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Browsing by Author "Yeo, Lami"

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Allergy-induced preterm labor after the ingestion of shellfish
(TAYLOR & FRANCIS LTD, 2010) Romero, Roberto; Kusanovic, Juan Pedro; Munoz, Hernan; Gomez, Ricardo; Lamont, Ronald F.; Yeo, Lami
Preterm parturition is a syndrome caused by several mechanisms of disease, including intrauterine infection/inflammation, uteroplacental ischemia, uterine overdistension, cervical disease, maternal/fetal stress, abnormal allogeneic responses, allergic reactions, and unknown insults. An allergic-like mechanism was proposed as a potential etiology for the preterm parturition syndrome, based on the observation that eosinophils were present in the amniotic fluid in a fraction of women with preterm labor and a history of allergy, coupled with the observation that conditioned media from degranulated mast cells (the effector cells of type 1 hypersensitivity) induced contractility of human myometrial strips. This communication describes a case of a pregnant woman who had an allergic reaction and regular uterine contractions after the ingestion of lobster meat, to which she was known to be allergic. Preterm labor subsided after the treatment of antihistamines and steroids. The patient subsequently delivered at term. At follow-up, the child was diagnosed with atopy and asthma, and required frequent use of inhaled corticosteroids and beta-2 adrenergic agents. The immunological basis for preterm labor induced by an allergic-like reaction (hypersensitivity) is reviewed.
Bacteria and endotoxin in meconium-stained amniotic fluid at term : Could intra-amniotic infection cause meconium passage?
(2014) Romero, Roberto; Yoon, Bo Hyun; Chaemsaithong, Piya; Cortez, Joséf; Park, ChanWook; González Pérez, Rogelio Iván; Behnke, Ernesto; Hassan, Sonia, S.; Chaiworapongsa, Tinnakorn,; Yeo, Lami
Characterization of amniotic fluid sludge in preterm and term gestations
(2022) Pedro Kusanovic, Juan; Jung, Eunjung; Romero, Roberto; Green, Pooja Mittal; Nhan-Chang, Chia-Ling; Vaisbuch, Edi; Erez, Offer; Kim, Chong Jai; Goncalves, Luis F.; Espinoza, Jimmy; Mazaki-Tovi, Shali; Chaiworapongsa, Tinnakorn; Diaz-Primera, Ramiro; Yeo, Lami; Suksai, Manaphat; Gotsch, Francesca; Hassan, Sonia S.
Objective To describe the characteristics of amniotic fluid sludge obtained from patients in term and preterm gestations. Methods This cross-sectional study included patients with dense aggregates of particulate matter detected in amniotic fluid, observed with transvaginal sonography. All patients were in labor and had an impending delivery, either preterm or at term. Echogenic material contained within amniotic fluid was retrieved transvaginally by needle amniotomy under direct visualization. The amniotic fluid analysis consisted of a Gram stain, cultures for aerobic/anaerobic bacteria and genital mycoplasmas, and a white blood cell count. Results Twenty-five patients ranging from 18 to 41 weeks of gestation were included in the study. We observed the following: (1) the appearance of amniotic fluid was consistent with pus-like material, vernix, or meconium by naked eye examination; (2) samples collected before 33 weeks of gestation (n = 13) had a pus-like appearance; however, after this gestational age, most of the samples [83% (10/12)] appeared to be consistent with vernix; (3) amniotic fluid cultures were positive for microorganisms in 13 patients, of which 10 were preterm gestations before 33 weeks; (4) the most frequent microorganisms retrieved by culture were genital mycoplasmas (Ureaplasma urealyticum [46% (6/13)]), followed by Mycoplasma hominis [31% (4/13)] and Candida albicans [15% (2/13)]; and (5) patients with sonographic particulate matter in preterm gestations frequently presented acute histologic chorioamnionitis and funisitis, but these conditions were rare in patients at term. Conclusion The nature of amniotic fluid particulate material varies as a function of gestational age. The material obtained in preterm gestations is frequently related to an inflammatory process, while that obtained at term is often consistent with vernix and appears to represent a maturational process.
