Skip to main content
PMC home page
Infectious Diseases in Obstetrics and Gynecology logoLink to Infectious Diseases in Obstetrics and Gynecology
. 1995;3(1):37–44. doi: 10.1155/S1064744995000287

Intrauterine Infection and Preterm Labor

Manju Monga 1,✉, Jorge D Blanco 1
PMCID: PMC2364409  PMID: 18475419

Abstract

Preterm birth remains the leading cause of perinatal mortality and morbidity. Evidence suggests that intrauterine infection plays an important role in the pathogenesis of preterm labor. This article reviews the clinical data supporting this theory and the cellular and biochemical mechanisms by which intrauterine infection may initiate uterine contractions. The clinical and laboratory methods of diagnosing clinical chorioamnionitis and asymptomatic bacterial invasion of the intraamniotic cavity are also reviewed. Finally, the management of clinical chorioamnionitis and asymptomatic microbial invasion of the amniotic fluid and the use of adjunctive antibiotic therapy in the treatment of preterm labor are presented.

Full Text

The Full Text of this article is available as a PDF (777.9 KB).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Amstey M. S., Steadman K. T. Asymptomatic gonorrhea and pregnancy. J Am Vener Dis Assoc. 1976 Sep;3(1):14–16. [PubMed] [Google Scholar]
  2. Arias F., Rodriquez L., Rayne S. C., Kraus F. T. Maternal placental vasculopathy and infection: two distinct subgroups among patients with preterm labor and preterm ruptured membranes. Am J Obstet Gynecol. 1993 Feb;168(2):585–591. doi: 10.1016/0002-9378(93)90499-9. [DOI] [PubMed] [Google Scholar]
  3. Bejar R., Curbelo V., Davis C., Gluck L. Premature labor. II. Bacterial sources of phospholipase. Obstet Gynecol. 1981 Apr;57(4):479–482. [PubMed] [Google Scholar]
  4. Bennett P. R., Rose M. P., Myatt L., Elder M. G. Preterm labor: stimulation of arachidonic acid metabolism in human amnion cells by bacterial products. Am J Obstet Gynecol. 1987 Mar;156(3):649–655. doi: 10.1016/0002-9378(87)90070-6. [DOI] [PubMed] [Google Scholar]
  5. Bobitt J. R., Hayslip C. C., Damato J. D. Amniotic fluid infection as determined by transabdominal amniocentesis in patients with intact membranes in premature labor. Am J Obstet Gynecol. 1981 Aug 15;140(8):947–952. doi: 10.1016/0002-9378(81)90090-9. [DOI] [PubMed] [Google Scholar]
  6. Broekhuizen F. F., Gilman M., Hamilton P. R. Amniocentesis for gram stain and culture in preterm premature rupture of the membranes. Obstet Gynecol. 1985 Sep;66(3):316–321. [PubMed] [Google Scholar]
  7. Casey M. L., Cox S. M., Beutler B., Milewich L., MacDonald P. C. Cachectin/tumor necrosis factor-alpha formation in human decidua. Potential role of cytokines in infection-induced preterm labor. J Clin Invest. 1989 Feb;83(2):430–436. doi: 10.1172/JCI113901. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Copper R. L., Goldenberg R. L., Creasy R. K., DuBard M. B., Davis R. O., Entman S. S., Iams J. D., Cliver S. P. A multicenter study of preterm birth weight and gestational age-specific neonatal mortality. Am J Obstet Gynecol. 1993 Jan;168(1 Pt 1):78–84. doi: 10.1016/s0002-9378(12)90889-3. [DOI] [PubMed] [Google Scholar]
  9. Cotton D. B., Hill L. M., Strassner H. T., Platt L. D., Ledger W. J. Use of amniocentesis in preterm gestation with ruptured membranes. Obstet Gynecol. 1984 Jan;63(1):38–43. [PubMed] [Google Scholar]
  10. Coultrip L. L., Grossman J. H. Evaluation of rapid diagnostic tests in the detection of microbial invasion of the amniotic cavity. Am J Obstet Gynecol. 1992 Nov;167(5):1231–1242. doi: 10.1016/s0002-9378(11)91694-9. [DOI] [PubMed] [Google Scholar]
