1
|
Gondane P, Kumbhakarn S, Maity P, Kapat K. Recent Advances and Challenges in the Early Diagnosis and Treatment of Preterm Labor. Bioengineering (Basel) 2024; 11:161. [PMID: 38391647 PMCID: PMC10886370 DOI: 10.3390/bioengineering11020161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2023] [Revised: 01/30/2024] [Accepted: 02/04/2024] [Indexed: 02/24/2024] Open
Abstract
Preterm birth (PTB) is the primary cause of neonatal mortality and long-term disabilities. The unknown mechanism behind PTB makes diagnosis difficult, yet early detection is necessary for controlling and averting related consequences. The primary focus of this work is to provide an overview of the known risk factors associated with preterm labor and the conventional and advanced procedures for early detection of PTB, including multi-omics and artificial intelligence/machine learning (AI/ML)- based approaches. It also discusses the principles of detecting various proteomic biomarkers based on lateral flow immunoassay and microfluidic chips, along with the commercially available point-of-care testing (POCT) devices and associated challenges. After briefing the therapeutic and preventive measures of PTB, this review summarizes with an outlook.
Collapse
Affiliation(s)
- Prashil Gondane
- Department of Medical Devices, National Institute of Pharmaceutical Education and Research Kolkata, 168, Maniktala Main Road, Kankurgachi, Kolkata 700054, India
| | - Sakshi Kumbhakarn
- Department of Medical Devices, National Institute of Pharmaceutical Education and Research Kolkata, 168, Maniktala Main Road, Kankurgachi, Kolkata 700054, India
| | - Pritiprasanna Maity
- Department of Regenerative Medicine and Cell Biology, Medical University of South Carolina, Charleston, SC 29425, USA
| | - Kausik Kapat
- Department of Medical Devices, National Institute of Pharmaceutical Education and Research Kolkata, 168, Maniktala Main Road, Kankurgachi, Kolkata 700054, India
| |
Collapse
|
2
|
Najjarzadeha M, Mohammad-Alizadeh-Charandabi S, Abbasalizadeh S, Asghari-Jafarabadi M, Mirghafourvand M. Technology-free predictors of preterm birth in singleton women with threatened preterm labor: a prospective cohort study. BMC Pregnancy Childbirth 2022; 22:826. [PMID: 36348314 PMCID: PMC9641943 DOI: 10.1186/s12884-022-05155-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2022] [Accepted: 10/26/2022] [Indexed: 11/11/2022] Open
Abstract
Background Prediction of preterm birth is still a challenge due to its multiple etiologies. This prospective cohort study aimed to determine the technology-free predictors of preterm birth in singleton women with threatened preterm labor. Methods This prospective cohort study was performed on 371 singleton women with gestational age of 23+ 6 to 36+ 4 weeks hospitalized for threatened preterm labor. The data were collected using a questionnaire including demographic characteristics, medical and maternal history, as well as the Perceived Stress Scale (PSS), the Multidimensional Scale of Perceived Social Support (MSPSS), and the WHO’s questionnaire of Violence against Women (VAW). The participants were followed-up until childbirth. The predictors were determined using multivariate logistic regression. Results Preterm birth occurred in 51% of women. Seven variables were determined as predictors; rupture of membranes [adjusted odds ratio 11.7, 95% confidence interval 5.4 to 25.6], cervical dilation [AOR 4.1, 95% CI 2.0 to 7.0], gravidity ≥6 [AOR 27.4, 95%CI 2.8 to 264.3], psychological violence during pregnancy [AOR 2.0, 95% CI 1.1 to 3.2], medical problems in pregnancy onset [AOR 1.7, 95% CI 1.1 to 2.8], vaginal bleeding/spotting [AOR 2.1, 95% CI 1.2 to 4.0] and woman age ≤ 19 [AOR 2.2, 95% CI 1.1 to 4.5]. The proportion of variance explained by all these factors was 33.6%. Conclusions The technology-free factors seems to have moderate power in preterm birth prediction in singleton pregnant women hospitalized for threatened preterm labor. However, these results are discoveries without verification or validation and need to be confirmed by generalizable studies.
