Clinical significance of the resistance proteins LRP, Pgp, MRP1, MRP3, and MRP5 in epithelial ovarian cancer.

OBJECTIVE: This study aimed to evaluate the correlation between the expressions of lung resistance protein (LRP), P-glycoprotein (Pgp), multidrug resistance-associated protein (MRP)-1, MRP3, and MRP5 and histopathological parameters and clinical outcome, and to determine the predictive and prognostic value of these transport proteins in patients with ovarian cancer. METHODS: Tumor samples from 111 chemonaive patients with epithelial ovarian cancer who underwent primary surgery from 2006 to 2010 were immunohistochemically stained for LRP, Pgp, MRP1, MRP3, and MRP5 expressions. RESULTS: MRP1 expression was greater among patients with late disease than among patients with early stage ovarian cancer [International Federation of Gynecology and Obstetrics (FIGO) I + II, 71.6% (confidence interval, 60-100); FIGO III + IV, 83.6% (confidence interval, 100-100); P = 0.03]. The histological subtype correlated with the expressions of LRP, Pgp, MRP1, and MRP3. Relapse of disease during the next 24 months occurred more often among patients with higher Pgp and MRP1 than among patients with lower Pgp and MRP1 expressions. FIGO stage, histological type, debulking efficiency, strong Pgp expression, and strong MRP1 expression correlated significantly with shorter progression-free survival (log-rank test, P = 0.001, P = 0.004, P = 0.001, P = 0.051, and P = 0.046, respectively). FIGO stage, histological type, debulking efficiency, and strong MRP1 expression correlated with poor patient survival (log-rank test, P = 0.001, P = 0.042, P = 0.005, and P = 0.018, respectively). CONCLUSIONS: Pgp and MRP1 expressions were clinically significant in patients with ovarian cancer. Pgp and MRP1 may be reliable, independent predictive and prognostic factors regarding the clinical outcome of ovarian cancer. MRP3 is less important as a predictive and prognostic factor than MRP1 expression. MRP5 and LRP expressions were not applicable prognostic parameters regarding ovarian cancer.

Comparative study of various subpopulations of cytotoxic cells in blood and ascites from patients with ovarian carcinoma.

AIM OF THE STUDY: A number of observations have indicated that the immune system plays a significant role in patients with epithelial ovarian cancer (EOC). In cases of EOC, the prognostic significance of tumour infiltrating lymphocytes has not been clearly explained yet. The aim is to determine the phenotype and activation molecules of cytotoxic T cell and NK cell subpopulations and to compare their representation in malignant ascites and peripheral blood in patients with ovarian cancer. MATERIAL AND METHODS: Cytotoxic cells taken from blood samples of the cubital vein and malignant ascites were obtained from 53 patients with EOC. Their surface and activation characteristics were determined by means of a flow cytometer. Immunophenotype multiparametric analysis of peripheral blood lymphocytes (PBLs) and tumour infiltrating lymphocytes (TILs) was carried out. RESULTS: CD3(+) T lymphocytes were the main population of TILs (75.9%) and PBLs (70.9%). The number of activating T cells was significantly higher in TILs: CD3(+)/69(+) 6.7% vs. 0.8% (p < 0.001). The representation of (CD3(-)/16(+)56(+)) NK cells in TILs was significantly higher: 11.0% vs. 5.6% (p = 0.041); likewise CD56(bright) and CD-56(bright) from CD56(+) cells were higher in TILs (both p < 0.001). The activation receptor NKG2D was present in 45.1% of TILs vs. 32.3% of PBLs (p = 0.034), but we did not find a significant difference in the numbers of CD56(+)/NKG2D(+) in TILs and PBLs. CONCLUSIONS: These results prove that the characteristics and intensity of anti-tumour responses are different in compared compartments (ascites/PBLs). The knowledge of phenotype and functions of effector cells is the basic precondition for understanding the anti-tumour immune response.

Lysophosphatidic acid (LPA)­a perspective marker in ovarian cancer.