  11. Daikoku N. H., Kaltreider D. F., Khouzami V. A., Spence M., Johnson J. W. Premature rupture of membranes and spontaneous preterm labor: maternal endometritis risks. Obstet Gynecol. 1982 Jan;59(1):13–20. [PubMed] [Google Scholar]
  12. Dray F., Frydman R. Primary prostaglandins in amniotic fluid in pregnancy and spontaneous labor. Am J Obstet Gynecol. 1976 Sep 1;126(1):13–19. doi: 10.1016/0002-9378(76)90457-9. [DOI] [PubMed] [Google Scholar]
  13. Dudley D. J., Trautman M. S., Araneo B. A., Edwin S. S., Mitchell M. D. Decidual cell biosynthesis of interleukin-6: regulation by inflammatory cytokines. J Clin Endocrinol Metab. 1992 Apr;74(4):884–889. doi: 10.1210/jcem.74.4.1548355. [DOI] [PubMed] [Google Scholar]
  14. Dudley D. J., Trautman M. S., Edwin S. S., Lundin-Schiller S., Mitchell M. D. Biosynthesis of interleukin-6 by cultured human chorion laeve cells: regulation by cytokines. J Clin Endocrinol Metab. 1992 Oct;75(4):1081–1086. doi: 10.1210/jcem.75.4.1400875. [DOI] [PubMed] [Google Scholar]
  15. Duff P., Kopelman J. N. Subclinical intra-amniotic infection in asymptomatic patients with refractory preterm labor. Obstet Gynecol. 1987 May;69(5):756–759. [PubMed] [Google Scholar]
  16. Edwards L. E., Barrada M. I., Hamann A. A., Hakanson E. Y. Gonorrhea in pregnancy. Am J Obstet Gynecol. 1978 Nov 15;132(6):637–641. doi: 10.1016/0002-9378(78)90856-6. [DOI] [PubMed] [Google Scholar]
  17. Egley C. C., Katz V. L., Herbert W. N. Leukocyte esterase: a simple bedside test for the detection of bacterial colonization of amniotic fluid. Am J Obstet Gynecol. 1988 Jul;159(1):120–122. doi: 10.1016/0002-9378(88)90504-2. [DOI] [PubMed] [Google Scholar]
  18. Elliott B., Brunham R. C., Laga M., Piot P., Ndinya-Achola J. O., Maitha G., Cheang M., Plummer F. A. Maternal gonococcal infection as a preventable risk factor for low birth weight. J Infect Dis. 1990 Mar;161(3):531–536. doi: 10.1093/infdis/161.3.531. [DOI] [PubMed] [Google Scholar]
  19. Feinstein S. J., Vintzileos A. M., Lodeiro J. G., Campbell W. A., Weinbaum P. J., Nochimson D. J. Amniocentesis with premature rupture of membranes. Obstet Gynecol. 1986 Aug;68(2):147–152. [PubMed] [Google Scholar]
  20. Garite T. J., Freeman R. K. Chorioamnionitis in the preterm gestation. Obstet Gynecol. 1982 May;59(5):539–545. [PubMed] [Google Scholar]
  21. Garite T. J., Freeman R. K., Linzey E. M., Braly P. The use of amniocentesis in patients with premature rupture of membranes. Obstet Gynecol. 1979 Aug;54(2):226–230. [PubMed] [Google Scholar]
  22. Gauthier D. W., Meyer W. J., Bieniarz A. Correlation of amniotic fluid glucose concentration and intraamniotic infection in patients with preterm labor or premature rupture of membranes. Am J Obstet Gynecol. 1991 Oct;165(4 Pt 1):1105–1110. doi: 10.1016/0002-9378(91)90480-f. [DOI] [PubMed] [Google Scholar]
  23. Gibbs R. S., Blanco J. D., St Clair P. J., Castaneda Y. S. Quantitative bacteriology of amniotic fluid from women with clinical intraamniotic infection at term. J Infect Dis. 1982 Jan;145(1):1–8. doi: 10.1093/infdis/145.1.1. [DOI] [PubMed] [Google Scholar]
  24. Gibbs R. S., Dinsmoor M. J., Newton E. R., Ramamurthy R. S. A randomized trial of intrapartum versus immediate postpartum treatment of women with intra-amniotic infection. Obstet Gynecol. 1988 Dec;72(6):823–828. doi: 10.1097/00006250-198812000-00001. [DOI] [PubMed] [Google Scholar]
