Serum and peritoneal fluid concentrations of soluble human leukocyte antigen, tumor necrosis factor alpha and interleukin 10 in patients with selected ovarian pathologies.

BACKGROUND: Although immune system plays a key role in the pathogenesis of both endometriosis and ovarian cancer, its function is different. Therefore, we hypothesized, that selected immune parameters can serve as diagnostic markers of these two conditions. The aim of this study was to compare serum and peritoneal fluid concentrations of sHLA-G, IL-10 and TNF-alpha in women with selected ovarian pathologies: benign serous cysts, endometrioma and malignant tumors. Clinical significance of using them for diagnostic purposes in women with serous ovarian cysts, endometriosis, and ovarian cancer, which in the future may improve the early diagnosis of ovarian diseases. CASE PRESENTATION: The study included women treated surgically for benign serous ovarian cysts, ovarian endometrioma and serous ovarian adenocarcinomas. Peripheral blood and peritoneal fluid samples were obtained intraoperatively. Patients with benign serous cysts, endometrioma and ovarian malignancies did not differ significantly in terms of their serum and peritoneal fluid concentrations of sHLA-G. Ovarian cancer patients presented with significantly higher median serum concentrations of IL-10 and TNF-alpha than other study subjects. Median concentrations of IL-10 and TNF-alpha in peritoneal fluid turned out to be the highest in ovarian cancer patients, followed by women with endometrioma and subjects with benign serous cysts. All these intergroup differences were statistically significant. Irrespective of the group, median concentrations of sHLA-G, IL-10 and TNF-alpha in peritoneal fluid were higher than serum levels of these markers. CONCLUSIONS: Elevated serum and peritoneal fluid concentrations of IL-10 and TNF-alpha distinguish ovarian malignancies and endometriomas from benign serous ovarian cysts. In contrast to endometriosis, ovarian malignancies are characterized by elevated peritoneal fluid concentrations of IL-10 and TNF-alpha, elevated serum concentrations of IL-10 and low serum levels of TNF-alpha. Serum and peritoneal fluid concentrations of sHLA-G have no diagnostic value in differentiating between ovarian malignancies and endometriomas.

Ocular manifestations in a newborn from a pregnancy complicated by an antiphospholipid syndrome--a case report.

The paper presents a case of ophthalmologic manifestations, episcleritis and retinal branch vein thrombosis, in a neonate born to a mother with antiphospholipid syndrome (APS) in the course of systemic lupus erythematosus. Female neonate (birth weight 1150 g, Apgar scores 6, 7 and 7) was born with respiratory distress syndrome, moderate anemia and grades I and II intraventricular hemorrhage. Ophthalmic examination revealed an enormous pre-retinal hemorrhage with accompanying thrombotic changes typical of retinal vein in the fundus of the left eye. Episcleritis was found in the anterior segment of the eye and later confirmed by ultrasound. Laboratory tests showed increased levels of maternal antibodies aCL IgG, antybeta2GP1 IgG and antybeta2GP1 IgM. No ANA, LA and SS-A/SS-B antibodies were detected. Increased concentrations of aCL IgG and a lengthening APTT were observed in newborn blood at first but the parameters normalized by 6 months of age. Our observations allowed us to conclude that early examination of neonates born to mothers with antiphospholipid syndrome is essential as it allows fast identification of pathological retinal changes by means of assessing the presence of aPL antibodies.

Personality traits assessed by the NEO Five-Factor Inventory (NEO-FFI) as part of the perinatal depression screening program.

BACKGROUND: As pre- and postnatal depression is a multifactorial disorder, the screening programmes which are currently in use in obstetric clinics remain problematic due to their inadequate standardization and limited efficacy. The evaluation of core risk factors for perinatal depression in the screening process, in addition to routine questionnaire-based tools such as the Edinburgh Postnatal Depression Scale (EPDS), might improve the diagnosis and early treatment of women affected by depression. This study was undertaken to analyze the relationship between personality traits and the risk of perinatal depression in pregnant and postpartum women. MATERIAL/METHODS: For the study, 229 patients (pregnant and postpartum women) admitted to an obstetric hospital in Poland were recruited. Two self-report questionnaires were used: the Edinburgh Postnatal Depression Scale (EPDS) as a screening tool for depressive symptoms and the NEO Five-Factor Inventory (NEO-FFI) for the evaluation of five personality traits in the studied patients. RESULTS: Neuroticism significantly increased the risk of perinatal depressive symptoms in both pregnant and postpartum women (OR=1.23 and OR=1.11, respectively). Personality traits related to a lower risk of perinatal depression in the group of pregnant women included extraversion, openness to experience, high degree of agreeableness and conscientiousness (OR=0.90, OR=0.92, OR=0.90 and OR=0.91, respectively). However, among at-risk postpartum women no additional factors, except neuroticism, affected the prevalence of depressive symptoms. CONCLUSIONS: Personality trait like neuroticism as measured by the NEO-FFI is associated with a greater risk of perinatal depression. The NEO-FFI is a useful tool, potentially adding significant value to the program of perinatal depression screening.

