PMID- 19900034
OWN - NLM
STAT- MEDLINE
DCOM- 20100607
LR  - 20211028
IS  - 1476-4954 (Electronic)
IS  - 1476-7058 (Print)
IS  - 1476-4954 (Linking)
VI  - 23
IP  - 4
DP  - 2010 Apr
TI  - The clinical significance of eosinophils in the amniotic fluid in preterm labor.
PG  - 320-9
LID - 10.3109/14767050903168465 [doi]
AB  - OBJECTIVE: White blood cells are not traditionally considered to be normally 
      present in amniotic fluid. This study was conducted after the observation that a 
      patient with preterm labor and intact membranes had eosinophils as a predominant 
      cell in the amniotic fluid, and had an episode of asthma during the index 
      pregnancy. The goal of this study was to determine whether women presenting with 
      preterm labor with eosinophils in the amniotic fluid had a different outcome than 
      those without eosinophils as the predominant white blood cell in the amniotic 
      cavity. METHODS: This retrospective case-control study included women who 
      presented with preterm labor and intact membranes between 24 and 34 weeks of 
      gestation. Patients underwent an amniocentesis shortly after admission for the 
      assessment of the microbiologic status of the amniotic cavity and/or fetal lung 
      maturity. Amniotic fluid was cultured for aerobic and anaerobic bacteria as well 
      as genital mycoplasmas. Cytologic studies included amniotic fluid white blood 
      cell count and differential, which was performed on cytocentrifuged specimens. 
      Patients with microbial invasion of the amniotic cavity and/or an amniotic fluid 
      white blood cell count >20 cells/mm(3) were excluded from the study. Cases were 
      defined as women in whom the differential contained >20% of eosinophils. Controls 
      were selected among women with an amniotic fluid eosinophil count <or=20% and 
      matched for gestational age at amniocentesis. The analysis was conducted with 
      non-parametric statistics. RESULTS: The study population consisted of 10 cases 
      and 50 controls. Gestational age and cervical dilatation at admission were 
      similar in both groups. Cases had a lower gestational age at delivery than 
      controls [34.6 weeks, inter-quartile range (IQR) 32-37.3 weeks vs. 38.0 weeks, 
      IQR 35-40 weeks, respectively; p = 0.018]. The prevalence of preterm delivery 
      <or=35 weeks was higher among patients who had >20% eosinophils than in the 
      control group [50% (5/10) vs. 18% (9/50), respectively; p = 0.029]. Similar 
      results were observed for delivery at <37 weeks [cases: 70% (7/10) vs. controls: 
      36% (18/50); p = 0.046]. CONCLUSIONS: Women with preterm labor and intact 
      membranes who have a large proportion of eosinophils in the amniotic fluid are at 
      an increased risk for spontaneous preterm delivery. These patients may have had 
      an episode of preterm labor related to a type I hypersensitivity reaction.
FAU - Romero, Roberto
AU  - Romero R
AD  - Perinatology Research Branch, NICHD/NIH/DHHS, Bethesda, Maryland, USA. 
      prbchiefstaff@med.wayne.edu
FAU - Kusanovic, Juan Pedro
AU  - Kusanovic JP
FAU - Gomez, Ricardo
AU  - Gomez R
FAU - Lamont, Ronald
AU  - Lamont R
FAU - Bytautiene, Egle
AU  - Bytautiene E
FAU - Garfield, Robert E
AU  - Garfield RE
FAU - Mittal, Pooja
AU  - Mittal P
FAU - Hassan, Sonia S
AU  - Hassan SS
FAU - Yeo, Lami
AU  - Yeo L
LA  - eng
GR  - ZIA HD002400-18/ImNIH/Intramural NIH HHS/United States
PT  - Journal Article
PT  - Research Support, N.I.H., Intramural
PL  - England
TA  - J Matern Fetal Neonatal Med
JT  - The journal of maternal-fetal & neonatal medicine : the official journal of the 
      European Association of Perinatal Medicine, the Federation of Asia and Oceania 
      Perinatal Societies, the International Society of Perinatal Obstetricians
JID - 101136916
SB  - IM
MH  - Amniocentesis
MH  - Amniotic Fluid/*cytology
MH  - Asthma/pathology
MH  - Case-Control Studies
MH  - Eosinophils/*pathology
MH  - Female
MH  - Gestational Age
MH  - Humans
MH  - Obstetric Labor, Premature/*pathology
MH  - Pregnancy
MH  - Pregnancy Complications/pathology
MH  - Retrospective Studies
PMC - PMC3470475
MID - NIHMS395402
EDAT- 2009/11/11 06:00
MHDA- 2010/06/09 06:00
PMCR- 2012/10/12
CRDT- 2009/11/11 06:00
PHST- 2009/11/11 06:00 [entrez]
PHST- 2009/11/11 06:00 [pubmed]
PHST- 2010/06/09 06:00 [medline]
PHST- 2012/10/12 00:00 [pmc-release]
AID - 10.3109/14767050903168465 [pii]
AID - 10.3109/14767050903168465 [doi]
PST - ppublish
SO  - J Matern Fetal Neonatal Med. 2010 Apr;23(4):320-9. doi: 
      10.3109/14767050903168465.