  25. Gilstrap L. C., 3rd, Leveno K. J., Cox S. M., Burris J. S., Mashburn M., Rosenfeld C. R. Intrapartum treatment of acute chorioamnionitis: impact on neonatal sepsis. Am J Obstet Gynecol. 1988 Sep;159(3):579–583. doi: 10.1016/s0002-9378(88)80012-7. [DOI] [PubMed] [Google Scholar]
  26. Gonik B., Bottoms S. F., Cotton D. B. Amniotic fluid volume as a risk factor in preterm premature rupture of the membranes. Obstet Gynecol. 1985 Apr;65(4):456–459. [PubMed] [Google Scholar]
  27. Gravett M. G., Hummel D., Eschenbach D. A., Holmes K. K. Preterm labor associated with subclinical amniotic fluid infection and with bacterial vaginosis. Obstet Gynecol. 1986 Feb;67(2):229–237. doi: 10.1097/00006250-198602000-00013. [DOI] [PubMed] [Google Scholar]
  28. Gravett M. G., Nelson H. P., DeRouen T., Critchlow C., Eschenbach D. A., Holmes K. K. Independent associations of bacterial vaginosis and Chlamydia trachomatis infection with adverse pregnancy outcome. JAMA. 1986 Oct 10;256(14):1899–1903. [PubMed] [Google Scholar]
  29. Greig P. C., Ernest J. M., Teot L., Erikson M., Talley R. Amniotic fluid interleukin-6 levels correlate with histologic chorioamnionitis and amniotic fluid cultures in patients in premature labor with intact membranes. Am J Obstet Gynecol. 1993 Oct;169(4):1035–1044. doi: 10.1016/0002-9378(93)90050-s. [DOI] [PubMed] [Google Scholar]
  30. Guzick D. S., Winn K. The association of chorioamnionitis with preterm delivery. Obstet Gynecol. 1985 Jan;65(1):11–16. [PubMed] [Google Scholar]
  31. Hameed C., Tejani N., Verma U. L., Archbald F. Silent chorioamnionitis as a cause of preterm labor refractory to tocolytic therapy. Am J Obstet Gynecol. 1984 Aug 1;149(7):726–730. doi: 10.1016/0002-9378(84)90111-x. [DOI] [PubMed] [Google Scholar]
  32. Handsfield H. H., Hodson W. A., Holmes K. K. Neonatal gonococcal infection. I. Orogastric contamination with Neisseria gonorrhoea. JAMA. 1973 Aug 13;225(7):697–701. doi: 10.1001/jama.225.7.697. [DOI] [PubMed] [Google Scholar]
  33. Harger J. H., Meyer M. P., Amortegui A., Macpherson T. A., Kaplan L., Mueller-Heubach E. Low incidence of positive amnionic fluid cultures in preterm labor at 27-32 weeks in the absence of clinical evidence of chorioamnionitis. Obstet Gynecol. 1991 Feb;77(2):228–234. doi: 10.1097/00006250-199102000-00013. [DOI] [PubMed] [Google Scholar]
  34. Hillier S. L., Martius J., Krohn M., Kiviat N., Holmes K. K., Eschenbach D. A. A case-control study of chorioamnionic infection and histologic chorioamnionitis in prematurity. N Engl J Med. 1988 Oct 13;319(15):972–978. doi: 10.1056/NEJM198810133191503. [DOI] [PubMed] [Google Scholar]
  35. Hillier S. L., Witkin S. S., Krohn M. A., Watts D. H., Kiviat N. B., Eschenbach D. A. The relationship of amniotic fluid cytokines and preterm delivery, amniotic fluid infection, histologic chorioamnionitis, and chorioamnion infection. Obstet Gynecol. 1993 Jun;81(6):941–948. [PubMed] [Google Scholar]
  36. Karim S. M., Devlin J. Prostaglandin content of amniotic fluid during pregnancy and labour. J Obstet Gynaecol Br Commonw. 1967 Apr;74(2):230–234. doi: 10.1111/j.1471-0528.1967.tb14866.x. [DOI] [PubMed] [Google Scholar]
  37. Keirse M. J., Flint A. P., Turnbull A. C. F prostaglandins in amniotic fluid during pregnancy and labour. J Obstet Gynaecol Br Commonw. 1974 Feb;81(2):131–135. doi: 10.1111/j.1471-0528.1974.tb00431.x. [DOI] [PubMed] [Google Scholar]
  38. Keirse M. J., Hicks B. R., Mitchell M. D., Turnbull A. C. Increase of the prostaglandin precursor, arachidonic acid, in amniotic fluid during spontaneous labour. Br J Obstet Gynaecol. 1977 Dec;84(12):937–940. doi: 10.1111/j.1471-0528.1977.tb12524.x. [DOI] [PubMed] [Google Scholar]