Characterization of the Fetal Blood Transcriptome and Proteome in Maternal Anti-Fetal Rejection: Evidence of a Distinct and Novel Type of Human Fetal Systemic Inflammatory Response
(2013) Lee, JoonHo; Romero, Roberto; Chaiworapongsa, Tinnakorn; Dong, Zhong; Tarca, Adi L.; Xu, Yu; Chiang, Po Jen; Kusanovic, Juan Pedro; Hassan, Sonia S.; Yeo, Lami; Yoon, Bo Hyun; Than, Nandor Gabor; Kim, Chong Jai
Clinical chorioamnionitis at term II: The intra-amniotic inflammatory response
(2016) Romero, Roberto; Chaemsaithong, Piya; Korzeniewski, Steven J.; Tarca, Adi L.; Bhatti, Gaurav; Xu, Zhonghui; Kusanovic, Juan Pedro; Dong, Zhong; Docheva, Nikolina; Martínez Varea, Alicia; Yoon, Bo Hyun; Hassan, Sonia S.; Chaiworapongsa, Tinnakorn; Yeo, Lami
Objective: Recent studies indicate that clinical chorioamnionitis is a heterogeneous condition and only approximately one-half of the patients have bacteria in the amniotic cavity, which is often associated with intra-amniotic inflammation. The objective of this study is to characterize the nature of the inflammatory response within the amniotic cavity in patients with clinical chorioamnionitis at term according to the presence or absence of 1) bacteria in the amniotic cavity and 2) intra-amniotic inflammation. Materials and methods: A retrospective cross-sectional case-control study was conducted to examine cytokine and chemokine concentrations in the amniotic fluid (AF). Cases consisted of women with clinical chorioamnionitis at term (n=45). Controls were women with uncomplicated pregnancies at term who did not have intra-amniotic inflammation and were in labor (n=24). Women with clinical chorioamnionitis were classified according to the results of AF cultures, broad-range polymerase chain reaction coupled with electrospray ionization mass spectrometry, and AF concentration of interleukin-6 (IL-6) into those: 1) without intra-amniotic inflammation, 2) with microbial-associated intra-amniotic inflammation, and 3) with intra-amniotic inflammation without detectable bacteria. The AF concentrations of 29 cytokines/chemokines were determined using sensitive and specific V-PLEX immunoassays. Results: 1) The AF concentrations of pro- and anti-inflammatory cytokines/chemokines such as interferon gamma (IFN-γ), tumor necrosis factor alpha (TNF-α), interleukin-4 (IL-4), macrophage inflammatory protein-1 beta (MIP-1β), and interleukin-8 (IL-8) (except Eotaxin-3) were significantly higher in women with clinical chorioamnionitis at term than in controls (term labor without intra-amniotic inflammation); 2) patients with microbial-associated intra-amniotic inflammation, and those with intra-amniotic inflammation without detectable bacteria, had a dramatic differential expression of cytokines and chemokines in AF compared to patients with spontaneous labor without intra-amniotic inflammation. However, no difference could be detected in the pattern of the intra-amniotic inflammatory response between patients with intra-amniotic inflammation with and without detectable bacteria; and 3) in patients with clinical chorioamnionitis at term but without intra-amniotic inflammation, the behavior of cytokines and chemokines in the AF was similar to those in spontaneous labor at term. Conclusions: Patients with clinical chorioamnionitis who had microbial-associated intra-amniotic inflammation or intra-amniotic inflammation without detectable bacteria had a dramatic upregulation of the intra-amniotic inflammatory response assessed by amniotic fluid concentrations of cytokines. A subset of patients with term clinical chorioamnionitis does not have intra-amniotic infection/inflammation, as demonstrated by elevated AF concentrations of inflammation-related proteins, when compared to women in term labor with uncomplicated pregnancies, suggesting over-diagnosis. These observations constitute the first characterization of the cytokine/chemokine network in the amniotic cavity of patients with clinical chorioamnionitis at term.