Successful outcome of pregnancy complicated by Werner's syndrome.

Werner's syndrome is an extremely rare genetic disorder of the autosomal recessive type, characterized by features suggesting premature aging in young adulthood. Because of the concomitant hypogonadism, pregnancy among patients with Werner's syndrome occurs extremely rarely. We present a case of a successful outcome of pregnancy complicated by Werner's syndrome in a 34-year-old primigravida. The reason for early delivery by caesarean section, at 34th week of pregnancy, was exacerbation of coronary symptoms, with early signs of cardiac insufficiency. A healthy female child was born in a good condition, with birth weight of 1950 g.

[Estimation of diagnostic value of the middle cerebral artery peak systolic velocity in prediction of fetal anemia in pregnancies complicated by alloimmunisation]. / Ocena wartosci diagnostycznej oznaczania wskaznika MoM PSV MCA w przewidywaniu niedokrwistosci u plodu w konflikcie serologicznym.

UNLABELLED: The use of the middle cerebral artery peak systolic velocity (PSV) for the noninvasive diagnosis of fetal anemia in pregnancies complicated by alloimmunisation has the potential to reduce the number of invasive procedures. OBJECTIVES: The study was undertaken to determine the detection of fetal anemia by fetal middle cerebral artery peak systolic velocity (MCA PSV). MATERIAL AND METHODS: 31 fetuses with red cell alloimmunisation were evaluated with Doppler ultrasongraphy. On the basis of ROC (AUC) analysis the cutoff point of MoM=1.215 with the highest sensitivity and specificity was established. We examined the relation between MoM=1.215 and neonatal hemoglobin level and the maternal antibody titre in the indirect antiglobulin test. Sensitivity specificity positive and negative value and statistical significance were calculated. CONCLUSIONS: Data reported to date suggest that a threshold of 1.215 multiples of the median can be used to better diagnostic of fetal anemia.

[Birth status and twin birth weight discordance]. / Stan urodzeniowy a rozbieznosc mas urodzeniowych blizniat.

OBJECTIVES: The aim of the research was to estimate the influence of birth weight discordance on birth status of twins. MATERIAL AND METHODS: Material of the research consisted of 560 foetuses derived from successful twin pregnancies. In the analysis the following factors were taken into consideration: birth status, gasometry, and birth weight discordance. RESULTS: The degree of birth weight discordance under 10% was noted in 50% of twin pregnancies (n = 140), discordance of 10%-20% was observed in 30.7% (n = 86), and > 20% - in 19.3% (n = 54). CONCLUSIONS: Birth weight discordance is an important risk factor for fetal and neonatal morbidity which is higher in smaller twins than in larger ones. Along with the degree of birth weight discordance, an increased risk of neonatal complications was observed.

[Cohabitation as a strong predicting factor of perinatal depression]. / Kohabitacja jako silny czynnik predykcyjny depresji okoloporodowej.

OBJECTIVES: The aim of this study was to assess if the marital status, especially cohabitation, of pregnant and postpartum women, has any influence on the incidence of perinatal depression symptoms. MATERIAL AND METHODS: 117 pregnant women (at 32-40 weeks of gestation) and 105 postpartum patients (2-5 days after the delivery) were included in the study. The Edinburgh Postnatal Depression Scale (EPDS) was used as a screening test for symptoms of pre- and postnatal depression. The risk of appearance of depressive symptoms was assessed in three groups of pregnant and postpartum patients - married, unpartnered and cohabitating. RESULTS: By means of the EPDS test, symptoms of perinatal depression were found in 17% of pregnant and 10% of postpartum women. In comparison to married women, the risk of appearance of depressive symptoms in unpartnered pregnant patients was almost 10-times higher (OR=9.34; 95% CI 1.42, 201.77), and several hundred times higher in cohabitating pregnant women (OR=975.86; 95% CI 116.73, 19502.00); the risk of depressive symptoms in postpartum unpartnered women was more than 2 times higher (OR=2.4; 95% CI 0.59, 9.72) and more than 20 times higher in cohabitating postpartum mothers (OR=23.2; 95% CI 5.89, 91.51). CONCLUSIONS: 1. the marital status of pregnant and postpartum women has a substantial influence on the risk of the development of perinatal depressive symptoms; this risk is highly increased in a group of cohabitating women compared to patients remaining in a formal partnership as well as women who live unpartnered, 2. clinical evaluation of women in the perinatal period should include the assessment of their psychosocial status, which can constitute a predicting factor of perinatal depression, 3. pregnant women living in informal partnership should be put under strict psychological surveillance.