  39. Krohn M. A., Hillier S. L., Lee M. L., Rabe L. K., Eschenbach D. A. Vaginal Bacteroides species are associated with an increased rate of preterm delivery among women in preterm labor. J Infect Dis. 1991 Jul;164(1):88–93. doi: 10.1093/infdis/164.1.88. [DOI] [PubMed] [Google Scholar]
  40. Lamont R. F., Anthony F., Myatt L., Booth L., Furr P. M., Taylor-Robinson D. Production of prostaglandin E2 by human amnion in vitro in response to addition of media conditioned by microorganisms associated with chorioamnionitis and preterm labor. Am J Obstet Gynecol. 1990 Mar;162(3):819–825. doi: 10.1016/0002-9378(90)91017-7. [DOI] [PubMed] [Google Scholar]
  41. Leigh J., Garite T. J. Amniocentesis and the management of premature labor. Obstet Gynecol. 1986 Apr;67(4):500–506. [PubMed] [Google Scholar]
  42. Lewis R. B., Schulman J. D. Influence of acetylsalicylic acid, an inhibitor of prostaglandin synthesis, on the duration of human gestation and labour. Lancet. 1973 Nov 24;2(7839):1159–1161. doi: 10.1016/s0140-6736(73)92934-6. [DOI] [PubMed] [Google Scholar]
  43. Lundin-Schiller S., Mitchell M. D. Prostaglandin production by human chorion laeve cells in response to inflammatory mediators. Placenta. 1991 Jul-Aug;12(4):353–363. doi: 10.1016/0143-4004(91)90343-e. [DOI] [PubMed] [Google Scholar]
  44. López Bernal A., Hansell D. J., Khong T. Y., Keeling J. W., Turnbull A. C. Prostaglandin E production by the fetal membranes in unexplained preterm labour and preterm labour associated with chorioamnionitis. Br J Obstet Gynaecol. 1989 Oct;96(10):1133–1139. doi: 10.1111/j.1471-0528.1989.tb03187.x. [DOI] [PubMed] [Google Scholar]
  45. Martius J., Krohn M. A., Hillier S. L., Stamm W. E., Holmes K. K., Eschenbach D. A. Relationships of vaginal Lactobacillus species, cervical Chlamydia trachomatis, and bacterial vaginosis to preterm birth. Obstet Gynecol. 1988 Jan;71(1):89–95. [PubMed] [Google Scholar]
  46. McCracken G. H., Jr, Shinefield H. R. Changes in the pattern of neonatal septicemia and meningitis. Am J Dis Child. 1966 Jul;112(1):33–39. doi: 10.1001/archpedi.1966.02090100069006. [DOI] [PubMed] [Google Scholar]
  47. McDonald H. M., O'Loughlin J. A., Jolley P., Vigneswaran R., McDonald P. J. Vaginal infection and preterm labour. Br J Obstet Gynaecol. 1991 May;98(5):427–435. doi: 10.1111/j.1471-0528.1991.tb10335.x. [DOI] [PubMed] [Google Scholar]
  48. McGregor J. A., French J. I., Reller L. B., Todd J. K., Makowski E. L. Adjunctive erythromycin treatment for idiopathic preterm labor: results of a randomized, double-blinded, placebo-controlled trial. Am J Obstet Gynecol. 1986 Jan;154(1):98–103. doi: 10.1016/0002-9378(86)90401-1. [DOI] [PubMed] [Google Scholar]
  49. McGregor J. A., French J. I., Richter R., Franco-Buff A., Johnson A., Hillier S., Judson F. N., Todd J. K. Antenatal microbiologic and maternal risk factors associated with prematurity. Am J Obstet Gynecol. 1990 Nov;163(5 Pt 1):1465–1473. doi: 10.1016/0002-9378(90)90607-9. [DOI] [PubMed] [Google Scholar]
  50. McGregor J. A., French J. I., Seo K. Adjunctive clindamycin therapy for preterm labor: results of a double-blind, placebo-controlled trial. Am J Obstet Gynecol. 1991 Oct;165(4 Pt 1):867–875. doi: 10.1016/0002-9378(91)90430-y. [DOI] [PubMed] [Google Scholar]
  51. McGregor J. A., Lawellin D., Franco-Buff A., Todd J. K. Phospholipase C activity in microorganisms associated with reproductive tract infection. Am J Obstet Gynecol. 1991 Feb;164(2):682–686. doi: 10.1016/s0002-9378(11)80046-3. [DOI] [PubMed] [Google Scholar]
