Intrauterine Growth Restriction Is a Direct Consequence of Localized Maternal Uropathogenic Escherichia coli Cystitis

Despite the continually increasing rates of adverse perinatal outcomes across the globe, the molecular mechanisms that underlie adverse perinatal outcomes are not completely understood. Clinical studies report that 10% of pregnant women will experience a urinary tract infection (UTI) and there is an association of UTIs with adverse perinatal outcomes. We introduced bacterial cystitis into successfully outbred female mice at gestational day 14 to follow pregnancy outcomes and immunological responses to determine the mechanisms that underlie UTI-mediated adverse outcomes. Outbred fetuses from mothers experiencing localized cystitis displayed intrauterine growth restriction (20–80%) as early as 48 hours post-infection and throughout the remainder of normal gestation. Robust infiltration of cellular innate immune effectors was observed in the uteroplacental tissue following introduction of UTI despite absence of viable bacteria. The magnitude of serum proinflammatory cytokines is elevated in the maternal serum during UTI. This study demonstrates that a localized infection can dramatically impact the immunological status as well as the function of non-infected distal organs and tissues. This model can be used as a platform to determine the mechanism(s) by which proinflammatory changes occur between non-contiguous genitourinary organ

Fetal acidemia prediction through short-term variation assessed by antepartum computerized cardiotocography in pregnant women with hypertension syndrome

Objective To establish a cut-off value for short-term variation (STV) assessed by computerized cardiotocography (CTG) as a single parameter in the prediction of acidemia at birth.Methods Cross-sectional study performed on 41 single gestations with diagnosis of hypertension syndrome after the 27th week and delivered by elective cesarean. Computerized CTG examinations were 20-min long at most, and were performed up to 24 before delivery. Immediately after delivery, blood samples were collected from the umbilical cord vessels to determine pH. To establish a cut-off value, a receiver operator characteristics (ROC) curve was created with STV as independent variable and umbilical artery pH as dependent variable. Later, sensitivity (S), specificity (E), positive predictive value (PPV), and negative predictive value (NPV) were calculated for the cut-off value obtained.Results A significant correlation was found between STV and acidemia at birth, and STV values <= 5.25 ms were significantly capable of predicting acidemia (pH < 7.20) (S = 57.1%; E = 85.2%; PPV = 66.6%; NPV = 79.3%; P < 0.05).Conclusions STV values of <= 5.25 ms could predict acidemia at birth in pregnant women with hypertension syndrome.Hosp & Maternity Leonor Mendes Barros, State Hlth Dept SES SP, São Paulo, BrazilUniversidade Federal de São Paulo, Dept Obstet, São Paulo, BrazilUniversidade Federal de São Paulo, Dept Obstet, São Paulo, BrazilWeb of Scienc