Collapse
|
3
|
Ghafoor S. Current and Emerging Strategies for Prediction and Diagnosis of Prelabour Rupture of the Membranes: A Narrative Review. Malays J Med Sci 2021; 28:5-17. [PMID: 34285641 PMCID: PMC8260062 DOI: 10.21315/mjms2021.28.3.2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Accepted: 10/25/2020] [Indexed: 01/27/2023] Open
Abstract
Prelabour rupture of membranes (PROM) refers to the disruption of foetal membranes before the onset of labour, resulting in the leakage of amniotic fluid. PROM complicates 3% and 8% of preterm and term pregnancies, respectively. Accurate and timely diagnosis is crucial for effective management to prevent adverse maternal- and foetal-outcomes. The diagnosis of equivocal PROM cases with traditional methods often becomes challenging in current obstetrics practice; therefore, various novel biochemical markers have emerged as promising diagnostic tools. This narrative review is sought to review the published data to understand the current and emerging trends in diagnostic modalities in term and preterm pregnancies complicated with PROM and the potential role of various markers for predicting preterm PROM (pPROM) and chorioamnionitis in women with pPROM.
Collapse
Affiliation(s)
- Saadia Ghafoor
- Kakshal Hospital, Kakshal, Peshawar, Khyber Pakhtunkhwa, Pakistan
| |
Collapse
|
4
|
Esin S, Tohma YA, Alay İ, Guden M, Colak E, Demirel N, Bas AY, Serdar Yalvac E, Kandemir O. Comparison of placental α microglobulin-1 protein assay (Amnisure) with speculum examination for the diagnosis of premature preterm rupture of membranes (PPROM): a clinical evaluation. J OBSTET GYNAECOL 2020; 41:703-707. [PMID: 32835549 DOI: 10.1080/01443615.2020.1789949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
In this study, we aimed to compare the clinical outcomes of Premature Preterm Rupture of Membranes (PPROM) cases diagnosed by classical speculum examination and by placental alpha microglobulin-1 protein (PAMG-1) assay. The medical records of all patients with singleton pregnancies that were diagnosed with PPROM were retrospectively reviewed. Singleton pregnancies with PPROM diagnosis that was confirmed either by direct visualisation of amniotic fluid leaking through the cervix or by placental alpha microglobulin-1 protein (PAMG-1) assay if no amniotic fluid leakage was documented were included in the study. Demographics, prenatal and postnatal characteristics were reviewed from the medical charts and were recorded. The study included 138 pregnancies with PPROM; 111 patients in clinical speculum examination group and 27 in PAMG-1 assay group. There were no significant differences in maternal and pregnancy characteristics between the clinical speculum examination and PAMG-1 assay groups. Foetal outcomes were comparable between clinical speculum examination and PAMG-1 assay groups. In the clinical speculum examination group, there were nine (8.1%) chorioamnionitis cases, however, there were no chorioamnionitis cases in the PAMG-1 assay group during the latency period (p = .21).Impact statementWhat is already known on this subject? Placental alpha microglobulin-1 protein assay uses immunochromatography method to detect trace amount of placental alpha microglobulin-1 protein in vaginal fluids and has high sensitivity and specificity for ROM diagnosis. However, to the best of our knowledge, the clinical outcome of ROM cases detected by classical speculum examination and by placental alpha microglobulin-1 protein assay has not been compared in the literature previously.What do the results of this study add? Although statistically insignificant, cases diagnosed by PAMG-1 assay had lower risk of chorioamnionitis during latency period.What are the implications of these findings for clinical practice and/or further research? Whether cases diagnosed by PAMG-1 assay represent a milder form of rupture of membranes than cases diagnosed by classical speculum examination group warrants further research.