  52. Miller J. M., Jr, Pupkin M. J., Hill G. B. Bacterial colonization of amniotic fluid from intact fetal membranes. Am J Obstet Gynecol. 1980 Mar 15;136(6):796–804. doi: 10.1016/0002-9378(80)90458-5. [DOI] [PubMed] [Google Scholar]
  53. Minkoff H., Grunebaum A. N., Schwarz R. H., Feldman J., Cummings M., Crombleholme W., Clark L., Pringle G., McCormack W. M. Risk factors for prematurity and premature rupture of membranes: a prospective study of the vaginal flora in pregnancy. Am J Obstet Gynecol. 1984 Dec 15;150(8):965–972. doi: 10.1016/0002-9378(84)90392-2. [DOI] [PubMed] [Google Scholar]
  54. Mitchell M. D., Bibby J., Hicks B. R., Turnbull A. C. Specific production of prostaglandin E by human amnion in vitro. Prostaglandins. 1978 Feb;15(2):377–382. doi: 10.1016/0090-6980(78)90177-6. [DOI] [PubMed] [Google Scholar]
  55. Mitchell M. D., Dudley D. J., Edwin S. S., Schiller S. L. Interleukin-6 stimulates prostaglandin production by human amnion and decidual cells. Eur J Pharmacol. 1991 Jan 3;192(1):189–191. doi: 10.1016/0014-2999(91)90090-d. [DOI] [PubMed] [Google Scholar]
  56. Mitchell M. D., Edwin S., Romero R. J. Prostaglandin biosynthesis by human decidual cells: effects of inflammatory mediators. Prostaglandins Leukot Essent Fatty Acids. 1990 Sep;41(1):35–38. doi: 10.1016/0952-3278(90)90128-8. [DOI] [PubMed] [Google Scholar]
  57. Mitchell M. D., Romero R. J., Avila C., Foster J. T., Edwin S. S. Prostaglandin production by amnion and decidual cells in response to bacterial products. Prostaglandins Leukot Essent Fatty Acids. 1991 Mar;42(3):167–169. doi: 10.1016/0952-3278(91)90152-u. [DOI] [PubMed] [Google Scholar]
  58. Molnár M., Romero R., Hertelendy F. Interleukin-1 and tumor necrosis factor stimulate arachidonic acid release and phospholipid metabolism in human myometrial cells. Am J Obstet Gynecol. 1993 Oct;169(4):825–829. doi: 10.1016/0002-9378(93)90011-7. [DOI] [PubMed] [Google Scholar]
  59. Morales W. J., Angel J. L., O'Brien W. F., Knuppel R. A., Finazzo M. A randomized study of antibiotic therapy in idiopathic preterm labor. Obstet Gynecol. 1988 Dec;72(6):829–833. doi: 10.1097/00006250-198812000-00002. [DOI] [PubMed] [Google Scholar]
  60. Møller M., Thomsen A. C., Borch K., Dinesen K., Zdravkovic M. Rupture of fetal membranes and premature delivery associated with group B streptococci in urine of pregnant women. Lancet. 1984 Jul 14;2(8394):69–70. doi: 10.1016/s0140-6736(84)90242-3. [DOI] [PubMed] [Google Scholar]
  61. Newton E. R., Dinsmoor M. J., Gibbs R. S. A randomized, blinded, placebo-controlled trial of antibiotics in idiopathic preterm labor. Obstet Gynecol. 1989 Oct;74(4):562–566. [PubMed] [Google Scholar]
  62. Novy M. J., Cook M. J., Manaugh L. Indomethacin block of normal onset of parturition in primates. Am J Obstet Gynecol. 1974 Feb 1;118(3):412–416. doi: 10.1016/s0002-9378(16)33801-7. [DOI] [PubMed] [Google Scholar]
  63. Oshiro B. T., Monga M., Blanco J. D. Intra-amniotic infections. Semin Perinatol. 1993 Dec;17(6):420–425. [PubMed] [Google Scholar]
  64. Oshiro B. T., Monga M., Eriksen N. L., Graham J. M., Weisbrodt N. W., Blanco J. D. Endotoxin, interleukin-1 beta, interleukin-6, or tumor necrosis factor-alpha do not acutely stimulate isolated murine myometrial contractile activity. Am J Obstet Gynecol. 1993 Dec;169(6):1424–1427. doi: 10.1016/0002-9378(93)90412-c. [DOI] [PubMed] [Google Scholar]
  65. Robertson P. A., Sniderman S. H., Laros R. K., Jr, Cowan R., Heilbron D., Goldenberg R. L., Iams J. D., Creasy R. K. Neonatal morbidity according to gestational age and birth weight from five tertiary care centers in the United States, 1983 through 1986. Am J Obstet Gynecol. 1992 Jun;166(6 Pt 1):1629–1645. doi: 10.1016/0002-9378(92)91551-k. [DOI] [PubMed] [Google Scholar]
