2019
Fetal Myocardial Function as Assessed by N-Terminal Fragment Brain Natriuretic Protein in Premature Fetuses Exposed to Intra-amniotic Inflammation
Irani RA, Buhimschi CS, Cross SN, Zhao G, Copel JA, Bhandari V, Buhimschi IA, Bahtiyar MO. Fetal Myocardial Function as Assessed by N-Terminal Fragment Brain Natriuretic Protein in Premature Fetuses Exposed to Intra-amniotic Inflammation. American Journal Of Perinatology 2019, 37: 745-753. PMID: 31121635, DOI: 10.1055/s-0039-1688909.Peer-Reviewed Original ResearchMeSH KeywordsAdultAmniocentesisAmniotic FluidBiomarkersChorioamnionitisEchocardiography, DopplerFemaleFetal BloodFetal HeartHumansInfant, NewbornInfant, PrematureInflammationInterleukin-6MaleMass SpectrometryNatriuretic Peptide, BrainPeptide FragmentsPlacentaPregnancyPremature BirthVentricular Function, LeftConceptsIntra-amniotic infection/inflammationBrain natriuretic proteinAmniotic fluidNT-proBNPTei indexNatriuretic proteinVentricular functionFetal exposureCord bloodCord IL-6Intra-amniotic inflammationFetal myocardial functionInfection/inflammationBlood NT-proBNPFetal heart functionNT-proBNP immunoassaysEnzyme-linked immunosorbentGestational agePremature fetusesFetal echocardiogramIL-6Circulatory levelsMyocardial functionHeart functionFetuses
2018
Tenascin-X in amniotic fluid and reproductive tissues of pregnancies complicated by infection and preterm prelabor rupture of membranes†
Rood KM, Buhimschi CS, Zhao G, Oliver EA, Summerfield T, Bahtiyar MO, Buhimschi IA. Tenascin-X in amniotic fluid and reproductive tissues of pregnancies complicated by infection and preterm prelabor rupture of membranes†. Biology Of Reproduction 2018, 100: 773-782. PMID: 30277495, PMCID: PMC6437262, DOI: 10.1093/biolre/ioy216.Peer-Reviewed Original ResearchConceptsIntra-amniotic infection/inflammationPreterm prelabor ruptureFetal membranesAmniotic fluidTNX expressionPrelabor ruptureInfection/inflammationLung maturity testingMembrane statusSpontaneous PPROMPregnancy complicationsNormal outcomeTherapeutic targetGenetic karyotypingReproductive tissuesPPROMMRNA expressionMaturity testingPregnancyWestern blottingMRNA levelsQRT-PCRExtracellular matrix proteinsCervixInflammation
2016
Limiting the Exposure of Select Fetuses to Intrauterine Infection/Inflammation Improves Short-Term Neonatal Outcomes in Preterm Premature Rupture of Membranes
Archabald KL, Buhimschi IA, Bahtiyar MO, Dulay AT, Abdel-Razeq SS, Pettker CM, Lipkind HS, Hardy JT, McCarthy ME, Zhao G, Bhandari V, Buhimschi CS. Limiting the Exposure of Select Fetuses to Intrauterine Infection/Inflammation Improves Short-Term Neonatal Outcomes in Preterm Premature Rupture of Membranes. Fetal Diagnosis And Therapy 2016, 42: 99-110. PMID: 27794570, PMCID: PMC11588317, DOI: 10.1159/000450997.Peer-Reviewed Original ResearchConceptsEarly-onset neonatal sepsisNeonatal outcomesPremature ruptureEarly deliveryIntrauterine infection/inflammationSetting of PPROMAdverse neonatal outcomesAmniotic fluid infectionPreterm premature ruptureShort-term outcomesInfection/inflammationIntra-amniotic infectionTerm neonatal outcomesSelect fetusesAntenatal exposureExpectant managementSingleton newbornsHospital dischargeNeonatal sepsisHaptoglobin-related proteinNewborn's riskFluid infectionGestational ageAdverse outcomesSelect subgroupEvidence for participation of neutrophil gelatinase‐associated lipocalin/matrix metalloproteinase‐9 (NGAL•MMP‐9) complex in the inflammatory response to infection in pregnancies complicated by preterm birth