Collapse
Affiliation(s)
- Sertac Esin
- Department of Obstetrics and Gynecology, Etlik Zübeyde Hanım Women's Health Teaching and Research Hospital, Ankara, Turkey
| | - Yusuf Aytac Tohma
- Department of Obstetrics and Gynecology, Etlik Zübeyde Hanım Women's Health Teaching and Research Hospital, Ankara, Turkey
| | - İsmail Alay
- Department of Obstetrics and Gynecology, Etlik Zübeyde Hanım Women's Health Teaching and Research Hospital, Ankara, Turkey
| | - Mahmut Guden
- Department of Obstetrics and Gynecology, Etlik Zübeyde Hanım Women's Health Teaching and Research Hospital, Ankara, Turkey
| | - Eser Colak
- Department of Obstetrics and Gynecology, Etlik Zübeyde Hanım Women's Health Teaching and Research Hospital, Ankara, Turkey
| | - Nihal Demirel
- Department of Neoatology, Ankara Yıldırım Beyazıt University, Ankara, Turkey
| | - Ahmet Yagmur Bas
- Department of Neoatology, Ankara Yıldırım Beyazıt University, Ankara, Turkey
| | - Ethem Serdar Yalvac
- Department of Obstetrics and Gynecology, Etlik Zübeyde Hanım Women's Health Teaching and Research Hospital, Ankara, Turkey
| | - Omer Kandemir
- Department of Obstetrics and Gynecology, Etlik Zübeyde Hanım Women's Health Teaching and Research Hospital, Ankara, Turkey
| |
Collapse
|
5
|
Abdelazim IA, Abu-Faza M, Hamed MES, Amer OO, Shikanova S, Zhurabekova G. Prenatal diagnosis of single umbilical artery complicated by intrauterine growth retardation and preterm labor: Case report. J Family Med Prim Care 2019; 8:2151-2154. [PMID: 31334199 PMCID: PMC6618188 DOI: 10.4103/jfmpc.jfmpc_394_19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Fetuses with single umbilical artery (SUA) at great risk of intrauterine growth retardation (IUGR), intrauterine fetal death (IUFD) and prematurity. A 24-years-old woman, 28 weeks’ gestation, presented to the Ahmadi hospital, Kuwait, with history of preterm premature rupture of fetal membranes (PPROM). After exclusion of the PPROM, the ultrasound scan of the studied woman showed; asymmetrical IUGR with SUA. The diagnosis of SUA confirmed by the color flow Doppler. She delivered spontaneously at 36 weeks+2, and a cut section in the umbilical cord done to confirm the diagnosis of SUA. The congenital and chromosomal abnormalities of the studied neonate excluded after normal pelvi-abdominal, brain ultrasound and normal karyotyping (46, xx); respectively. The prenatal diagnosed SUA in the studied cases associated with IUGR, preterm labor (PTL) and small for gestational age (SGA). SUA can be considered a marker of diagnosable congenital fetal malformation (CFM) and aneuploidy.
Collapse
Affiliation(s)
- Ibrahim A Abdelazim
- Department of Obstetrics and Gynecology, Ain Shams University, Cairo, Egypt.,Department of Obstetrics and Gynecology, Ahmadi Hospital, Kuwait Oil Company, Ahmadi, Kuwait
| | - Mohannad Abu-Faza
- Department of Obstetrics and Gynecology, Ahmadi Hospital, Kuwait Oil Company, Ahmadi, Kuwait
| | - Mohamed E S Hamed
- Department of Obstetrics and Gynecology, Ain Shams University, Cairo, Egypt
| | - Osama O Amer
- Department of Obstetrics and Gynecology, Ghamra Military hospital, Cairo, Egypt
| | - Svetlana Shikanova
- Department of Obstetrics and Gynecology No. 1, West Kazakhstan Marat Ospanov Medical University, Aktobe, Kazakhstan
| | - Gulmira Zhurabekova
- Department of Normal and Topographical Anatomy, West Kazakhstan Marat Ospanov Medical University, Aktobe, Kazakhstan
| |
Collapse
|
6
|
Wang Y, Luo H, Che G, Li Y, Gao J, Yang Q, Zhou B, Gao L, Wang T, Liang Y, Zhang L. Placental protein 14 as a potential biomarker for diagnosis of preterm premature rupture of membranes. Mol Med Rep 2018; 18:113-122. [PMID: 29749501 PMCID: PMC6059659 DOI: 10.3892/mmr.2018.8967] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2018] [Accepted: 04/03/2018] [Indexed: 12/14/2022] Open
Abstract