To compare plasma lysophosphatidic acid (LPA) levels in ovarian cancer patients in women with benign ovarian tumors and in women with no ovarian pathology. We correlated clinico-pathological parameters with plasma LPA levels. Capillary electrophoresis with indirect ultraviolet detection was used to analyze the plasma LPA levels of 159 patients (81 patients with ovarian cancer, 27 women without ovarian or uterine pathologies, and 51 patients with benign ovarian tumors) during a 5-year period. Patients with ovarian cancer had a significantly higher plasma LPA level (n=81; median (med), 11.53 µmol/l; range, 1.78-43.21 µmol/l) compared with controls with no ovarian pathology (n=27; med, 1.86 µmol/l; range, 0.94-9.73 µmol/l), and patients with benign ovarian tumor (n=51; med, 6.17 µmol/l; range, 1.12-25.23 µmol/l; P<0.001). We found that plasma LPA levels were associated with the International Federation of Gynecology and Obstetrics stage. The histological subtype and grade of ovarian cancer did not influence the plasma LPA levels in this study. The plasma LPA level can be a useful marker for ovarian cancer, particularly in the early stages of the disease.

Ultrasound measurements of the transverse diameter of the fetal thymus in uncomplicated singleton pregnancies.

OBJECTIVE: To determine sonographically the transverse diameter of the fetal thymus and present nomogram for the transverse diameter of the fetal thymus in uncomplicated singleton pregnancies between 19 and 38 weeks of gestation. SETTING: Department of Obstetrics and Gynecology, Charles University in Prague, Faculty of Medicine Hradec Kralove, University Hospital Hradec Kralove, Czech Republic. METHODS: A prospective study was performed. The transverse diameter of the fetal thymus was measured by the one experienced examiner in 198 healthy fetuses between 19 and 38 weeks of gestation. RESULTS: The transverse diameters of the fetal thymus were obtained from 183 of the 198 subjects. The regression equation was expressed as a function of gestational age: the transverse diameter of the fetal thymus (mm) = 1.001 × gestational age (week) - 0.932 or 0.143 × day - 1.34. Both the correlation coefficients, r=0.91 for weeks and r=0.92 for days were found to be highly statistically significant (p<0.0001). CONCLUSION: This study presents normative data (mean, 5th and 95th) for the ultrasound measurements of the transverse diameter of the fetal thymus in healthy singleton pregnancies.

Umbilical cord blood concentrations of IL-6, IL-8, and MMP-8 in pregnancy complicated by preterm premature rupture of the membranes and histological chorioamnionitis.

OBJECTIVE: To determine whether umbilical cord blood concentrations of interleukin-6 (IL-6), interleukin-8 (IL-8), and matrix metalloproteinase-8 (MMP-8) are of value in the diagnosis of histological chorioamnionitis (HCA) and funisitis in patients with preterm premature rupture of membranes (PPROM). SETTING: Department of Obstetrics and Gynaecology, Charles University in Prague, Faculty of Medicine Hradec Kralove, University Hospital Hradec Kralove, Czech Republic. METHODS: We compared umbilical cord blood IL-6, IL-8, and MMP-8 concentrations in 83 women with PPROM between 24th and 36th gestational weeks with the presence and the absence of HCA/funisitis using nonparametric tests (Mann-Whitney U test), given the non-normal distribution of analyte. Comparisons of proportions were performed the D'Agostino and Pearson omnibus normality test and the Shapiro-Wilk test. RESULTS: Patients with HCA had a significantly higher median umbilical cord blood IL-6 concentration than patients without histological signs of inflammation (12.0 pg/mL [2.1-138.3] versus 2.7 pg/mL [0.1-12.4]; p=0.004) but did not have significantly higher median umbilical cord IL-8 (29.9 pg/mL [14.0-186.3]; versus 18.9 pg/mL [7.9-89.4]; p=0.13) and MMP-8 (2.9 pg/mL [0.5-25.2] versus 0.5 ng/mL [0.5-7.9]; p=0.18). Patients with HCA and funisitis had a significantly higher median umbilical cord blood IL-6 (222 pg/mL [95.3-411.7] versus 6.1 pg/mL [1.3-18.5]; p<0.0001) and IL-8 (20.9 pg/mL [8.4-37.7] versus 190.7 pg/mL [83.8-554.2]; p=0.0004) concentration than patients with HCA alone. Differences were not found in MMP-8 concentrations (3.7 ng/mL [0.5-21.4] versus 2.4 ng/mL [0.5-88.1]; p=0.7). CONCLUSION: HCA was associated with a significant increase in umbilical cord blood IL-6 concentration. In patients with HCA and funisitis, umbilical cord blood IL-6 and IL-8 were significantly higher than those without histological signs of inflammation.

Prenatal diagnosis of an intertwin membrane hematoma.