Rood KM, Buhimschi IA, Rodewald Millen K, Bahtiyar MO, Thung S, Summerfield T, Zhao G, Ackerman W, Shellhaas C, Samuels P, Buhimschi CS. Evidence for participation of neutrophil gelatinase‐associated lipocalin/matrix metalloproteinase‐9 (NGAL•MMP‐9) complex in the inflammatory response to infection in pregnancies complicated by preterm birth. American Journal Of Reproductive Immunology 2016, 76: 108-117. PMID: 27251223, PMCID: PMC4942349, DOI: 10.1111/aji.12523.Peer-Reviewed Original ResearchConceptsIntra-amniotic infection/inflammationNeutrophil gelatinase-associated lipocalinMatrix metalloproteinase-9Preterm birthNGAL mRNA expressionGelatinase-associated lipocalinNormal pregnancy outcomeAmniotic fluid levelsInfection/inflammationPlacental villous trophoblastNGAL levelsPregnancy outcomesInflammatory conditionsInflammatory responseMetalloproteinase-9Villous trophoblastFluid levelsInnate immunityCollagenolytic effectMRNA expressionGelatinolytic activityPregnancyHost-microbe interactionsQRT-PCRAmniochorion
2015
Compartmentalization of acute phase reactants Interleukin-6, C-Reactive Protein and Procalcitonin as biomarkers of intra-amniotic infection and chorioamnionitis
Dulay AT, Buhimschi IA, Zhao G, Bahtiyar MO, Thung SF, Cackovic M, Buhimschi CS. Compartmentalization of acute phase reactants Interleukin-6, C-Reactive Protein and Procalcitonin as biomarkers of intra-amniotic infection and chorioamnionitis. Cytokine 2015, 76: 236-243. PMID: 25957466, PMCID: PMC4824401, DOI: 10.1016/j.cyto.2015.04.014.Peer-Reviewed Original ResearchMeSH KeywordsAdultAmniocentesisAmniotic FluidAsymptomatic InfectionsBiomarkersCalcitoninCalcitonin Gene-Related PeptideChorioamnionitisC-Reactive ProteinFemaleFetal BloodFetal Membranes, Premature RuptureHumansInfant, NewbornInterleukin-6Obstetric Labor, PrematurePlacentaPregnancyPregnancy Complications, InfectiousPremature BirthProtein PrecursorsSystemic Inflammatory Response SyndromeConceptsIntra-amniotic infectionC-reactive proteinSubclinical intra-amniotic infectionIL-6Blood IL-6 levelsBlood IL-6Maternal blood levelsSystemic inflammatory responseIL-6 levelsNon-invasive biomarkersSubgroup of casesChorioamnionitis groupHistological chorioamnionitisInflammatory markersPreterm laborCRP levelsInflammatory biomarkersMaternal serumPlacental pathologyAcute phasePregnant womenBlood levelsSubclinical phaseInterleukin-6Cord bloodAmniotic Fluid Soluble Myeloid Differentiation‐2 (sMD‐2) as Regulator of Intra‐amniotic Inflammation in Infection‐induced Preterm Birth
Dulay AT, Buhimschi CS, Zhao G, Oliver EA, Abdel-Razeq SS, Shook LL, Bahtiyar MO, Buhimschi IA. Amniotic Fluid Soluble Myeloid Differentiation‐2 (sMD‐2) as Regulator of Intra‐amniotic Inflammation in Infection‐induced Preterm Birth. American Journal Of Reproductive Immunology 2015, 73: 507-521. PMID: 25605324, PMCID: PMC4430418, DOI: 10.1111/aji.12362.Peer-Reviewed Original ResearchConceptsMyeloid differentiation 2Preterm birthSMD-2Fetal membranesInflammation-induced preterm birthHuman AFIntra-amniotic inflammatory responseInfection-induced preterm birthIntra-amniotic inflammationIL-6 levelsNormal pregnancy outcomeDifferentiation 2MD-2 mRNATime-dependent fashionPregnancy outcomesImmunohistochemistry findingsTLR4 ligandInflammatory cytokinesInflammatory responseHost responseMRNA expressionLevel of expressionWestern blottingHistological localizationAF samples
2011
Ultrasonographic Evaluation of Myometrial Thickness and Prediction of a Successful External Cephalic Version
Buhimschi CS, Buhimschi IA, Wehrum MJ, Molaskey-Jones S, Sfakianaki AK, Pettker CM, Thung S, Campbell KH, Dulay AT, Funai EF, Bahtiyar MO. Ultrasonographic Evaluation of Myometrial Thickness and Prediction of a Successful External Cephalic Version. Obstetrics And Gynecology 2011, 118: 913-920. PMID: 21934456, DOI: 10.1097/aog.0b013e31822e63fe.Peer-Reviewed Original ResearchConceptsAmniotic fluid indexExternal cephalic versionFundal myometrial thicknessSuccessful external cephalic versionMyometrial thicknessCephalic versionFluid indexHigher amniotic fluid indexAbdominal ultrasonographic scansFetal spine positionConsecutive pregnant womenAbsolute risk reductionBody mass indexExternal cephalic version successStrong independent predictorAbdominal wall thicknessMultivariate regression analysisPlacental thicknessBreech presentationIndependent predictorsFetal weightMass indexPregnant womenUltrasonographic evaluationBirth weightIL-6 Trans-Signaling System in Intra-Amniotic Inflammation, Preterm Birth, and Preterm Premature Rupture of the Membranes