Premature rupture of membranes (PROM) is a common pregnancy complication that frequently results in maternal and perinatal morbidity. The present methods for diagnosing PROM do not satisfy clinical requirements. The present study aimed to examine the proteome profile of amniotic fluid (AF) and maternal plasma, screen unique proteins in AF, and evaluate their diagnostic value for diagnosing PROM. The proteome profiles of AF and maternal plasma were examined via liquid chromatography coupled with tandem mass spectrometry-based proteomic techniques. The protein expression levels of diagnostic candidates in AF, maternal plasma and vaginal fluid were determined by ELISA analysis and Magnetic Luminex® screening assays. The diagnostic value of potential biomarkers was evaluated using receiver operating characteristic curves. A lateral flow assay was developed based on colloidal gold immunochromatography technology. The present study identified 540 unique proteins in AF, 12 of which were chosen for further detection. The present results demonstrated that expression levels of pulmonary surfactant-associated protein B, BPI fold-containing family A member 1, zymogen granule protein 16 homolog B, EGF-containing fibulin-like extracellular matrix protein 1, keratin, type II cytoskeletal 4, keratin, type I cytoskeletal 19, placental protein 14 (PP14), insulin-like growth factor-binding protein 2, mesothelin and serpin family B member 3 were significantly higher in AF compared with in maternal plasma (P<0.01). Furthermore, PP14 was observed to have excellent diagnostic accuracy for preterm PROM (PPROM), with a respective sensitivity and specificity of 100 and 87.5% when the cutoff value was 0.008 µg/ml. The PP14-based lateral flow assay demonstrated a visual detection threshold of 0.008 µg/ml. The results from the present study suggested that PP14 may be a novel potential biomarker for PPROM, and may be developed into a lateral flow assay for bedside application to rapidly diagnose PPROM.
Collapse
Affiliation(s)
- Yanyun Wang
- Laboratory of Molecular Translational Medicine, Center for Translational Medicine, Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, Department of Obstetrics and Gynecology, West China Second University Hospital, Chengdu, Sichuan 610041, P.R. China
| | - Haibo Luo
- Institute of Forensic Medicine, West China School of Basic Sciences and Forensic Medicine, Sichuan University, Chengdu, Sichuan 610041, P.R. China
| | - Guanglu Che
- Laboratory of Molecular Translational Medicine, Center for Translational Medicine, Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, Department of Obstetrics and Gynecology, West China Second University Hospital, Chengdu, Sichuan 610041, P.R. China
| | - Yanqin Li
- Department of Perinatal Healthcare, Shuangliu District Maternal and Child Health Hospital, Chengdu, Sichuan 610200, P.R. China
| | - Jun Gao
- Department of Perinatal Healthcare, Shuangliu District Maternal and Child Health Hospital, Chengdu, Sichuan 610200, P.R. China
| | - Qiongli Yang
- Department of Perinatal Healthcare, Shuangliu District Maternal and Child Health Hospital, Chengdu, Sichuan 610200, P.R. China
| | - Bin Zhou
- Laboratory of Molecular Translational Medicine, Center for Translational Medicine, Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, Department of Obstetrics and Gynecology, West China Second University Hospital, Chengdu, Sichuan 610041, P.R. China
| | - Linbo Gao
- Laboratory of Molecular Translational Medicine, Center for Translational Medicine, Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, Department of Obstetrics and Gynecology, West China Second University Hospital, Chengdu, Sichuan 610041, P.R. China
| | - Tao Wang
- Laboratory of Molecular Translational Medicine, Center for Translational Medicine, Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, Department of Obstetrics and Gynecology, West China Second University Hospital, Chengdu, Sichuan 610041, P.R. China
| | - Yujie Liang
- Department of Perinatal Healthcare, Shuangliu District Maternal and Child Health Hospital, Chengdu, Sichuan 610200, P.R. China
| | - Lin Zhang
- Laboratory of Molecular Translational Medicine, Center for Translational Medicine, Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, Department of Obstetrics and Gynecology, West China Second University Hospital, Chengdu, Sichuan 610041, P.R. China
| |
Collapse
|
7
|
Abdelazim IA. Evaluation of the performance of the insulin-like growth factor-binding protein-1/alpha-fetoprotein test in diagnosing ruptured fetal membranes in pregnant women. J Perinatol 2016; 36:77. [PMID: 26707691 DOI: 10.1038/jp.2015.180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- I A Abdelazim
- Department of Obstetrics and Gynecology, Ain Shams University, Cairo, Egypt.,Ahmadi Hospital, Kuwait Oil Company (KOC), Ahmadi, Kuwait
| |
Collapse
|