The chorion layer of fetal membranes is prematurely destroyed in women with preterm premature rupture of the membranes.

Preterm premature rupture of the membranes (PPROM) is an important etiology of preterm birth and source of significant neonatal morbidity. We propose that PPROM occurs in the setting of long-standing altered tissue remodeling, which creates a vulnerable environment for the fetal membranes and pregnancy. We tested the hypothesis that PPROM is the result of tissue remodeling in the fetal membranes, specifically the chorion, and this weakening of the chorion compromises the protection provided to the amnion.

Maternal serum interleukin-6 levels predict impending funisitis in preterm premature rupture of membranes after completion of antibiotics.

Objective: To determine if maternal serum interleukin-6 (IL-6) levels remain predictive of funisitis after completion of antibiotic administration in preterm premature rupture of membranes (PPROM).

Methods: A secondary analysis of a prospective cohort study. Daily blood samples obtained from PPROM subjects were analyzed for IL-6 by enzyme-linked immunosorbent assay.

Cervical ripening with foley balloon plus fixed versus incremental low-dose oxytocin: a randomized controlled trial.

Objective: To evaluate cervical ripening with foley balloon combined with a fixed vs. incremental low-dose oxytocin infusion.

Methods: Women presenting for term labor induction were randomized to fixed low-dose or standard incremental low-dose oxytocin infusion following foley balloon placement.

Gastrointestinal Conditions during Pregnancy.

Pregnancy causes anatomic and physiologic changes in the gastrointestinal tract. Pregnant women with intestinal disease such as Crohn disease or ulcerative colitis pose a management challenge in clinical diagnosis, radiologic evaluation, and treatment secondary to potential risk to the fetus. Heightened physician awareness on possible etiologies such as appendicitis, diverticulitis, and rarely colorectal cancer is required for rapid diagnosis and treatment to improve maternal/fetal outcome.

Maternal levels of prostacyclin, thromboxane, ICAM, and VCAM in normal and preeclamptic pregnancies.

Problem: To evaluate whether impaired endothelial function and endothelial inflammatory response occur in parallel in the women with preeclampsia.

Method Of Study: Venous blood was drawn from normal (n=40) and severe preeclamptic (sPE) (n=40) pregnant women when they were admitted to the L&D Unit and 24 hrs after delivery. Plasma and serum samples were extracted and measured for 6-keto PGF1α and TXB(2) (stable metabolites of PGI2 and TXA2), and intercellular adhesion molecule (ICAM) and vascular cell adhesion molecule (VCAM) by ELISA.

Maternal circulating TNF-alpha levels are highly correlated with IL-10 levels, but not IL-6 and IL-8 levels, in women with pre-eclampsia.

Problem: Several lines of evidence have shown that maternal cytokine levels of tumor necrosis factor-alpha (TNF-alpha), interleukin (IL)-6, IL-8, and IL-10 were altered in women with pre-eclampsia (PE) compared to those from normal pregnancies. In this study, we determined whether these cytokine levels are correlated before and after delivery in patients with PE.

Method Of Study: Venous blood was obtained from 50 women diagnosed with severe PE at the time of admission and 24 hr after delivery.

Increased neutrophil numbers account for leukocytosis in women with preeclampsia.

We evaluated the leukocyte differentials in women with normal pregnancies and in pregnancies complicated by preeclampsia (PE). A retrospective study was performed in 240 women who were delivered at Louisiana State University Health Sciences Center-Shreveport, Louisiana, from January 1, 2002, to July 31, 2003. A total of 80 patients were studied in each group: normal pregnancy, mild PE, or severe PE.

Prostacyclin and thromboxane levels in women with severe preeclampsia undergoing magnesium sulfate therapy during antepartum and postpartum periods.

Objective: To study effects of magnesium sulfate (MgSO(4)) on prostacyclin (PGI(2)) and thromboxane A(2) (TXA(2)) levels in women with severe preeclampsia during antepartum and postpartum periods.

Methods: Women with severe preeclampsia were randomized into two groups. Patients in Group A were continuously infused with MgSO(4) for 24 hours postpartum.

Expectant management of preterm premature rupture of membranes and nonvertex presentation: what are the risks?

Objective: Preterm premature rupture of membranes (PPROM) continues to be a major cause of preterm births. The objective of this study was to compare the morbidity of patients with PPROM nonvertex presentations with patients with PPROM with vertex presentations.

Study Design: A retrospective analysis of data from 74 patients with PPROM with nonvertex presentations (study group) and 74 patients with PPROM with vertex presentations (control group) comprised the 2 study groups.

Urolithiasis in pregnancy: Current diagnosis, treatment, and pregnancy complications.

Unlabelled: Urolithiasis complicates up to one in every 200 pregnancies; consequently, the practicing obstetrician should be aware of the symptoms of urolithiasis, the diagnostic procedures available for its diagnosis, and their associated risks. These include ultrasound, urography, and magnetic resonance imaging. Diagnosis of urolithiasis during pregnancy can be a challenge as a result of the normal physiological changes of pregnancy.