Clinical chorioamnionitis at term VIII: a rapid MMP-8 test for the identification of intra-amniotic inflammation
(2017) Chaiyasit, Noppadol; Romero, Roberto; Chaemsaithong, Piya; Docheva, Nikolina; Bhatti, Gaurav; Kusanovic, Juan Pedro; Dong, Zhong; Yeo, Lami; Pacora, Percy; Hassan,Sonia S.; Erez, Offer
Clinical chorioamnionitis at term X: microbiology, clinical signs, placental pathology, and neonatal bacteremia implications for clinical care
(2021) Romero, Roberto; Pacora, Percy; Kusanovic, Juan Pedro; Jung, Eunjung; Panaitescu, Bogdan; Maymon, Eli; Erez, Offer; Berman, Susan; Bryant, David R.; Gomez-Lopez, Nardhy; Theis, Kevin R.; Bhatti, Gaurav; Kim, Chong Jai; Yoon, Bo Hyun; Hassan, Sonia S.; Hsu, Chaur-Dong; Yeo, Lami; Diaz-Primera, Ramiro; Marin-Concha, Julio; Lannaman, Kia; Alhousseini, Ali; Gomez-Roberts, Hunter; Varrey, Aneesha; Garcia-Sanchez, Angel; Gervasi, Maria Teresa
Objectives: Clinical chorioamnionitis at term is considered the most common infection-related diagnosis in labor and delivery units worldwide. The syndrome affects 5-12% of all term pregnancies and is a leading cause of maternal morbidity and mortality as well as neonatal death and sepsis. The objectives of this study were to determine the (1) amniotic fluid microbiology using cultivation and molecular microbiologic techniques; (2) diagnostic accuracy of the clinical criteria used to identify patients with intraamniotic infection; (3) relationship between acute inflammatory lesions of the placenta (maternal and fetal inflammatory responses) and amniotic fluid microbiology and inflammatory markers; and (4) frequency of neonatal bacteremia.
Could alterations in maternal plasma visfatin concentration participate in the phenotype definition of preeclampsia and SGA?
(TAYLOR & FRANCIS LTD, 2010) Mazaki Tovi, Shali; Romero, Roberto; Kim, Sun Kwon; Vaisbuch, Edi; Kusanovic, Juan Pedro; Erez, Offer; Chaiworapongsa, Tinnakorn; Gotsch, Francesca; Mittal, Pooja; Nhan Chang, Chia Ling; Than, Nandor Gabor; Gomez, Ricardo; Nien, Jyh Kae; Edwin, Samuel S.; Pacora, Percy; Yeo, Lami; Hassan, Sonia S.
Objective. Women with preeclampsia and those who delivered a small-for-gestational-age (SGA) neonate share several mechanisms of disease, including chronic uteroplacental ischemia and failure of physiologic transformation of the spiral arteries. However, the clinical manifestation of these obstetrical syndromes is remarkably different. It has been proposed that an altered maternal metabolic state, as well as a unique circulating cytokines milieu, predispose women to develop either preeclampsia or SGA. Compelling evidence suggests that adipose tissue orchestrates both metabolic pathways and immunological responses via the production of adipokines. Visfatin is a novel adipocytokine with metabolic and immunomodulating properties. The objective of this study was to determine whether preeclampsia and SGA are associated with alterations in maternal circulating visfatin concentrations.
Does a perturbation in visfatin homeostasis participate in the phenotype definition of preeclampsia and SGA?
