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Are amniotic fluid neutrophils in women with intraamniotic infection and/or inflammation of fetal or maternal origin?
- Source :
- American Journal of Obstetrics & Gynecology; Dec2017, Vol. 217 Issue 6, p693.e1-693.e16, 1p
- Publication Year :
- 2017
-
Abstract
- <bold>Background: </bold>Neutrophils are the most abundant white blood cells found in the amniotic cavity of women with intraamniotic infection and/or inflammation. The current belief is that these neutrophils are of fetal origin. However, abundant neutrophils have been found in the amniotic fluid of women with a severe acute maternal inflammatory response but without a severe fetal inflammatory response in the placenta, suggesting that these innate immune cells can also be of maternal origin or a mixture of both fetal and maternal neutrophils.<bold>Objective: </bold>We sought to investigate the origin of amniotic fluid neutrophils from women with intraamniotic infection and/or inflammation and to correlate these findings with acute histologic maternal and fetal inflammatory responses in the placenta.<bold>Study Design: </bold>Amniotic fluid was collected from 15 women with suspected intraamniotic infection and/or inflammation (positive microbiological cultures and/or interleukin-6 concentrations ≥2.6 ng/mL). Amniotic fluid neutrophils were purified by fluorescence-activated cell sorting, DNA was extracted, and DNA fingerprinting was performed. DNA fingerprinting was also performed in the umbilical cord and maternal blood DNA. Fluorescence in situ hybridization was assayed in women with male neonates. Blinded placental histopathological evaluations were conducted.<bold>Results: </bold>First, DNA fingerprinting revealed that 43% (6/14) of women who underwent a single amniocentesis had mostly fetal neutrophils in the amniotic fluid. Second, DNA fingerprinting showed that 36% (5/14) of the women who underwent a single amniocentesis had predominantly maternal neutrophils in the amniotic fluid. Third, DNA fingerprinting indicated that 21% (3/14) of the women who underwent a single amniocentesis had an evident mixture of fetal and maternal neutrophils in the amniotic fluid. Fourth, DNA fingerprinting revealed that a woman who underwent 2 amniocenteses (patient 15) had fetal neutrophils first, and as infection progressed, abundant maternal neutrophils invaded the amniotic cavity. Fifth, fluorescence in situ hybridization confirmed DNA fingerprinting results by showing that both fetal and maternal neutrophils were present in the amniotic fluid. Sixth, most of the women who had predominantly amniotic fluid neutrophils of fetal origin at the time of collection delivered extremely preterm neonates (71% [5/7]). Seventh, all of the women who had predominantly amniotic fluid neutrophils of maternal origin at the time of collection delivered term or late preterm neonates (100% [6/6]). Eighth, 2 of the women who had an evident mixture of fetal and maternal neutrophils in the amniotic fluid at the time of collection delivered extremely preterm neonates (67% [2/3]), and the third woman delivered a term neonate (33% [1/3]). Finally, most of the women included in this study presented acute maternal and fetal inflammatory responses in the placenta (87% [13/15]).<bold>Conclusion: </bold>Amniotic fluid neutrophils can be either predominantly of fetal or maternal origin, or a mixture of both fetal and maternal origin, in women with intraamniotic infection and/or inflammation. The findings herein provide evidence that both fetal and maternal neutrophils can invade the amniotic cavity, suggesting that both the fetus and the mother participate in the host defense mechanisms against intraamniotic infection. [ABSTRACT FROM AUTHOR]
- Subjects :
- AMNIOTIC liquid
NEUTROPHILS
INFLAMMATION
NATURAL immunity
PREGNANCY complications
FLUORESCENCE in situ hybridization
AMNIOCENTESIS
CYTOKINES
DNA
DNA fingerprinting
FETAL diseases
FLOW cytometry
GESTATIONAL age
PREMATURE infants
INTERLEUKINS
DURATION of pregnancy
CROSS-sectional method
DISEASE progression
LEUKOCYTE count
Subjects
Details
- Language :
- English
- ISSN :
- 00029378
- Volume :
- 217
- Issue :
- 6
- Database :
- Supplemental Index
- Journal :
- American Journal of Obstetrics & Gynecology
- Publication Type :
- Academic Journal
- Accession number :
- 126478981
- Full Text :
- https://doi.org/10.1016/j.ajog.2017.09.013