[Personality profiles of pregnant and postpartum women with symptoms of perinatal depression: the differences of self image in the sphere of psychological needs]. / Profile osobowosci u kobiet ciezarnych i poloznic z objawami depresji okoloporodowej: róznice obrazu siebie w obszarze potrzeb psychologicznych.

OBJECTIVES: The aim of the following study was to assess personality profiles of pregnant and postpartum women with symptoms of perinatal depression and to estimate the differences in their real and ideal self image in the sphere of psychological needs. MATERIAL AND METHODS: 50 pregnant (between 32-40 weeks of gestation) and 26 postpartum women (2-5 days after the delivery) were recruited for the study. Edinburgh Postnatal Depression Scale (EPDS) was used as a screening test for symptoms of pre- and postnatal depression. Personality profiles were evaluated by means of the Adjective Check List (ACL) with 15 need scales. RESULTS: Postpartum women in comparison to pregnant patients described their self image at a statistically significant higher level as far as the needs for domination, nurturance, affiliation, heterosexuality and exhibition were concerned. No significant differences were observed in these groups of patients in the domain of ideal self image. CONCLUSIONS: 1/ pregnant and postpartum women, suffering from perinatal depressive disturbances, differ in terms of the self-assessment of some of their real psychological needs, but do not differ in terms of the ideal self image; 2/ observed differences between pregnant and postpartum women are basically consistent with the change of the role which is associated with the pregnancy and postpartum period; 3/ a positive change of the real self image, which is connected with the maternal role in the postpartum period, takes place in women irrespectively of their depression; 4/ observed multiple and significant differences between the ideal and real self image in pregnant as well as postpartum women with perinatal depressive disturbances indicate their lack of self-acceptance which requires individualized psychological intervention.

[Ways of coping in stressful situations and anxiety-state or anxiety-trait among women with symptoms of perinatal depression]. / Style radzenia sobie w sytuacjach stresowych a Lek-stan i Lek-cecha u kobiet z objawami depresji okoloporodowej.

OBJECTIVES: The aim of the following study was to establish whether there is any connection between an elevation of anxiety experienced by women during pregnancy or postpartum and their styles of coping with stressful situations, as well as to assess if those factors influence higher risk of incidence of perinatal depressive symptoms. MATERIAL AND METHODS: A total of 229 patients admitted to the Department of Foeto-Maternal Medicine, Pomeranian Medical University, Szczecin in 2006-2007, were recruited for the study. By means of the Edinburgh Postnatal Depression Scale (EPDS), a study group of 76 pregnant and postpartum women with high risk of perinatal depression was assigned, as well as a control group of 153 patients without such risk. The level of anxiety and ways of coping in stressful situations were measured by means of the CISS (Coping Inventory for Stressful Situations) and STAI (State-Trait Anxiety Inventory) questionnaires. RESULTS: It has been shown that specific styles of coping in stressful situations and Anxiety-state or Anxiety-trait have substantial influence on higher risk of perinatal depressive symptoms in women. CONCLUSIONS: 1) The risk of perinatal depressive symptoms is associated with ways of coping with stressful situations or Anxiety-state and Anxiety-trait, 2) the risk of perinatal depression among pregnant women increases with an elevation of emotion-concentrated styles of coping in stressful situations, 3) the risk of perinatal depression among postpartum women increases with an elevation of emotion-concentrated ways of coping in stressful situations and engagement in substitute activities, 4) analysis of undertaken research indicate for suitableness of early diagnosis of specific styles of coping in stressful situations in order to implement proper therapy directed at the reduction of the risk of perinatal depression.

[Intrapartum amnioinfusion in patients with meconium-stained amniotic fluid]. / Amnioinfuzja sródporodowa u pacjentek 2 obecnoscia smólki w plynie owodniowym.