Lee SY, Buhimschi IA, Dulay AT, Ali UA, Zhao G, Abdel-Razeq SS, Bahtiyar MO, Thung SF, Funai EF, Buhimschi CS. IL-6 Trans-Signaling System in Intra-Amniotic Inflammation, Preterm Birth, and Preterm Premature Rupture of the Membranes. The Journal Of Immunology 2011, 186: 3226-3236. PMID: 21282511, PMCID: PMC3800180, DOI: 10.4049/jimmunol.1003587.Peer-Reviewed Original ResearchMeSH KeywordsAdultAmniocentesisAmniotic FluidCytokine Receptor gp130FemaleFetal Membranes, Premature RuptureHumansInfant, NewbornInfant, PrematureInflammation MediatorsInterleukin-6Matrix Metalloproteinase 9Matrix Metalloproteinase InhibitorsPregnancyPregnancy ComplicationsPremature BirthReceptors, Interleukin-6Signal TransductionYoung AdultConceptsIntra-amniotic inflammationSIL-6RIL-6RPremature ruptureIL-6Classic IL-6 signalingAF IL-6RT-PCRPreterm premature ruptureIL-6 signalingMatrix metalloprotease-9Real-time RT-PCRActivation of cellsPhysiologic constituentPreterm laborPreterm birthIL-6 TransGestational ageThird trimesterInflammatory cellsSecond trimesterNormal gestationMetalloprotease-9IL-6 bindsFetal membranes
2010
Interpretation of Amniotic Fluid White Blood Cell Count in “Bloody Tap” Amniocenteses in Women With Symptoms of Preterm Labor
Abdel-Razeq SS, Buhimschi IA, Bahtiyar MO, Rosenberg VA, Dulay AT, Han CS, Werner EF, Thung S, Buhimschi CS. Interpretation of Amniotic Fluid White Blood Cell Count in “Bloody Tap” Amniocenteses in Women With Symptoms of Preterm Labor. Obstetrics And Gynecology 2010, 116: 344-354. PMID: 20664395, PMCID: PMC4142228, DOI: 10.1097/aog.0b013e3181e8fec6.Peer-Reviewed Original ResearchConceptsWhite blood cellsAmniotic fluid white blood cellBlood cell countWBC countAmniotic fluidBloody tapAmniotic fluid white blood cell countCell countAmniotic fluid WBC countRBC/White blood cell countPositive amniotic fluid cultureMaternal WBC countRed blood cell countCells/Number of neutrophilsAbsence of inflammationSetting of inflammationAmniotic fluid culturePositive likelihood ratioAmniotic fluid samplesIntraamniotic inflammationPreterm laborConsecutive womenFluid cultureAcceleration/ejection time ratio in the fetal pulmonary artery predicts fetal lung maturity
Azpurua H, Norwitz ER, Campbell KH, Funai EF, Pettker CM, Kleine M, Bahtiyar MO, Malkus H, Copel JA, Thung SF. Acceleration/ejection time ratio in the fetal pulmonary artery predicts fetal lung maturity. American Journal Of Obstetrics And Gynecology 2010, 203: 40.e1-40.e8. PMID: 20417479, DOI: 10.1016/j.ajog.2010.01.075.Peer-Reviewed Original ResearchConceptsAcceleration time/ejection time ratioEjection time ratioFetal lung maturityLecithin/sphingomyelin ratioFetal pulmonary arteryLung maturitySphingomyelin ratioPulmonary arteryAcceleration/ejection time ratioPulmonary artery blood flowSystolic/diastolic ratioYale-New Haven HospitalAmniotic fluid biomarkersAmniotic fluid lecithin/sphingomyelin ratioArtery blood flowFlow velocity waveformsFlow velocity parametersNew noninvasive techniqueSingleton pregnanciesDiastolic ratioPulsatility indexUltrasound evaluationFluid biomarkersPotential confoundersStudy criteria
2009
Fetal renal artery impedance as assessed by Doppler ultrasound in pregnancies complicated by intraamniotic inflammation and preterm birth