We report a case of a 26-year-old woman, gravida 2, para 1, with a dichorionic diamniotic twin pregnancy at 33 weeks of gestation with a 1-day history of mild vaginal bleeding and irregular uterine activity. Ultrasonography showed 18 x 15 x 3-cm-sized complex hypoechoic mass located in the dividing intertwin membrane. Based on this finding, the diagnosis of an intertwin membrane hematoma was made. This unusual sonographic diagnosis was confirmed during the cesarean section. In the case of dichorionic twin pregnancy, partial placental abruption can lead to a subclinical intertwin membrane hematoma.

Value of amniotic fluid interleukin-8 for the prediction of histological chorioamnionitis in preterm premature rupture of membranes.

OBJECTIVE: To determine whether amniotic fluid levels of interleukin-8 (IL-8) are of value in the antenatal diagnosis of acute histological chorioamnionitis (HCA) in preterm premature rupture of membranes (PPROM). SETTING: Department of Obstetrics and Gynaecology, Charles University, Medical School and University Hradec Kralove, Czech Republic. METHODS: We compared amniotic fluid IL-8 levels in twenty-nine pregnant women with preterm premature rupture of membranes between 24th and 36th gestational weeks with presence and absence acute histological chorioamnionitis or/and microbial invasion in the amniotic cavity using nonparametric tests (Mann-Whitney test), given the non-normal distribution of analyte. Comparisons of proportions were performed with Shapiro-Wilk normality test. RESULTS: Patients with HCA had a significantly higher median amniotic fluid IL-8 concentration than patients without the histological signs of chorioamnionitis (1867 pg/mL, 826-5577 versus 1045 pg/mL, 60-4133, p=0.013). Patients with MIAC had a significantly higher median amniotic fluid level than patients without invasion (1888 pg/mL, 519-5577 versus 1225 pg/mL, 60-2766, p= 0.017). Women with HCA and MIAC had a significantly higher median amniotic fluid IL-8 level than women without histological signs of chorioamnionitis and microbial invasion (3117 pg/mL, 826-5577 versus 1468 pg/mL, 394-2766, p=0.034). CONCLUSIONS: HCA or/and MIAC are associated with a significant increase of amniotic fluid interleukin-8 levels. Amniotic fluid IL-8 seems to be a marker of intraamniotic inflammation.

Preterm premature rupture of the membranes and genital mycoplasmas.

OBJECTIVE: The purpose of this study was to evaluate the prevalence of cervical colonization by genital mycoplasmas in patients with preterm premature rupture of the membranes (PPROM). METHOD: We studied 225 women between 24 and 36 weeks of gestation with PPROM. Cervical swabs were obtained for genital mycoplasmas and standard vaginal smears of bacterial culture were performed at the time of patients' admission. In the control group were 225 women with a normal pregnancy. RESULTS: Ureaplasma urealyticum was detected in 68% (152/225) and Mycoplasma hominis was detected in 28% (63/225) of the patients with PPROM between 24 and 36 weeks of gestation and. In the control group Ureaplasma urealyticum was found in 17% (38/225) and Mycoplasma hominis in 15% (35/225) pregnant women. CONCLUSION: Our results provide evidence of an association between cervical colonization with genital mycoplasmas and preterm premature rupture of the membranes.

Relationship of vaginal microflora to PROM, pPROM and the risk of early-onset neonatal sepsis.

BACKGROUND: Infections are among the most frequent causes of premature delivery and premature discharges of amniotic fluid. The vaginal ecosystem significantly contributes to the development of these conditions. Premature rupture of membranes (PROM) and preterm premature rupture of membranes (pPROM) are associated with an increased risk of intra-amniotic infection. The intra-amniotic infection negatively affects perinatal morbidity and mortality of newborns. OBJECTIVES: Finding of relationship of vaginal microflora to PROM, pPROM and the risk of early-onset neonatal sepsis. METHODS: A prospective study was implemented in 152 women with singleton gestations with PROM (n=52) and pPROM (n=47); the control group included 53 women with physiologic pregnancy and delivery at normal term without PROM. In all the women, aerobic cultivations from the vagina and cervix for Chlamydia trachomatis were provided before initiation of antibiotic treatment, the microbial picture of vagina was examined, and the cultivation examination of urine was carried out. The placenta was subjected to histopathologic examination. For the diagnosis of early-onset sepsis, we used concentrations of cytokines IL-6, IL-8, TNF-alpha, and the adhesion molecule, ICAM-1, from the venous umbilical blood taken immediately after delivery and cutting of the umbilical cord. Demonstrated early neonatal sepsis served as a further criterion. RESULTS: The most frequent bacteriologic findings throughout the group were coagulase-negative Staphylococci, Ureaplasma, Candida albicans, and Streptococcus viridans. Women with a diagnosis of urinary tract infection or diabetes mellitus were excluded from the study. We found no statistically significant relationship between a specific bacterial strain and PROM and pPROM. We found a statistically significant association between the risk for intra-amniotic infection and the finding of S. viridans (p<0.001). There was also a statistically significant relationship between the microbiologic picture of the vagina VI and infection risk (p<0.002). CONCLUSIONS: Based on results of the present study, it is clear that the use of cultivation and microscopic findings in the vagina and cervix for the timely diagnosis of the risk of early-onset neonatal sepsis is restricted.