OBJECTIVES: The aim of the study was to evaluate the effect of intrapartum amnioinfusion in the presence of meconium stained amniotic fluid. MATERIAL AND METHODS: 93 women with meconium-stained amniotic fluid were assigned to receive amnioinfusion or no amnioinfusion (128 women). The trials were evaluated for fetal distress syndrome, route of delivery, fetal acidemia, Apgar score at 1 and 5 min., meconium aspiration syndrome, postpartum endometritis and maternal hospital stays. RESULT: Amnioinfusion in cases of meconium-stained fluid did not improve the number of fetal distress symptoms during fetal heart rate monitoring. Amnioinfusion was associated with a significant decrease of neonatal acidemia although it did not improve Apgar score. In our study amnioinfusion was not associated with reduction in the incidence of neonatal outcome and puerperial complications.

[HLA-G alleles and risk of early pregnancy loss]. / Ryzyko niepowodzen wczesnej ciazy w zaleznosci od alleli HLA-G.

INTRODUCTION: To investigate whether HLA-G gene polymorphism is associated with adverse pregnancy outcome, we screened exons 2, 3, 4 of HLA-G gene in 59 women with reproductive failure and 36 fertile women. The HLA-G 10108 allele was more common in the group of examined women than in women from the control group (OR = 5,9; p = 0,09), but this difference was not statistically significant. RESULTS: We conclude that the HLA-G 10108 allele might influence pregnancy outcome in the Polish population, but further studies are needed in this regard.

The analysis of the correlation between extracellular fetal DNA concentration in maternal circulation and severity of preeclampsia.

INTRODUCTION: Increased fetal DNA in maternal plasma has been reported in pregnancies complicated by preeclampsia. Fetal DNA may by liberated from fetal or placental cells during apoptosis. The aim of the study is the estimation of the correlation between clinical and biochemical characteristics of preeclampsia and the concentration of fetal DNA in maternal circulation. MATERIAL AND METHODS: Peripherial blood samples were obtained from women suffering from preeclampsia and healthy pregnant women between 20 and 28 weeks of pregnancy. For analysis of DNA isolated from maternal plasma real time PCR were performed. CONCLUSIONS: 1. Significant increase of fetal DNA concentration in preeclamptic women plasma is associated with severe course of preeclampsia and especially with fetal distress symptoms. 2. The evaluation of number of fetal DNA copies in pregnant women plasma is characterized by high sensitivity but low specificity of this test in regards to preeclampsia with complications such as HELLP syndrome and intrauterine growth retardation (IUGR).

[Association between HLA-DQA1, HLA-DQB1 alleles and risk of early pregnancy loss]. / Zwiazek miedzy allelami HLA-DQA1, HLA-DQB1 a ryzykiem niepowodzenia ciazy.

AIM: The aim of the study is to identify HLA-DQA1, HLA-DQB1 allele and to assess the risk of early pregnancy loss of women, couples with reproductive failure in the first trimester of pregnancy in comparison with fertile women, couples. The study group (B) enrolled 61 couples with reproductive failure and the control group (C) enrolled 20 fertile couples with at least 2 children. METHOD: HLA-DQA1 gene typing was performed using PCR-sequence-specific primer (SSP) on the high resolution level according to established procedure of labeling and using the detection kit (FASTYPE DQASSP Typing, FASTYPE DQA "High Resolution" Typing Sheet) purchased from Bio-Synthesis (USA). RESULTS: In female patient the highest risk quotient was associated with alleles HLA-DQA 01101/0105 OR 7.19 (95% CI 1.18-5.23; p=0.03) and HLA-DQB5 OR 3.67 (95% CI=1.11-12.0; p=0.037). The lowest but statistically significant risk of pregnancy failure in this group was related to allele HLA-DQB6 OR 0.48 (95% CI=0.22-1.04; p=0.087). In patient and control couples the significantly increased risk of pregnancy failure was related to the frequency of HLA-DQB5 allele OR 2.3 (95% CI 1.09-4.82; p=0,035). The lowest risk quotient in the patient couples was associated with HLA-DQ 0302/0303 allele OR 0.44 (95% CI 0.14-1.36; p=ns). SUMMARY: HLA-DQA and HLA-DQB allele might influence pregnancy outcome in the Polish population, but further studies are necessary in this regard.

Antigens HLA-G, sHLA- G and sHLA- class I in reproductive failure.

