ABSTRACT
Introducción: el diagnóstico de corioamnionitis se basa en criterios clínicos que no alcanzan una sensibilidad mayor al 60%, y que tienen poca utilidad para predecir el compromiso fetal. El ultrasonido surge como una alternativa útil en el diagnóstico. Al mejorar el diagnóstico con la búsqueda de marcadores ecográficos de infección fetal podemos impactar en la morbimortalidad perinatal al poder intervenir de forma temprana a las gestantes en riesgo de compromiso fetal, especialmente corioamnionitis con curso subclínico. El objetivo de esta revisión es conocer la evidencia que soporta la asociación entre los hallazgos ecográficos del ultrasonido y la presencia de corioamnionitis e infección fetal in utero. Materiales y métodos: se realizó una revisión de la literatura existente en las bases de datos medline, ovid, ebsco, ProQuest, lilacs, SciELO desde enero de 1985 hasta octubre de 2012. Se incluyeron los artículos de revisión e investigaciones originales.Resultados: en las gestantes con parto pretérmino y ruptura prematura de membranas ovulares el acortamiento cervical, la presencia de "sludge", el oligohidramnios y la involución del timo son los marcadores que han mostrado mayor asociación con infección amniótica.Conclusiones: el ultrasonido es una herramienta por considerar en el diagnóstico de infección materna y fetal in utero.
Introduction: A diagnosis of chorioamnionitis is based on clinical criteria which only manage 60% sensitivity and have little usefulness in predicting fetal compromise. Ultrasound emerges as a useful diagnostic alternative. An impact might be made on perinatal morbimortality by improving diagnosis through the search for echographic markers of fetal infection, thereby enabling early intervention in pregnant women at risk of fetal compromise, especially regarding subclinical chorioamnionitis. This review was aimed at providing evidence supporting an association between ultrasounds echographic findings and the presence of chorioamnionitis in in utero (congenital) fetal infection.Materials and methods: A review of the existing literature was made in medline, ovid, ebsco, ProQuest, lilacs and scielo databases from January 1985 to October 2012. Original research and review articles were included. Results: Cervical length shortening, the presence of sludge, oligohydramnios and thymus involution are the markers which have been shown to have the greatest association with intra-amniotic infection.Conclusions: Ultrasound is a tool to be considered when diagnosing in utero maternal and fetal infection.
Subject(s)
Female , Pregnancy , Cervix Uteri , Chorioamnionitis , Fetal Heart , Oligohydramnios , Prenatal Diagnosis , Respiration , Thymus Gland , Ultrasonography , Ultrasonography, DopplerABSTRACT
BACKGROUND: Interleukin-7 receptor (IL-7R) alpha-deficient mice have small numbers of B cells and alpha beta T cells in periphery, they totally lack gamma sigma T cells. In addition, the V-J recombination and transcription of TCRgamma genes is also severely impaired in IL-7Ralpha-deficient mice. Stat5, a signaling molecule of the IL-7R, induces germline transcription in the TCRgamma locus, and promotes V-J recombination and gamma sigma T cell development. However, the roles for IL-7R signaling pathway in thymic or extrathymic gamma sigma T cell development are largely unknown. METHODS: To clarify the role of the IL-7 receptor in proliferation and survival of gamma sigma T cells, we introduced the TCR gamma sigma transgene, Vgamma2/ Vsigma5, into IL-7Ralpha-deficient mice, and investigated the development of gamma sigma T cells. RESULTS: We found that Vgamma2/Vsigma5 transgene restored gamma sigma T cells in the epithelium of the small intestine (IEL) but not in the thymus and the spleen. Further addition of a bcl-2 transgene resulted in partial recovery of gamma sigma T cells in the thymus and the spleen of these mice. CONCLUSION: Taken together, this study revealed that the IL-7Ralpha is indispensable for proliferation and survival mainly in thymic gamma sigma T cell development.