  66. Romero R., Avila C., Santhanam U., Sehgal P. B. Amniotic fluid interleukin 6 in preterm labor. Association with infection. J Clin Invest. 1990 May;85(5):1392–1400. doi: 10.1172/JCI114583. [DOI] [PMC free article] [PubMed] [Google Scholar]
  67. Romero R., Brody D. T., Oyarzun E., Mazor M., Wu Y. K., Hobbins J. C., Durum S. K. Infection and labor. III. Interleukin-1: a signal for the onset of parturition. Am J Obstet Gynecol. 1989 May;160(5 Pt 1):1117–1123. doi: 10.1016/0002-9378(89)90172-5. [DOI] [PubMed] [Google Scholar]
  68. Romero R., Durum S., Dinarello C. A., Oyarzun E., Hobbins J. C., Mitchell M. D. Interleukin-1 stimulates prostaglandin biosynthesis by human amnion. Prostaglandins. 1989 Jan;37(1):13–22. doi: 10.1016/0090-6980(89)90028-2. [DOI] [PubMed] [Google Scholar]
  69. Romero R., Emamian M., Quintero R., Wan M., Hobbins J. C., Mazor M., Edberg S. The value and limitations of the Gram stain examination in the diagnosis of intraamniotic infection. Am J Obstet Gynecol. 1988 Jul;159(1):114–119. doi: 10.1016/0002-9378(88)90503-0. [DOI] [PubMed] [Google Scholar]
  70. Romero R., Emamian M., Wan M., Quintero R., Hobbins J. C., Mitchell M. D. Prostaglandin concentrations in amniotic fluid of women with intra-amniotic infection and preterm labor. Am J Obstet Gynecol. 1987 Dec;157(6):1461–1467. doi: 10.1016/s0002-9378(87)80245-4. [DOI] [PubMed] [Google Scholar]
  71. Romero R., Hobbins J. C., Mitchell M. D. Endotoxin stimulates prostaglandin E2 production by human amnion. Obstet Gynecol. 1988 Feb;71(2):227–228. [PubMed] [Google Scholar]
  72. Romero R., Jimenez C., Lohda A. K., Nores J., Hanaoka S., Avila C., Callahan R., Mazor M., Hobbins J. C., Diamond M. P. Amniotic fluid glucose concentration: a rapid and simple method for the detection of intraamniotic infection in preterm labor. Am J Obstet Gynecol. 1990 Sep;163(3):968–974. doi: 10.1016/0002-9378(90)91106-m. [DOI] [PubMed] [Google Scholar]
  73. Romero R., Kadar N., Hobbins J. C., Duff G. W. Infection and labor: the detection of endotoxin in amniotic fluid. Am J Obstet Gynecol. 1987 Oct;157(4 Pt 1):815–819. doi: 10.1016/s0002-9378(87)80061-3. [DOI] [PubMed] [Google Scholar]
  74. Romero R., Manogue K. R., Mitchell M. D., Wu Y. K., Oyarzun E., Hobbins J. C., Cerami A. Infection and labor. IV. Cachectin-tumor necrosis factor in the amniotic fluid of women with intraamniotic infection and preterm labor. Am J Obstet Gynecol. 1989 Aug;161(2):336–341. doi: 10.1016/0002-9378(89)90515-2. [DOI] [PubMed] [Google Scholar]
  75. Romero R., Mazor M., Brandt F., Sepulveda W., Avila C., Cotton D. B., Dinarello C. A. Interleukin-1 alpha and interleukin-1 beta in preterm and term human parturition. Am J Reprod Immunol. 1992 Apr-May;27(3-4):117–123. doi: 10.1111/j.1600-0897.1992.tb00737.x. [DOI] [PubMed] [Google Scholar]
  76. Romero R., Mazor M., Tartakovsky B. Systemic administration of interleukin-1 induces preterm parturition in mice. Am J Obstet Gynecol. 1991 Oct;165(4 Pt 1):969–971. doi: 10.1016/0002-9378(91)90450-6. [DOI] [PubMed] [Google Scholar]
  77. Romero R., Mazor M., Wu Y. K., Avila C., Oyarzun E., Mitchell M. D. Bacterial endotoxin and tumor necrosis factor stimulate prostaglandin production by human decidua. Prostaglandins Leukot Essent Fatty Acids. 1989 Sep;37(3):183–186. doi: 10.1016/0952-3278(89)90083-5. [DOI] [PubMed] [Google Scholar]