It can be supposed that relation between HLA-G polymorphism and sHLA-G protein expression are associated with successful embryo implantation and pregnancy maintenance. The aim of the study was the estimation specific differences in expression of sHLA-G and sHLA- class I antigens in women with reproductive failure in comparison with fertile women. The study sample enrolled 80 women, divided into 2 groups. The study group (B) enrolled 60 women with reproductive failure including 20 women with 3 recurrent spontaneous abortions in the first trimester of pregnancy (RSA), 20 women with empty sac (ES) and 20 women with 3 consecutive in-vitro fertilization failures (IVFf). The control group (C) enrolled 20 fertile women with at least 2 children. Soluble HLA- class I antigens (sHLA-I) and soluble HLA-G (sHLA-G) were determined using ELISA test kits from IBio Vendor Labolatory Medicine, Inc. HLA-G allele found in individuals in our study were identified by comparing the obtained bp sequences of exon 2., 3. and 4. with bp sequences of HLA-G antigen published at the Nolan Research Institute website. The highest concentration of sHLA-I is noted among women with HLA-G 10401 allele which differed significantly for the mean sHLA-I concentration calculated for all the remaining alleles (p<0.0001). The most prevalent alleles were: HLA-G 10101, 10102 and 10108 with sHLA-I concentrations among women bearing those alleles significantly lower in comparison to the HLA-G 10401 carriers (p<0.001). Allele 10101 and 10102 was related to the lower significantly plasma sHLA-I concentrations than 10108 allele (p<0.02). Lowest mean sHLA-G values were observed in the IVFf group with significant difference from the remaining groups (p<0.05). To conclude, sHLA-G molecules is associated to certain HLA-G alleles and imply that sHLA-G levels are under genetic control. Low concentration sHLA-G seems to be prognostically important in IVF failure.

Maternal adipose tissue, maternal and cord blood essential fatty acids and their long-chain polyunsaturated derivatives composition after elective caesarean section.

BACKGROUND: The essential fatty acids and their long-chain polyunsaturated derivatives (LC PUFAs) are important for the growth and maturation of the fetal organism. OBJECTIVE: The aim of a study was to assess the profile of the essential fatty acids and their LC PUFAs in the blood and adipose tissue of pregnant women and in the cord blood after elective caesarean section. DESIGN: The study group comprised 36 women and 38 their full-term babies born after elective caesarean section. In maternal adipose tissue, maternal blood (separately in plasma and erythrocytes) and cord blood (separately arterial and venous) composition of the fatty acids in total lipids was estimated with gas chromatography. RESULTS: In the maternal plasma and erythrocytes the weight percent content of linoleic acid and alfalinolenic acid was higher and of LC PUFAs was lower than in plasma and erythrocytes from the umbilical vein with the exception of EPA and DPA. In the maternal subcutaneous adipose tissue the content of alfalinolenic acid was higher and of linoleic acid and of LC PUFAs were lower than in maternal plasma and erythrocytes. There was no significant difference in the weight percent content of estimated acids between the venous and arterial umbilical blood. In the maternal plasma the weight percent content of linoleic acid, alfalinolenic acid and LC PUFAs was lower than in the maternal erythrocytes. CONCLUSION: Differences between maternal and cord blood essential fatty acids and their metabolites indicate that preferential placental transfer of n-6 and n-3 fatty acid metabolites or faster metabolic turnover of linolenic and arachidonic acids in the fetus than in mother is possible.

[Monoamnotic twin pregnancy. Multicenter study]. / Ciaza blizniacza jednoowodniowa. Badanie wieloosrodkowe.

OBJECTIVE: The purpose of this study was to evaluate of perinatal mortality and morbidity of monoamniotic twins. STUDY DESIGN: This was a multicenter retrospective analysis of 26 monoamniotic twin gestations identified between 1985 and 2004 in a 3 perinatal departments. Of these 26 pregnancies, 11 women were admitted electively for inpatient fetal monitoring. Overall mortality rates, the risk of intrauterine fetal death and neonatal mortality and morbidity, pregnancy complications and fetal anomalies were calculated. RESULTS: Monoamniotic twin pregnancies were diagnosed reliably prenatally by ultrasound in 22 women and at delivery in 4 cases. Of the 26 gestations, spontaneous fetal losses before 22 weeks of gestation were 4 cases. The overall loss rate and the perinatal mortality rate were 52% and 19.4%, respectively. Twenty-two women had both twins alive at 24 weeks of gestation; 11 women were admitted electively for inpatient fetal monitoring at 26-27 week of gestation. In this group there were 2 neonatal deaths. No intrauterine fetal death occurred in any hospitalized patient. In our series there were 100% incidence of prematurity, 38,5% of umbilical cord entaglement, 23% of TTTS, 3.6% of TRAP and 9.6% fetal congenital anomalies. CONCLUSION: Monoamniotic twins are at extremly risk of pregnancy complications and fetal loss. These pregnancies can be diagnosed reliably by ultrasound in most cases. Electively admitted women for inpatient fetal monitoring could be improved neonatal survival and decreased perinatal morbidity.

