstetrics and Gynecology, Nnamdi Azikiwe University, Nnewi, Nigeria.,Department of Obstetrics and Gynecology, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Nigeria
| | - Euzebus C Ezugwu
- Department of Obstetrics and Gynaecology, University of Nigeria Teaching Hospital, Enugu, Enugu State, Nigeria
| | - Ifeanyichukwu U Ezebialu
- Department of Obstetrics and Gynecology, Chukwuemeka Odumegwu Ojukwu University Teaching Hospital, Awka, Nigeria
| | - Nnabuike O Ojiegbe
- Department of Obstetrics and Gynecology, Federal Medical Center, Umuahia, Nigeria
| | - Richard O Egeonu
- Department of Obstetrics and Gynecology, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Nigeria
| | - Chukwudi C Obiora
- Department of Obstetrics and Gynecology, ESUT Teaching Hospital, Enugu, Nigeria
| | - Chigozie G Okafor
- Department of Obstetrics and Gynecology, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Nigeria
| | - Joseph I Ikechebelu
- Effective Care Research Unit, Department of Obstetrics and Gynecology, Nnamdi Azikiwe University, Nnewi, Nigeria.,Department of Obstetrics and Gynecology, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Nigeria
| | - Ahizechukwu C Eke
- Division of Maternal Fetal Medicine, Department of Gynecology and Obstetrics, John Hopkins University School of Medicine, Baltimore, MD, USA
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Huang S, Xia W, Sheng X, Qiu L, Zhang B, Chen T, Xu S, Li Y. Maternal lead exposure and premature rupture of membranes: a birth cohort study in China. BMJ Open 2018; 8:e021565. [PMID: 30037873 PMCID: PMC6059302 DOI: 10.1136/bmjopen-2018-021565] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
OBJECTIVES Maternal exposure to lead (Pb) has been suggested to correlate with adverse birth outcomes, but evidence supporting an association between Pb exposure and premature rupture of membranes (PROM) is limited. The aim of our study was to investigate whether maternal Pb exposure was associated with PROM and preterm PROM. DESIGN Cross-sectional cohort study. STUDY POPULATION The present study involved 7290 pregnant women from the Healthy Baby Cohort in Wuhan, China, during 2012-2014. MAIN OUTCOME MEASURES PROM was defined as spontaneous rupture of amniotic membranes before the onset of labour and was determined with a pH ≥6.5 for vaginal fluid. Maternal urinary Pb level was adjusted by creatinine concentration, and its relationship with PROM was analysed by logistic regression. RESULTS The IQR of maternal urinary Pb concentrations of the study population was 2.30-5.64 µg/g creatinine with a median of 3.44 µg/g creatinine. Increased risk of PROM was significantly associated with elevated levels of Pb in maternal urine (adjusted OR 1.23, 95% CI 1.0 to 1.47 for the medium tertile; adjusted OR 1.51, 95% CI 1.27 to 1.80 for the highest tertile). The risk of preterm PROM associated with Pb levels was significantly higher when compared with the lowest tertile (adjusted OR 1.24, 95% CI 0.80 to 1.92 for the medium tertile; adjusted OR 1.73, 95% CI 1.15 to 2.60 for the highest tertile). In addition, the relationship between Pb and PROM was more pronounced among primiparous women than multiparous women (p for interaction <0.01). CONCLUSIONS Our study found that higher levels of maternal Pb exposure was associated with increased risk of PROM, indicating that exposure to Pb during pregnancy may be an important risk factor for PROM.
