Purpose: To evaluate the use of wearable sensors for prediction of intraamniotic infection in pregnant women with PPROM.
Materials And Methods: In a prospective proof of principle study, we included 50 patients diagnosed with PPROM at the University Hospital Zurich between November 2017 and May 2020. Patients were instructed to wear a bracelet during the night, which measures physiological parameters including wrist skin temperature, heart rate, heart rate variability, and breathing rate. A two-way repeated measures ANOVA was performed to evaluate the difference over time of both the wearable device measured parameters and standard clinical monitoring values, such as body temperature, pulse, leucocytes, and C-reactive protein, between women with and without intraamniotic infection.
Results: Altogether, 23 patients (46%) were diagnosed with intraamniotic infection. Regarding the physiological parameters measured with the bracelet, we observed a significant difference in breathing rate (19 vs 16 per min, P < .01) and heart rate (72 vs 67 beats per min, P = .03) in women with intraamniotic infection compared to those without during the 3 days prior to birth. In parallel to these changes standard clinical monitoring values were significantly different in the intraamniotic infection group compared to women without infection in the 3 days preceding birth.
Conclusion: Our results suggest that wearable sensors are a promising, noninvasive, patient friendly approach to support the early detection of intraamniotic infection in women with PPROM. However, confirmation of our findings in larger studies is required before implementing this technique in standard clinical management.
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http://dx.doi.org/10.1007/s00404-022-06753-4 | DOI Listing |
ACS Infect Dis
January 2025
Department of Microbiology, Genetics, and Immunology, Michigan State University, East Lansing, Michigan 48824, United States.
Group B (GBS) is a major cause of fetal and neonatal mortality worldwide. Many of the adverse effects of invasive GBS are associated with inflammation; therefore, understanding bacterial factors that promote inflammation is of critical importance. Membrane vesicles (MVs), which are produced by many bacteria, may modulate host inflammatory responses.
View Article and Find Full Text PDFInnate Immun
December 2024
Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.
Background: We aimed to investigate the potential of altered levels of various acute phase proteins (APPs) in the plasma, either used alone or in combination with ultrasound-, clinical-, and conventional blood-based tests, for predicting the risk of intra-amniotic inflammation (IAI), microbial invasion of the amniotic cavity (MIAC), histologic chorioamnionitis (HCA), and funisitis in women with preterm premature rupture of membranes (PPROM).
Methods: A total of 195 consecutive pregnancies involving singleton women with PPROM (at 23 + 0-34 + 0 weeks) who underwent amniocentesis and from whom plasma samples were obtained at amniocentesis were retrospectively included in this study. Amniotic fluid (AF) was cultured to assess the MIAC and analyzed for interleukin (IL)-6 levels to define IAI (AF IL-6 level of ≥2.
Eur J Obstet Gynecol Reprod Biol
December 2024
Maternal-Fetal Medicine Unit, Department of Obstetrics, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain.
Chorioamnionitis is a significant contributor to non-hypoxic fetal compromise, increasing the risk of neonatal encephalopathy and cerebral palsy. This paper highlights the limitations of traditional diagnostic methods for chorioamnionitis, which rely on histopathology, microbiology, and clinical signs, and emphasizes the importance of recognizing the fetal inflammatory response using intrapartum cardiotocography (CTG). By understanding the physiological pathways of inflammation, clinicians can identify characteristic CTG patterns.
View Article and Find Full Text PDFAm J Perinatol
January 2025
Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Duke University, Durham, North Carolina.
Objective: A single-center randomized trial showed improved latency with use of indomethacin and cefazolin (I/C) during and following exam-indicated cerclage (EIC). The same center recently published a pre/post comparison demonstrating similar results. This research aimed to validate the protocol in a different setting.
View Article and Find Full Text PDFJ Matern Fetal Neonatal Med
December 2025
Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden.
Introduction: Intraamniotic infection (IAI) is one of the main possible complications of preterm prelabor rupture of membranes (PPROM) and can lead to severe consequences for the neonate, such as early onset neonatal sepsis (EONS). Available diagnostic tools for IAI have poor diagnostic performance, which may result in both over- and underdiagnoses of IAI. In a search for better diagnostic tools, we have examined short-term variation (STV) in fetal heart rate.
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