Relationship of amniotic-type placenta inflammation to pPROM, PROM and risk of early onset neonatal sepsis.

BACKGROUND: PROM and pPROM and early onset neonatal sepsis negatively affect the neonatal perinatal mortality and morbidity. OBJECTIVES: The target of the work was to evaluate the relationship between chorioamnionitis, funisitis and PROM, pPROM and the risk of early onset neonatal sepsis. METHODS: We examined 152 samples of the placenta and umbilical cord, histologically and microbiologically, in 53 women without PROM, 52 women with PROM and 47 women with pPROM. RESULTS: We demonstrated a statistically significant relationship of chorioamnionitis and funisitis to the risk of early-onset neonatal sepsis. We demonstrated no relationship between pathological findings in the placenta and PROM or pPROM. CONCLUSIONS: The histological findings of an amniotic-type placentitis can particularly be used for supporting or possibly excluding the diagnosis of early onset neonatal sepsis.

Relationship of IL-6, IL-8, TNF and sICAM-1 levels to PROM, pPROM, and the risk of early-onset neonatal sepsis.

BACKGROUND: Intraamniotic infections negatively affect the mortality and morbidity in parturients and newborns. The prognosis of the disease is associated with a timely diagnosis of these conditions. One of approaches to providing timely information on the risk of the initiation of intra-amniotic infection and early-onset neonatal sepsis is the examination of cytokine levels. OBJECTIVES: The purpose of the work was to evaluate the importance of the cytokines, IL-6, IL-8, and TNF-alpha, and the adhesive molecule, sICAM-1, as risk factors for early-onset neonatal sepsis and intra-amniotic infections. METHODS: In a group of 152 women we sampled the blood from the umbilical cord vein immediately after delivery for the determination of the cytokines IL-6, IL-8 and TNF-alpha, and the adhesive molecule, sICAM-1, in newborns. RESULTS: The sensitivity and specificity results are as follows, respectively: IL-6, 0.800 and 0.972; TNF-alpha, 0.364 and 0.943; IL-8, 0.875 and 0.965; and sICAM-1, 0.833 and 0.952. CONCLUSIONS: For screening purposes, it is suitable to determine levels of IL-8, IL-6, and sICAM-1. For the screening examination, one of the cytokines mentioned is sufficient, i.e., IL-8 or IL-6, or the level of the adhesive molecule, sICAM-1. It is unnecessary to combine these markers.

Soluble Toll-like receptor 1 family members in the amniotic fluid of women with preterm prelabor rupture of the membranes.

OBJECTIVE: To determine soluble Toll-like receptor (sTLR) 1, sTLR2 and sTLR6 concentrations in amniotic fluid (AF) of women with preterm prelabor rupture of membranes (PPROM) and if there is an association with microbial invasion of the amniotic cavity and histological chorioamnionitis (HCA). METHODS: Cross-sectional study was performed. Forty-two women with singleton PPROM pregnancies at a gestational age between 24 + 0 and 36 + 6 weeks were included in the study (twenty-two women with presence of both microbial invasion of the amniotic cavity and HCA, and 20 women without microbial invasion of the amniotic cavity and HCA). Amniocenteses were performed, and the concentrations of sTLRs were determined by sandwich enzyme-linked immunosorbent assays. RESULTS: Women with microbial invasions of the amniotic cavity and HCA (n = 22) had significantly higher median sTLR1, sTLR2 and sTLR6 levels than those without (n = 20). (20.4 ng/mL vs. 0.44 ng/mL; p < 0.0001, 577.6 ng/mL vs. 60.7 ng/mL; p < 0.0001 and 0.44 ng/mL vs. 0.26 ng/mL; p = 0.02, respectively). CONCLUSIONS: Women with microbial invasion of the amniotic cavity and HCA had higher AF sTLR1, 2 and 6 levels.