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Affiliation(s)
- Sha Huang
- Key Laboratory of Environment and Health (HUST), Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubation), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Wei Xia
- Key Laboratory of Environment and Health (HUST), Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubation), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xia Sheng
- Key Laboratory of Environment and Health (HUST), Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubation), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Lin Qiu
- Key Laboratory of Environment and Health (HUST), Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubation), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Bin Zhang
- Healthcare Department, Wuhan Medical and Health Center for Women and Children, Wuhan, China
| | - Tian Chen
- Key Laboratory of Environment and Health (HUST), Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubation), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Shunqing Xu
- Key Laboratory of Environment and Health (HUST), Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubation), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yuanyuan Li
- Key Laboratory of Environment and Health (HUST), Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubation), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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Wang Y, Luo H, Che G, Li Y, Gao J, Yang Q, Zhou B, Gao L, Wang T, Liang Y, Zhang L. Placental protein 14 as a potential biomarker for diagnosis of preterm premature rupture of membranes. Mol Med Rep 2018; 18:113-122. [PMID: 29749501 PMCID: PMC6059659 DOI: 10.3892/mmr.2018.8967] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2018] [Accepted: 04/03/2018] [Indexed: 12/14/2022] Open
Abstract
Premature rupture of membranes (PROM) is a common pregnancy complication that frequently results in maternal and perinatal morbidity. The present methods for diagnosing PROM do not satisfy clinical requirements. The present study aimed to examine the proteome profile of amniotic fluid (AF) and maternal plasma, screen unique proteins in AF, and evaluate their diagnostic value for diagnosing PROM. The proteome profiles of AF and maternal plasma were examined via liquid chromatography coupled with tandem mass spectrometry-based proteomic techniques. The protein expression levels of diagnostic candidates in AF, maternal plasma and vaginal fluid were determined by ELISA analysis and Magnetic Luminex® screening assays. The diagnostic value of potential biomarkers was evaluated using receiver operating characteristic curves. A lateral flow assay was developed based on colloidal gold immunochromatography technology. The present study identified 540 unique proteins in AF, 12 of which were chosen for further detection. The present results demonstrated that expression levels of pulmonary surfactant-associated protein B, BPI fold-containing family A member 1, zymogen granule protein 16 homolog B, EGF-containing fibulin-like extracellular matrix protein 1, keratin, type II cytoskeletal 4, keratin, type I cytoskeletal 19, placental protein 14 (PP14), insulin-like growth factor-binding protein 2, mesothelin and serpin family B member 3 were significantly higher in AF compared with in maternal plasma (P<0.01). Furthermore, PP14 was observed to have excellent diagnostic accuracy for preterm PROM (PPROM), with a respective sensitivity and specificity of 100 and 87.5% when the cutoff value was 0.008 µg/ml. The PP14-based lateral flow assay demonstrated a visual detection threshold of 0.008 µg/ml. The results from the present study suggested that PP14 may be a novel potential biomarker for PPROM, and may be developed into a lateral flow assay for bedside application to rapidly diagnose PPROM.
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Affiliation(s)
- Yanyun Wang
- Laboratory of Molecular Translational Medicine, Center for Translational Medicine, Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, Department of Obstetrics and Gynecology, West China Second University Hospital, Chengdu, Sichuan 610041, P.R. China
| | - Haibo Luo
- Institute of Forensic Medicine, West China School of Basic Sciences and Forensic Medicine, Sichuan University, Chengdu, Sichuan 610041, P.R. China
| | - Guanglu Che
- Laboratory of Molecular Translational Medicine, Center for Translational Medicine, Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, Department of Obstetrics and Gynecology, West China Second University Hospital, Chengdu, Sichuan 610041, P.R. China
| | - Yanqin Li
- Department of Perinatal Healthcare, Shuangliu District Maternal and Child Health Hospital, Chengdu, Sichuan 610200, P.R. China
| | - Jun Gao
- Department of Perinatal Healthcare, Shuangliu District Maternal and Child Health Hospital, Chengdu, Sichuan 610200, P.R. China
| | - Qiongli Yang
- Department of Perinatal Healthcare, Shuangliu District Maternal and Child Health Hospital, Chengdu, Sichuan 610200, P.R. China
| | - Bin Zhou
- Laboratory of Molecular Translational Medicine, Center for Translational Medicine, Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, Department of Obstetrics and Gynecology, West China Second University Hospital, Chengdu, Sichuan 610041, P.R. China
| | - Linbo Gao
- Laboratory of Molecular Translational Medicine, Center for Translational Medicine, Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, Department of Obstetrics and Gynecology, West China Second University Hospital, Chengdu, Sichuan 610041, P.R. China
| | - Tao Wang
- Laboratory of Molecular Translational Medicine, Center for Translational Medicine, Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, Department of Obstetrics and Gynecology, West China Second University Hospital, Chengdu, Sichuan 610041, P.R. China
| | - Yujie Liang
- Department of Perinatal Healthcare, Shuangliu District Maternal and Child Health Hospital, Chengdu, Sichuan 610200, P.R. China
| | - Lin Zhang
- Laboratory of Molecular Translational Medicine, Center for Translational Medicine, Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, Department of Obstetrics and Gynecology, West China Second University Hospital, Chengdu, Sichuan 610041, P.R. China
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Majors CE, Smith CA, Natoli ME, Kundrod KA, Richards-Kortum R. Point-of-care diagnostics to improve maternal and neonatal health in low-resource settings. LAB ON A CHIP 2017; 17:3351-3387. [PMID: 28832061 PMCID: PMC5636680 DOI: 10.1039/c7lc00374a] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Abstract
Each day, approximately 830 women and 7400 newborns die from complications during pregnancy and childbirth. Improving maternal and neonatal health will require bringing rapid diagnosis and treatment to the point of care in low-resource settings. However, to date there are few diagnostic tools available that can be used at the point of care to detect the leading causes of maternal and neonatal mortality in low-resource settings. Here we review both commercially available diagnostics and technologies that are currently in development to detect the leading causes of maternal and neonatal mortality, highlighting key gaps in development where innovative design could increase access to technology and enable rapid diagnosis at the bedside.
