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Yoshikawa K, Kiyoshima C, Hirakawa T, Urushiyama D, Fukagawa S, Izuchi D, Sanui A, Kurakazu M, Miyata K, Nomiyama M, Setoue T, Nagamitsu S, Nabeshima K, Hata K, Yasunaga S, Miyamoto S. Diagnostic predictability of miR-4535 and miR-1915-5p expression in amniotic fluid for foetal morbidity of infection. Placenta 2021; 114:68-75. [PMID: 34479063 DOI: 10.1016/j.placenta.2021.08.059] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2021] [Revised: 07/26/2021] [Accepted: 08/23/2021] [Indexed: 01/01/2023]
Abstract
INTRODUCTION Clinical prediction of foetal inflammatory response syndrome (FIRS) is highly necessary. We have previously reported that miR-4535 and miR-1915-5p are potential biomarkers for severe chorioamnionitis based on the results of microRNA array analysis. Therefore, we evaluated the relationship between foetal morbidity of infection and miR-4535, miR-1915-5p, interleukin (IL)-6, or 16S rDNA copy number levels in amniotic fluid from pregnant women with chorioamnionitis. METHODS Amniotic fluid from 57 pregnant women with preterm premature membrane rupture or threatened premature labour were collected. Infants with WBC counts <5000/μL or >20,000/μL, CRP >0.5 mg/mL, or IgM >20 mg/mL at birth received a diagnosis of suspicious foetal infection, and those requiring antibiotic administration for >5 days were considered infected newborns. miR-4535, miR-1915-5p, and IL-6 levels and 16S rDNA copy number were evaluated. Mann-Whitney U test and Dunn's test were used for comparison. The area under the curve (AUC) and Youden index were calculated to examine the diagnostic accuracy of foetal morbidity of infection. RESULTS miR-4535, miR-1915-5p, 16S rDNA, and IL-6 were significantly higher in patients with severe chorioamnionitis than in patients with chorionitis or sub-chorionitis (P < 0.05). miR-4535 and miR-1915-5p levels were significantly associated with WBC counts <5000/μL or >20,000/μL, CRP >0.5 mg/mL, or IgM >20 mg/mL (P < 0.05). AUC values of miR-4535 and miR-1915-5p indicated moderate or low accuracy for foetal morbidity of infection, while those of IL-6 and 16S rDNA seemed unreliable. DISCUSSION MiR-4535 and miR-1915-5p levels in amniotic fluid may be considered clinically predictive for foetal morbidity of infection.
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Affiliation(s)
| | | | | | | | | | | | - Ayako Sanui
- Department of Obstetrics & Gynecology, Japan
| | | | | | - Makoto Nomiyama
- Department of Obstetrics and Gynecology, National Hospital Organization Saga Hospital, Saga, Japan
| | - Takashi Setoue
- Center for Maternal, Foetal & Neonatal Medicine, Fukuoka University Hospital, Fukuoka, Japan
| | | | | | - Kenichiro Hata
- Department of Maternal-Fetal Biology, National Research Institute for Child Health and Development, Tokyo, Japan
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Kurakazu M, Yotsumoto F, Arima H, Izuchi D, Urushiyama D, Miyata K, Kiyoshima C, Fukagawa S, Yoshikawa K, Kurakazu M, Hirakawa T, Shigekawa K, Araki R, Sanui A, Murata M, Nabeshima K, Miyamoto S. The combination of maternal blood and amniotic fluid biomarkers improves the predictive accuracy of histologic chorioamnionitis. Placenta 2019; 80:4-7. [PMID: 31103065 DOI: 10.1016/j.placenta.2019.03.007] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2018] [Revised: 03/13/2019] [Accepted: 03/19/2019] [Indexed: 11/29/2022]
Abstract
INTRODUCTION This study was performed to determine whether the combination of maternal blood and amniotic fluid biomarkers can improve the predictive accuracy of histologic chorioamnionitis (HC). METHODS This retrospective study included 80 singleton pregnant women who were suspected to have intrauterine infection and underwent measurement of two maternal blood biomarkers [maternal white blood cell count (mWBC) and maternal C-reactive protein level (mCRP)] and three amniotic fluid biomarkers [amniotic white blood cell count (aCell), amniotic glucose level (aGlucose), and amniotic lactate dehydrogenase level (aLDH)]. We divided the patients into two groups based on the presence or absence of HC and assessed the predictors of HC using logistic regression models: Model 1, combination of mWBC and mCRP; Model 2, combination of Model 1 and aGlucose; and Model 3, combination of Model 2, aCell, and aLDH. RESULTS The multivariable analysis showed that aCell was the only significant predictor of HC [odds ratio, 1.24; 95% confidence interval (CI), 1.06-1.68] independent of mWBC, mCRP, aGlucose, and aLDH. The c-statistics were higher in Model 3 (0.803; 95% CI, 0.701-0.905) than Model 1 (0.634; 95% CI, 0.511-0.758) and Model 2 (0.785; 95% CI, 0.684-0.887). DISCUSSION We found that the combination of maternal blood and amniotic fluid biomarkers can improve the predictive accuracy of HC. Therefore, our data provide relevant information to support counseling with regard to improving the predictive accuracy of HC in patients with suspected intrauterine infection.