Azpurua H, Dulay AT, Buhimschi IA, Bahtiyar MO, Funai E, Abdel-Razeq SS, Luo G, Bhandari V, Copel JA, Buhimschi CS. Fetal renal artery impedance as assessed by Doppler ultrasound in pregnancies complicated by intraamniotic inflammation and preterm birth. American Journal Of Obstetrics And Gynecology 2009, 200: 203.e1-203.e11. PMID: 19185102, PMCID: PMC3791328, DOI: 10.1016/j.ajog.2008.11.001.Peer-Reviewed Original ResearchConceptsCord blood IL-6End-diastolic blood flowRenal artery pulsatility indexArtery pulsatility indexBlood IL-6Amniotic fluid indexIntraamniotic inflammationResistance indexPulsatility indexPreterm birthIL-6Blood flowSerum blood urea nitrogen levelAF IL-6 levelsInflammation-associated preterm birthRenal artery resistance indexSystolic/diastolic ratioBlood urea nitrogen levelsAge-reference rangeCord blood interleukinRenal vascular bedIL-6 levelsHours of lifeUrea nitrogen levelsBlood interleukin
2008
Fetal Heart Rate Monitoring Patterns in Women with Amniotic Fluid Proteomic Profiles Indicative of Inflammation
Buhimschi C, Abdel-Razeq S, Cackovic M, Pettker C, Dulay A, Bahtiyar M, Zambrano E, Martin R, Norwitz E, Bhandari V, Buhimschi I. Fetal Heart Rate Monitoring Patterns in Women with Amniotic Fluid Proteomic Profiles Indicative of Inflammation. American Journal Of Perinatology 2008, 25: 359-372. PMID: 18512201, PMCID: PMC2724874, DOI: 10.1055/s-2008-1078761.Peer-Reviewed Original ResearchConceptsEarly-onset neonatal sepsisIntra-amniotic inflammationFetal heart rate monitoring patternsHistological chorioamnionitisPreterm birthPredictive valueAcute histological chorioamnionitisFetuses of womenHuman Development criteriaUseful clinical indicatorNegative predictive valuePositive predictive valueMonitoring patternsNeonatal sepsisPremature neonatesGestational ageLaboratory criteriaAntibiotic treatmentClinical indicatorsChild healthSensitive predictorInflammationAdmissionNeonatesInitial evaluationFetal Adrenal Gland Volume and Cortisol/Dehydroepiandrosterone Sulfate Ratio in Inflammation-Associated Preterm Birth
Buhimschi CS, Turan OM, Funai EF, Azpurua H, Bahtiyar MO, Turan S, Zhao G, Dulay A, Bhandari V, Copel JA, Buhimschi IA. Fetal Adrenal Gland Volume and Cortisol/Dehydroepiandrosterone Sulfate Ratio in Inflammation-Associated Preterm Birth. Obstetrics And Gynecology 2008, 111: 715-722. PMID: 18310376, DOI: 10.1097/aog.0b013e3181610294.Peer-Reviewed Original ResearchMeSH KeywordsAdrenal GlandsAdultAmniotic FluidBiomarkersChorioamnionitisDehydroepiandrosterone SulfateFemaleFetal BloodHumansHydrocortisoneInfant, NewbornInfant, PrematureInterleukin-6Organ SizePituitary-Adrenal SystemPregnancyPremature BirthSpectrometry, Mass, Matrix-Assisted Laser Desorption-IonizationUltrasonography, PrenatalConceptsAdrenal gland volumeFetal adrenal gland volumeIntraamniotic inflammationGland volumeInterleukin-6Preterm birthCord blood IL-6 levelsBlood IL-6 levelsCord blood IL-6Blood IL-6IL-6 levelsCortisol/Dehydroepiandrosterone Sulfate RatioPituitary-adrenocortical systemConsecutive singleton fetusesThree-dimensional ultrasonographyAdrenal volumeFetal adaptationGestational ageSteroid exposureFetal cortisolFetal weightSingleton fetusesUterine contractionsAdrenocortical axisDHEA ratioUsing Proteomic Analysis of the Human Amniotic Fluid to Identify Histologic Chorioamnionitis
Buhimschi IA, Zambrano E, Pettker CM, Bahtiyar MO, Paidas M, Rosenberg VA, Thung S, Salafia CM, Buhimschi CS. Using Proteomic Analysis of the Human Amniotic Fluid to Identify Histologic Chorioamnionitis. Obstetrics And Gynecology 2008, 111: 403-412. PMID: 18238979, DOI: 10.1097/aog.0b013e31816102aa.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultAmniocentesisAmniotic FluidBiomarkersBlack or African AmericanChorioamnionitisFemaleHumansInflammationPregnancyPregnancy Complications, InfectiousPregnancy OutcomePrevalenceProteomeProteomicsReproducibility of ResultsSensitivity and SpecificitySeverity of Illness IndexSpectrometry, Mass, Matrix-Assisted Laser Desorption-IonizationWhite PeopleConceptsHistologic chorioamnionitisAmniotic fluidIntra-amniotic inflammationGrade of inflammationAbsence of biomarkersHuman amniotic fluidSurface-enhanced laser desorption ionization timeAfrican American womenPreterm laborSingleton pregnanciesDelivery intervalPlacental pathologyGestational agePremature ruptureSevere inflammationEarly recognitionChorioamnionitisChorionic plateInflammationTherapeutic interventionsProteomic biomarkersCalgranulin CBiomarkersProteomic analysisScores