Intraamniotic inflammatory response to bacteria: analysis of multiple amniotic fluid proteins in women with preterm prelabor rupture of membranes.

OBJECTIVE: To analyse whether intraamniotic inflammation in response to bacteria is different below and above gestational age 32 weeks in pregnancies complicated by preterm prelabor rupture of membranes (PPROM). METHODS: A prospective study was performed, and 115 women with singleton pregnancies complicated by PPROM at gestational ages between 24(0/7) and 36(6/7) weeks were included in the study. Transabdominal amniocenteses were performed. Amniotic fluid was analysed using polymerase chain reactions for genital mycoplasmas and cultured for aerobic and anaerobic bacteria. The concentrations of 26 proteins in the amniotic fluid were determined simultaneously using multiplex technology. RESULTS: Bacteria were found in the amniotic fluid of 43% (49/115) of the women. The women were stratified into two subgroups according to gestational age 32 weeks. The amniotic fluid levels of four (interleukin-6, interleukin-10, CC chemokine ligands 2, and 3) and one specific (CC chemokine ligands 2) proteins were higher in women with the presence of bacteria in the amniotic fluid below and above 32 gestational weeks, respectively. CONCLUSIONS: An intraamniotic inflammatory response to bacteria in pregnancies complicated by PPROM seems to be different below and above 32 weeks of gestation.

Prediction of nutritive intake energy and substrates of Czech pregnant women.

OBJECTIVE: Equations linking nutritional intake of energy and substrates (NIES) to anthropometry during pregnancy are currently unknown. The aim of this longitudinal study was to determine the predictive equations for NIES as an expression of dietary patterns. METHODS: In total, 152 randomly recruited healthy pregnant Czech women (non-smokers, non-users of long-term medications or abusers of alcohol or drugs, normoglycemic, euthyroid, and non-anemic) were divided into two cohorts: group 1 (n = 31) was used for the determination of equations for NIES during pregnancy, and group 2 (n = 121) for cross-validation of these equations. In both study groups, anthropometry was measured and resting energy expenditure obtained by indirect calorimetry after 12 h of fasting during four phases of pregnancy. NIES was evaluated from self-reported dietary intake records over 7 d. RESULTS: Strong relations were found between NIES and anthropometric parameters, especially the difference between pregnancy body weight and ideal body weight. By correlation analysis and linear regression, new predictive equations were derived for NIES during pregnancy using the difference between pregnancy body weight and ideal body weight. A high concordance was observed between values from the predictive equations and the actual assessed values of NIES in group 2. CONCLUSION: The proposed equations for nutritional intake of energy, protein, and fats have a reasonable prediction power during pregnancy in relation to physiologic birth outcome.

Anthropometric measured fat-free mass as essential determinant of resting energy expenditure for pregnant and non-pregnant women.

OBJECTIVE: There is conflicting evidence as to whether anthropometric parameters are related to resting energy expenditure (REE) during pregnancy. The aim of this prospective longitudinal study was to precisely assess a major anthropometric determinant of REE for pregnant and non-pregnant women with verification of its use as a possible predictor. METHODS: One hundred fifty-two randomly recruited, healthy, pregnant Czech women were divided into groups G1 and G2. G1 (n = 31) was used for determination of the association between anthropometric parameters and REE. G2 (n = 121) and a group of non-pregnant women (G0; n = 24) were used for verification that observed relations were suitable for the prediction of REE during pregnancy. The women in the study groups were measured during four periods of pregnancy for REE by indirect calorimetry and anthropometric parameters after 12 h of fasting. RESULTS: Associations were found in all groups between measured REE by indirect calorimetry and anthropometric parameters such as weight, fat mass, fat-free mass (FFM), body surface area, and body mass index (P < 0.0001). The best derived predictor, REE/FFM (29.5 kcal/kg, r = 0.70, P < 0.0001), in group G1 was statistically verified in group G2 and compared with G0. CONCLUSION: Anthropometrically measured FFM with its metabolically active components is an essential determinant of REE in pregnancy. REE/FFM can be used for the prediction of REE in pregnant and non-pregnant woman.