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Affiliation(s)
- Masamitsu Kurakazu
- Department of Obstetrics and Gynecology, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
| | - Fusanori Yotsumoto
- Department of Obstetrics and Gynecology, Faculty of Medicine, Fukuoka University, Fukuoka, Japan.
| | - Hisatomi Arima
- Department of Preventive Medicine and Public Health, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
| | - Daisuke Izuchi
- Department of Obstetrics and Gynecology, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
| | - Daichi Urushiyama
- Department of Obstetrics and Gynecology, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
| | - Kohei Miyata
- Department of Obstetrics and Gynecology, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
| | - Chihiro Kiyoshima
- Department of Obstetrics and Gynecology, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
| | - Satoshi Fukagawa
- Department of Obstetrics and Gynecology, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
| | - Kenichi Yoshikawa
- Department of Obstetrics and Gynecology, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
| | - Mariko Kurakazu
- Department of Obstetrics and Gynecology, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
| | - Toyofumi Hirakawa
- Department of Obstetrics and Gynecology, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
| | - Koichi Shigekawa
- Department of Obstetrics and Gynecology, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
| | - Ryota Araki
- Department of Obstetrics and Gynecology, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
| | - Ayako Sanui
- Center for Maternal, Fetal and Neonatal Medicine, Fukuoka University Hospital, Fukuoka, Japan
| | - Masaharu Murata
- Center for Maternal, Fetal and Neonatal Medicine, Fukuoka University Hospital, Fukuoka, Japan
| | - Kazuki Nabeshima
- Department of Pathology, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
| | - Shingo Miyamoto
- Department of Obstetrics and Gynecology, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
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Yamamoto N, Takeuchi R, Izuchi D, Yuge N, Miyazaki M, Yasunaga M, Egashira K, Ueoka Y, Inoue Y. Hysteroscopic adhesiolysis for patients with Asherman's syndrome: menstrual and fertility outcomes. Reprod Med Biol 2013; 12:159-166. [PMID: 29662367 DOI: 10.1007/s12522-013-0149-x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2013] [Accepted: 04/15/2013] [Indexed: 02/07/2023] Open
Abstract
Purpose Most patients with Asherman's syndrome present with infertility and menstrual problems. In this retrospective clinical study, we analyzed patients with Asherman's syndrome who underwent hysteroscopic adhesiolysis to examine their associated symptoms, disease etiologies, and fertility outcomes. Methods Twenty-seven patients with Asherman's syndrome that were diagnosed using hysteroscopy were recruited. The chief complaints were infertility, hypomenorrhea, and amenorrhea. Each case of Asherman's syndrome was classified according to the American Fertility Society classification. Hysteroscopic adhesiolysis was performed in all cases and concomitant transabdominal ultrasonography was conducted in cases with extensive and dense adhesions. Results There were no complications associated with the hysteroscopic procedure. Normal menstrual cycles resumed in all cases. Of the 16 infertile patients, 9 conceived. Three patients achieved term deliveries and one patient is currently pregnant. None of the patients had obstetric complications. Two patients had spontaneous abortions, one had an ectopic pregnancy, one had an abortion at 16 weeks' gestation due to cervical incompetence, and one had a molar pregnancy and required uterine artery embolization for uncontrolled hemorrhaging during a dilatation and curettage procedure. Conclusions Hysteroscopic adhesiolysis with transabdominal ultrasonography is a suitable treatment method for Asherman's syndrome. Subfertile patients with Asherman's syndrome undergoing adhesiolysis should be appropriately informed about the risk of associated life-threatening complications and preterm delivery.
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Affiliation(s)
- Nari Yamamoto
- Department of Obstetrics and Gynecology Hamanomachi Hospital 3-5-27 Maizuru, Chuo-ku 810-0073 Fukuoka Japan
| | - Reiko Takeuchi
- Department of Obstetrics and Gynecology Hamanomachi Hospital 3-5-27 Maizuru, Chuo-ku 810-0073 Fukuoka Japan
| | - Daisuke Izuchi
- Department of Obstetrics and Gynecology Hamanomachi Hospital 3-5-27 Maizuru, Chuo-ku 810-0073 Fukuoka Japan
| | - Norihito Yuge
- Department of Obstetrics and Gynecology Hamanomachi Hospital 3-5-27 Maizuru, Chuo-ku 810-0073 Fukuoka Japan
| | - Masahide Miyazaki
- Department of Obstetrics and Gynecology Hamanomachi Hospital 3-5-27 Maizuru, Chuo-ku 810-0073 Fukuoka Japan
| | - Masafumi Yasunaga
- Department of Obstetrics and Gynecology Hamanomachi Hospital 3-5-27 Maizuru, Chuo-ku 810-0073 Fukuoka Japan
| | - Katsuko Egashira
- Department of Obstetrics and Gynecology Hamanomachi Hospital 3-5-27 Maizuru, Chuo-ku 810-0073 Fukuoka Japan
| | - Yousuke Ueoka
- Department of Obstetrics and Gynecology Hamanomachi Hospital 3-5-27 Maizuru, Chuo-ku 810-0073 Fukuoka Japan
| | - Yoshihito Inoue
- Department of Obstetrics and Gynecology Hamanomachi Hospital 3-5-27 Maizuru, Chuo-ku 810-0073 Fukuoka Japan
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