  78. Romero R., Quintero R., Oyarzun E., Wu Y. K., Sabo V., Mazor M., Hobbins J. C. Intraamniotic infection and the onset of labor in preterm premature rupture of the membranes. Am J Obstet Gynecol. 1988 Sep;159(3):661–666. doi: 10.1016/s0002-9378(88)80030-9. [DOI] [PubMed] [Google Scholar]
  79. Romero R., Roslansky P., Oyarzun E., Wan M., Emamian M., Novitsky T. J., Gould M. J., Hobbins J. C. Labor and infection. II. Bacterial endotoxin in amniotic fluid and its relationship to the onset of preterm labor. Am J Obstet Gynecol. 1988 May;158(5):1044–1049. doi: 10.1016/0002-9378(88)90216-5. [DOI] [PubMed] [Google Scholar]
  80. Romero R., Sepulveda W., Mazor M., Brandt F., Cotton D. B., Dinarello C. A., Mitchell M. D. The natural interleukin-1 receptor antagonist in term and preterm parturition. Am J Obstet Gynecol. 1992 Oct;167(4 Pt 1):863–872. doi: 10.1016/s0002-9378(12)80003-2. [DOI] [PubMed] [Google Scholar]
  81. Romero R., Sibai B., Caritis S., Paul R., Depp R., Rosen M., Klebanoff M., Sabo V., Evans J., Thom E. Antibiotic treatment of preterm labor with intact membranes: a multicenter, randomized, double-blinded, placebo-controlled trial. Am J Obstet Gynecol. 1993 Oct;169(4):764–774. doi: 10.1016/0002-9378(93)90003-2. [DOI] [PubMed] [Google Scholar]
  82. Romero R., Sirtori M., Oyarzun E., Avila C., Mazor M., Callahan R., Sabo V., Athanassiadis A. P., Hobbins J. C. Infection and labor. V. Prevalence, microbiology, and clinical significance of intraamniotic infection in women with preterm labor and intact membranes. Am J Obstet Gynecol. 1989 Sep;161(3):817–824. doi: 10.1016/0002-9378(89)90409-2. [DOI] [PubMed] [Google Scholar]
  83. Romero R., Tartakovsky B. The natural interleukin-1 receptor antagonist prevents interleukin-1-induced preterm delivery in mice. Am J Obstet Gynecol. 1992 Oct;167(4 Pt 1):1041–1045. doi: 10.1016/s0002-9378(12)80035-4. [DOI] [PubMed] [Google Scholar]
  84. Romero R., Wu Y. K., Brody D. T., Oyarzun E., Duff G. W., Durum S. K. Human decidua: a source of interleukin-1. Obstet Gynecol. 1989 Jan;73(1):31–34. [PubMed] [Google Scholar]
  85. Romero R., Wu Y. K., Sirtori M., Oyarzun E., Mazor M., Hobbins J. C., Mitchell M. D. Amniotic fluid concentrations of prostaglandin F2 alpha, 13,14-dihydro-15-keto-prostaglandin F2 alpha (PGFM) and 11-deoxy-13,14-dihydro-15-keto-11, 16-cyclo-prostaglandin E2 (PGEM-LL) in preterm labor. Prostaglandins. 1989 Jan;37(1):149–161. doi: 10.1016/0090-6980(89)90038-5. [DOI] [PubMed] [Google Scholar]
  86. Romero R., Yoon B. H., Mazor M., Gomez R., Diamond M. P., Kenney J. S., Ramirez M., Fidel P. L., Sorokin Y., Cotton D. The diagnostic and prognostic value of amniotic fluid white blood cell count, glucose, interleukin-6, and gram stain in patients with preterm labor and intact membranes. Am J Obstet Gynecol. 1993 Oct;169(4):805–816. doi: 10.1016/0002-9378(93)90009-8. [DOI] [PubMed] [Google Scholar]
  87. Romero R., Yoon B. H., Mazor M., Gomez R., Gonzalez R., Diamond M. P., Baumann P., Araneda H., Kenney J. S., Cotton D. B. A comparative study of the diagnostic performance of amniotic fluid glucose, white blood cell count, interleukin-6, and gram stain in the detection of microbial invasion in patients with preterm premature rupture of membranes. Am J Obstet Gynecol. 1993 Oct;169(4):839–851. doi: 10.1016/0002-9378(93)90014-a. [DOI] [PubMed] [Google Scholar]
  88. Seo K., McGregor J. A., French J. I. Preterm birth is associated with increased risk of maternal and neonatal infection. Obstet Gynecol. 1992 Jan;79(1):75–80. [PubMed] [Google Scholar]
