Thompson et al, Prostaglandin levels after PROM J. Perinat. Med. 20(1992)5-9 Elevation of prostaglandin levels in pregnancies complicated by premature rupture of the membranes Peter J. Thompson 1 , Anne Greenough 1 , Kypros H. Nicolaides 2 , and Andres Lopez- Bernal 3 'Dept of Child Health and 2 Harris Birthright Research Centre for Fetal Medi- cine, King's College Hospital, London, U.K., and 3 Nuffield Dept of Obstetrics and Gynaecology, John Radcliffe Maternity Hospital, Oxford, U.K. 1 Introduction Premature labour and infection are common as- sociations of pregnancies complicated by pre- mature rupture of the membranes (PROM) [2]. Both conditions are associated with elevation of prostaglandin levels. It therefore seems likely that prostaglandin levels may be increased in pregnancies complicated by PROM. It has now become possible to gain access to the fetal cir- culation, during pregnancy and before the onset of labour, by cordocentesis, ultrasound guided puncture of the umbilical cord [13]. The aim of the present study was, by using this technique, to establish if indeed maternal and/or fetal prostaglandin levels were elevated in pregnancies complicated by PROM compared to control pregnancies with intact membranes. 2 Patients Nine maternal and fetal samples were obtained from patients with pregnancies complicated by PROM, the median onset of PROM being 28 weeks (22 —31). All these pregnancies were com- plicated by oligohydramnios and it is our routine policy in cases of second trimester oligohydram- nios to perform fetal blood sampling for kary- otyping [3]. The rationale is that, irrespective of the underlying cause of the oligohydramnios, if the parents wish to continue with the pregnancy, the prolonged hospitalisation and likely delivery by caesarian section necessitate that all steps are taken to exclude fetal abnormalities. Cordocen- tesis was performed in these 9 patients at a Curriculum vitae Dr PETER THOMPSON is an obstetrician in train- ing. At present he is a research fellow supported by the Medical Research Council. His research fo- cuses on factors influenc- ing antenatal lung growth, first trimester di- agnostic procedures and perinatal infection. median of 4 days (range 1 —38) following pre- mature rupture of the membranes and at a me- dian of 29 weeks of gestation (range 25 —32). No patient was in labour at the time of the cordocentesis, delivery occurred at a median of 19 days (range 1—63) after the cordocentesis and at a median gestational age of 33 weeks (range 28 —37). There was no clinical evidence of maternal infection at the time of cordocen- tesis, but subsequently one mother developed a temperature and high white cell count, another mother a urinary trarct infection and a third had a positive blood culture at the time of delivery, all three patients delivered within one week of the cordocentesis. Control maternal and fetal samples were ob- tained from 12 patients at between 22 and 32 weeks of gestation. All had intact membranes and no evidence of infection or preterm labour. 1991 by Walter de Gruyter & Co. Berlin - New York Brought to you by | New York University Bobst Library Technical Services Authenticated Download Date | 6/26/15 2:24 PM