Umbilical cord blood concentration of soluble scavenger receptor for hemoglobin, but not pentraxin 3, is of value for the early postpartum identification of the presence of histological chorioamnionitis.

OBJECTIVE: To determine whether umbilical cord blood concentrations of soluble scavenger receptor for hemoglobin (sCD163) and pentraxin 3 (PTX3) are of value in the early postpartum diagnosis of histological chorioamnionitis in preterm prelabor rupture of membranes (PPROM). METHODS: Eighty-three women with pregnancies complicated by PPROM between 24 and 36 weeks of gestation with (n = 38) and without (n = 45) the presence of histological chorioamnionitis were included in the study. We compared umbilical cord blood sCD163 and PTX3 levels in preterm neonates from PPROM pregnancies with versus without the presence of histological chorioamnionitis using nonparametric test (Mann-Whitney U test). RESULTS: The presence of histological chorioamnionitis was associated with a higher median umbilical cord blood sCD163, but not PTX3 concentration, to compare with the absence of histological chorioamnionitis [sCD163: median 1466 ng/mL, interquartile range (IQR) 1187-1828 vs. 1168 ng/mL, IQR 887-1595; p = 0.01; PTX3: median 3.96 ng/mL, IQR 2.24-6.77 vs. 2.95 ng/mL, IQR 1.74-6.93; p = 0.49]. CONCLUSIONS: HCA is associated with an increase of umbilical cord blood sCD163, but not PTX3 concentration. Umbilical cord blood sCD163 seems to be a postpartum marker of the presence of histological chorioamnionitis.

Amniotic fluid concentrations of soluble scavenger receptor for hemoglobin (sCD163) in pregnancy complicated by preterm premature rupture of the membranes and histologic chorioamnionitis.

OBJECTIVE: To determine changes in the amniotic fluid, soluble form of scavenger receptor for hemoglobin (sCD163) concentrations during advancing gestation, and in patients with preterm premature rupture of membranes (PPROM) complicated by histological chorioamnionitis were studied. METHODS: One hundred and fifty-two women with singleton pregnancies were enrolled. The concentration of sCD163 in amniotic fluid was determined using sandwich enzyme immunoassay technique. RESULTS: Women in the midtrimester had a significantly higher median amniotic fluid sCD163 concentration than those at term not in labor (308 ng/ml vs. 217 ng/ml; p = 0.04). Patients with PPROM and histological chorioamnionitis had a higher median amniotic fluid sCD163 level than those with PPROM without histological chorioamnionitis (885 ng/ml vs. 288 ng/ml; p < 0.0001). CONCLUSIONS: Amniotic fluid sCD163 concentrations decrease with advancing gestation. Amniotic fluid sCD163 concentrations are significantly higher in women with PPROM between 24 and 36 gestational weeks with histological chorioamnionitis than those without histological signs of inflammation.

Pentraxin 3 in amniotic fluid as a marker of intra-amniotic inflammation in women with preterm premature rupture of membranes.

OBJECTIVE: To determine whether amniotic fluid levels of pentraxin 3 (PTX3) are of value in the prenatal diagnosis of acute histological chorioamnionitis in preterm premature rupture of membranes (PPROM). METHODS: Forty pregnant women with PPROM between 24 and 36 weeks of pregnancy without (n=21) and with (n=19) histological chorioamnionitis (PPROM group) and 42 women between 16 and 20 weeks of pregnancy (midtrimester group) were included in the study. We compared amniotic fluid PTX3 levels in the PPROM group with versus without histological chorioamnionitis, and between the PPROM and the midtrimester groups using nonparametric tests (Mann-Whitney test), given the non-normal distribution of the analyte. RESULTS: Patients with histological chorioamnionitis had a significantly higher median amniotic fluid PTX3 concentration than patients without the histological signs of chorioamnionitis (3.69ng/mL [0.51-106.8] versus 0.8ng/mL [0.36-121.0]; P=0.015). Patients in the PPROM group reached a significantly higher median amniotic fluid concentration of PTX3 compared with those in the midtrimester group (1.0ng/mL [0.36-121.0] versus 0.67ng/mL [0.4-2.8]; P=0.007). CONCLUSION: Histological chorioamnionitis is associated with a significant increase of amniotic fluid pentraxin 3 levels. Amniotic fluid pentraxin 3 appears to be a marker of intra-amniotic inflammation.