  89. Skoll M. A., Moretti M. L., Sibai B. M. The incidence of positive amniotic fluid cultures in patients preterm labor with intact membranes. Am J Obstet Gynecol. 1989 Sep;161(3):813–816. doi: 10.1016/0002-9378(89)90407-9. [DOI] [PubMed] [Google Scholar]
  90. Takahashi K., Imai A., Tamaya T. Preterm labor and bacterial intra-amniotic infection: arachidonic acid liberation by the action of phospholipase A2. Arch Gynecol Obstet. 1988;244(1):1–6. doi: 10.1007/BF00931396. [DOI] [PubMed] [Google Scholar]
  91. TambyRaja R. L., Salmon J. A., Karim S. M., Ratnam S. S. F prostaglandin levels in amniotic fluid in premature labour. Prostaglandins. 1977 Feb;13(2):339–348. doi: 10.1016/0090-6980(77)90013-2. [DOI] [PubMed] [Google Scholar]
  92. Thomsen A. C., Mørup L., Hansen K. B. Antibiotic elimination of group-B streptococci in urine in prevention of preterm labour. Lancet. 1987 Mar 14;1(8533):591–593. doi: 10.1016/s0140-6736(87)90234-0. [DOI] [PubMed] [Google Scholar]
  93. Vintzileos A. M., Campbell W. A., Nochimson D. J., Weinbaum P. J., Escoto D. T., Mirochnick M. H. Qualitative amniotic fluid volume versus amniocentesis in predicting infection in preterm premature rupture of the membranes. Obstet Gynecol. 1986 Apr;67(4):579–583. [PubMed] [Google Scholar]
  94. Wahbeh C. J., Hill G. B., Eden R. D., Gall S. A. Intra-amniotic bacterial colonization in premature labor. Am J Obstet Gynecol. 1984 Mar 15;148(6):739–743. doi: 10.1016/0002-9378(84)90558-1. [DOI] [PubMed] [Google Scholar]
  95. Wallace R. L., Herrick C. N. Amniocentesis in the evaluation of premature labor. Obstet Gynecol. 1981 Apr;57(4):483–486. [PubMed] [Google Scholar]
  96. Watts D. H., Krohn M. A., Hillier S. L., Eschenbach D. A. The association of occult amniotic fluid infection with gestational age and neonatal outcome among women in preterm labor. Obstet Gynecol. 1992 Mar;79(3):351–357. doi: 10.1097/00006250-199203000-00005. [DOI] [PubMed] [Google Scholar]
  97. Weible D. R., Randall H. W., Jr Evaluation of amniotic fluid in preterm labor with intact membranes. J Reprod Med. 1985 Oct;30(10):777–780. [PubMed] [Google Scholar]
  98. Weitz C. M., Ghodgaonkar R. B., Dubin N. H., Niebyl J. R. Prostaglandin F metabolite concentration as a prognostic factor in preterm labor. Obstet Gynecol. 1986 Apr;67(4):496–499. [PubMed] [Google Scholar]
  99. White C. P., Wilkins E. G., Roberts C., Davidson D. C. Premature delivery and group B streptococcal bacteriuria. Lancet. 1984 Sep 8;2(8402):586–586. doi: 10.1016/s0140-6736(84)90811-0. [DOI] [PubMed] [Google Scholar]
  100. Willman E. A., Collins W. P. The metabolism of prostaglandin E2 by tissues from the human uterus and foeto-placental unit. Acta Endocrinol (Copenh) 1978 Mar;87(3):632–642. doi: 10.1530/acta.0.0870632. [DOI] [PubMed] [Google Scholar]
  101. Yoder P. R., Gibbs R. S., Blanco J. D., Castaneda Y. S., St Clair P. J. A prospective, controlled study of maternal and perinatal outcome after intra-amniotic infection at term. Am J Obstet Gynecol. 1983 Mar 15;145(6):695–701. doi: 10.1016/0002-9378(83)90575-6. [DOI] [PubMed] [Google Scholar]
  102. Zlatnik F. J., Cruikshank D. P., Petzold C. R., Galask R. P. Amniocentesis in the identification of inapparent infection in preterm patients with premature rupture of the membranes. J Reprod Med. 1984 Sep;29(9):656–660. [PubMed] [Google Scholar]
  103. Zuckerman H., Reiss U., Rubinstein I. Inhibition of human premature labor by indomethacin. Obstet Gynecol. 1974 Dec;44(6):787–792. [PubMed] [Google Scholar]

Articles from Infectious Diseases in Obstetrics and Gynecology are provided here courtesy of Wiley

RESOURCES