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Affiliation(s)
- Catherine E Majors
- Department of Bioengineering, Rice University, 6100 Main Street, MS-142, Houston, TX 77005, USA.
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Le A, Wang ZH, Dai XY, Xiao TH, Zhuo R, Zhang B, Xiao Z, Fan X. Icaritin inhibits decidualization of endometrial stromal cells. Exp Ther Med 2017; 14:5949-5955. [PMID: 29285144 PMCID: PMC5740763 DOI: 10.3892/etm.2017.5278] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2016] [Accepted: 07/28/2017] [Indexed: 12/12/2022] Open
Abstract
The aim of the present study was to investigate the effects of Icaritin on the proliferation and decidualization of endometrial stromal cells (ESCs). A total of 20 specimens of endometrium were collected during hysterectomy at the Gynecology Department of Shenzhen Nanshan People's Hospital (Shenzhen, China) between August 2014 and December 2015. The endometrium was digested with high concentrations of collagenase and DNase and filtered with meshes, and then the glandular epithelial and stromal cells were separated by the adhesion purification method. The purity of stromal cells was identified by vimetin and cytokeratin 7 immunostaining. The estradiol + progesterone (E2+P4) and/or cyclic adenosine monophosphate (cAMP) were added to induce an in vitro decidualization model, which was used to analyze the effect of Icaritin on the decidualization ability of the human ESCs. The decidualization markers of human ESCs, prolactin (PRL) and insulin-like growth factor-binding protein 1 (IGFBP-1), was analyzed by reverse-transcription quantitative polymerase chain reaction measurements of the mRNA levels, PRL immunostaining and ELISA analysis of the IGFBP-1 protein levels in the cells or cell culture supernatant separately. The results demonstrated that treatment with E2+P4 and/or cAMP for 96 h was able to induce decidualization in ESCs, and that the cells demonstrated polygon-shaped epithelioid changes. The cell nuclei revealed multinuclear changes, and the cells were also observed to be large and round in shape. The PRL expression and upregulated IGFBP-1 mRNA and protein levels in the E2+P4+cAMP treatment group indicated successful decidualization of the in vitro model. However, the addition of Icaritin inhibited the expression of PRL and IGFBP-1 mRNA, as well as IGFBP-1 protein in the induced ESCs compared with groups without Icaritin. These results suggest that Icaritin was able to inhibit the expression of decidualization-related genes in ESCs in vitro. However, the exact mechanisms require further investigation.
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Affiliation(s)
- Aiwen Le
- Department of Obstetrics and Gynecology, Affiliated Shenzhen Nanshan People's Hospital of Guangdong Medical University, Shenzhen, Guangdong 518052, P.R. China
| | - Zhong Hai Wang
- Department of Obstetrics and Gynecology, Affiliated Shenzhen Nanshan People's Hospital of Guangdong Medical University, Shenzhen, Guangdong 518052, P.R. China
| | - Xiao Yun Dai
- Department of Obstetrics and Gynecology, Affiliated Shenzhen Nanshan People's Hospital of Guangdong Medical University, Shenzhen, Guangdong 518052, P.R. China
| | - Tian Hui Xiao
- Department of Obstetrics and Gynecology, Affiliated Shenzhen Nanshan People's Hospital of Guangdong Medical University, Shenzhen, Guangdong 518052, P.R. China
| | - Rong Zhuo
- Department of Obstetrics and Gynecology, Affiliated Shenzhen Nanshan People's Hospital of Guangdong Medical University, Shenzhen, Guangdong 518052, P.R. China
| | - Baozhen Zhang
- Laboratory for Reproductive Health, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, Guangdong 518055, P.R. China
| | - Zhonglin Xiao
- Laboratory for Reproductive Health, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, Guangdong 518055, P.R. China
| | - Xiujun Fan
- Laboratory for Reproductive Health, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, Guangdong 518055, P.R. China
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Lecerf M, Vardon D, Morello R, Lamendour N, Dreyfus M. Comparaison des performances diagnostiques de deux tests de rupture prématurée des membranes (IGFBP-1/PAMG-1) en pratique clinique. ACTA ACUST UNITED AC 2015; 44:832-9. [DOI: 10.1016/j.jgyn.2014.10.012] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2014] [Revised: 09/28/2014] [Accepted: 10/14/2014] [Indexed: 10/24/2022]
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