[Anomalies of the tongue in the fetus and neonate]. / Nieprawidlowosci jezyka u plodu i noworodka.

This work reviews the literature on the development of the tongue and its function during fetal life. Research on fetal behavior in general and functioning of structures of the skull, face and neck during fetal life in particular was very difficult, not to say impossible, until the present era of ultrasonography with flow (color Doppler and power Doppler), as well as 3D and 4D imaging. The results of measurements of the tongue, its perimeter, length, and area in normal fetuses and in fetuses with chromosomal aberrations are discussed. Abnormalities of the tongue appear as isolated defects or in association with other genetic abnormalities. Initial ultrasonographic detection of abnormalities of the fetal tongue demands further examination with more sophisticated sonographic methods. Some researchers also advocate karyotyping. Reports are discussed on the function of the tongue, such as protrusion, licking, grooving, sucking, yawning, and swallowing, and the time during pregnancy when these functions appear concurrently with growing complexity of movements of the fetus. These functions of the tongue have been studied in normal fetuses and in those with abnormalities during fetal life, such as Rh immunization and intrauterine growth retardation. Attention should focus on the presence of fetal tumors of the tongue or floor of the oral cavity. Prenatal diagnosis of tumors of the oral cavity and throat enables treatment to be undertaken immediately after birth and during the neonatal period.

[Concentration of the soluble molecule ICAM-1 (sICAM-1) in the amniotic fluid as the marker of the intrauterine infection at pregnant women and at newborns]. / Stezenie rozpuszczalnej molekuly ICAM-1 (sICAM-1) w plynie owodniowym jako wskaznik infekcji wewnatrzmacicznej u ciezarnych i u noworodków.

UNLABELLED: THE AIM of this study was to evaluate the usefulness of determining concentrations of sICAM-1 in amniotic fluid as an indicator of intrauterine infection in pregnant women and infants. MATERIAL AND METHODS: the study was conducted on a group of 60 pregnant women by taking samples of amniotic fluid during delivery. Thirty of the women in the group had normal delivery and 30 had Caesarean section. The women were divided into three subgroups: 1) with (n-30) or without (n-30) symptoms of infection in the infant; with (n-21) or without (n-39) symptoms of intrauterine infection in the pregnant woman; with (n-14) or without (n-23) symptoms of simultaneous infection in both mother and child; with premature termination of pregnancy (n-17) or term delivery (n-43). Concentrations of sICAM-1 were determined by ELISA method using monoclonal antibodies specific for sICAM-1, and the use of Quantikine kit from the firm RD Systems Europe Ltd. Statistical analysis was conducted using the U Mann-Whitney test, chi square and ROC (Receiver Operating Characteristic) curve. LR (likelihood ratio) was also determined. RESULTS: statistically significantly higher concentrations of sICAM were detected in the amniotic fluid of the group of mothers with intrauterine infection, symptoms of simultaneous infection in both mother and child and in the group with premature pregnancy termination - respectively p<0.02; p<0.001; and p<0.0001. ROC analysis, taking into account infection in infants (AUC- 0.623) allowed the determination of a cut off value of sICAM concentration in amniotic fluid of 422 ng/ml. That value is clinically useful for confirming intrauterine origins of symptoms of infection in pregnant women (sensitivity - 52.9%, specificity - 86.8%, LR - 5.03). It might also be useful in predicting infection in infants born of women who showed symptoms of infection before delivery (sensitivity - 72.7%, specificity - 95.7%, LR - 16.73). CONCLUSIONS: 1. Clinical symptoms of intrauterine infection in pregnant women, simultaneous infection in both mother and child and premature pregnancy termination are correlated with significant increase of sICAM concentrations in the amniotic fluid. 2. An increase of sICAM concentration in the amniotic fluid >422 ng/ml allows confirmation of intrauterine origin of infection symptoms in pregnant women and allows the prediction of infection in infants born of women who showed symptoms of infection.