2007
The receptor for advanced glycation end products (RAGE) system in women with intraamniotic infection and inflammation
Buhimschi IA, Zhao G, Pettker CM, Bahtiyar MO, Magloire LK, Thung S, Fairchild T, Buhimschi CS. The receptor for advanced glycation end products (RAGE) system in women with intraamniotic infection and inflammation. American Journal Of Obstetrics And Gynecology 2007, 196: 181.e1-181.e13. PMID: 17306673, DOI: 10.1016/j.ajog.2006.09.001.Peer-Reviewed Original ResearchConceptsIntra-amniotic infectionPolymerase chain reactionAF cultureAdvanced glycation end productsAmniotic fluid inflammationThird-trimester controlsEarlier gestational agePlacental villous tissueDegree of inflammationAcute histologic chorioamnionitisNegative AF culturePositive AF cultureExtravillous trophoblast cellsGlycation end productsGestational age dependenceReal-time polymerase chain reactionQuantitative real-time polymerase chain reactionHistologic chorioamnionitisIntraamniotic infectionPreterm deliveryInflammatory biomarkersPlacental pathologyGestational ageRAGE systemAcute inflammationProteomic Profiling of the Amniotic Fluid to Detect Inflammation, Infection, and Neonatal Sepsis
Buhimschi CS, Bhandari V, Hamar BD, Bahtiyar MO, Zhao G, Sfakianaki AK, Pettker CM, Magloire L, Funai E, Norwitz ER, Paidas M, Copel JA, Weiner CP, Lockwood CJ, Buhimschi IA. Proteomic Profiling of the Amniotic Fluid to Detect Inflammation, Infection, and Neonatal Sepsis. PLOS Medicine 2007, 4: e18. PMID: 17227133, PMCID: PMC1769412, DOI: 10.1371/journal.pmed.0040018.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultAmniocentesisAmniotic FluidBiomarkersFemaleHumansInflammationMiddle AgedPregnancyPregnancy Complications, InfectiousPregnancy OutcomeProteomeProteomicsReproducibility of ResultsSensitivity and SpecificitySepsisSpectrometry, Mass, Matrix-Assisted Laser Desorption-IonizationConceptsEarly-onset neonatal sepsisAmniotic fluid inflammationIntra-amniotic infectionMR scoreNeonatal sepsisAmniotic fluidHistological chorioamnionitisDelivery intervalNewborn Special Care UnitGram stainEarly-onset sepsisIntra-amniotic inflammationDegree of inflammationSpecial care unitsIntrauterine inflammationPlacental inflammationShorter amniocentesisPreterm deliveryPreterm laborSingleton pregnanciesConsecutive womenPreterm birthCare unitGestational agePremature rupture
2006
A low vaginal “pool” amniotic fluid glucose measurement is a predictive but not a sensitive marker for infection in women with preterm premature rupture of membranes
Buhimschi CS, Sfakianaki AK, Hamar BG, Pettker CM, Bahtiyar MO, Funai E, Norwitz ER, Copel JA, Lockwood CJ, Buhimschi IA. A low vaginal “pool” amniotic fluid glucose measurement is a predictive but not a sensitive marker for infection in women with preterm premature rupture of membranes. American Journal Of Obstetrics And Gynecology 2006, 194: 309-316. PMID: 16458622, DOI: 10.1016/j.ajog.2005.07.070.Peer-Reviewed Original ResearchConceptsIntra-amniotic infectionPreterm premature rupturePredictive valuePremature ruptureGlucose measurementsCohen's kappa measureGlucose levelsGlucose concentrationIntra-amniotic infection/inflammationEnd of enrollmentInfection/inflammationRed blood cell countBlood cell countPositive microbial culturesNegative AF cultureCharacteristic curve analysisNegative microbial culturesNegative predictive valuePositive predictive valueClinical laboratory analysisKappa measureConsecutive womenNoninfected groupTransabdominal amniocentesisSensitive marker