(2009) Kim, Sun Kwon; Romero, Roberto; Mazaki-Tovi, Shali; Kusanovic, Juan Pedro; Vaisbuch, Edi; Erez, Offer; Than, Nandor; Gotsch, Francesca; Nhan-Chang, Chia-Ling; Chiaworapongsa, Tinnakorn; Gómez Mora, Ricardo Alberto; Mittal, Pooja; Hassan, Sonia; Pacora, Percy; Yeo, Lami
Objective: Women with preeclampsia (PE) and those who delivered a small for gestational age (SGA) neonate share several mechanisms of disease including: chronic uteroplacental ischemia and failure of physiologic transformation of the spiral arteries. However, the clinical manifestation of these obstetrical syndromes is remarkably different. It has been proposed that an altered maternal metabolic state, as well as a unique circulating cytokines milieu, predispose women to develop either PE or SGA (Ness&Sibai AJOG 2006;195:40). Compelling evidence suggests that adipose tissue orchestrates both metabolic pathways and immunological responses via the production of adipokines. Visfatin is a novel adipocytokine with metabolic and immunomodulating properties. The objective of this study was to determine whether PE and SGA are associated with alterations in maternal circulating visfatin concentrations. Methods: This cross-sectional study included 255 pregnant women in the following groups: 1) normal pregnancy (n = 158); 2) patients with PE (n = 43) of which 32 had an AGA and 11 had an SGA neonate; and 3) patients who delivered an SGA neonate without PE (n = 54). Maternal plasma visfatin concentrations were measured by ELISA. Non-parametric tests and multiple linear regression analysis were used. Results: 1) Women who delivered an SGA neonate had higher median maternal plasma visfatin concentration than those with normal pregnancy (median: 20.0ng/ml, interquartile range: 17.2–24.6 vs. 15.2 ng/ml, 12.1–19.2, respectively; p. Conclusion: 1) Mothers with SGA, but not with PE, had a higher maternal plasma visfatin concentration than those with a normal pregnancy; 2) This finding suggests differential involvement of adipokines in SGA and PE; 3) We propose that perturbation of adipokine homeostasis may be implicated in the phenotypic definition and distinction of PE and SGA
Isobaric labeling and tandem mass spectrometry: A novel approach for profiling and quantifying proteins differentially expressed in amniotic fluid in preterm labor with and without intra-amniotic infection/inflammation
(TAYLOR & FRANCIS LTD, 2010) Romero, Roberto; Kusanovic, Juan Pedro; Gotsch, Francesca; Erez, Offer; Vaisbuch, Edi; Mazaki Tovi, Shali; Moser, Allan; Tam, Sunny; Leszyk, John; Master, Stephen R.; Juhasz, Peter; Pacora, Percy; Ogge, Giovanna; Gomez, Ricardo; Yoon, Bo H.; Yeo, Lami; Hassan, Sonia S.; Rogers, Wade T.
Methods. A cross-sectional study was designed and included AF samples from patients with spontaneous PTL and intact membranes in the following groups: (1) patients without IAI who delivered at term (n = 26); (2) patients who delivered preterm without IAI (n = 25); and (3) patients with IAI (n = 24). Proteomic profiling of AF samples was performed using a workflow involving tryptic digestion, iTRAQ labeling and multiplexing, strong cation exchange fractionation, and liquid chromatography tandem mass spectrometry. Twenty-five separate 4-plex samples were prepared and analyzed.
Maternal and neonatal circulating visfatin concentrations in patients with pre-eclampsia and a small-for-gestational age neonate
(TAYLOR & FRANCIS LTD, 2010) Mazaki Tovi, Shali; Vaisbuch, Edi; Romero, Roberto; Kusanovic, Juan Pedro; Chaiworapongsa, Tinnakorn; Kim, Sun Kwon; Nhan Chang, Chia Ling; Gomez, Ricardo; Savasan, Zeynep Alpay; Madan, Ichchha; Yoon, Bo Hyun; Yeo, Lami; Mittal, Pooja; Ogge, Giovanna; Gonzalez, Juan M.; Hassan, Sonia S.
Objective. Maternal circulating visfatin concentrations are higher in patients with a small-for-gestational-age (SGA) neonate than in those who delivered an appropriate-for-gestational age (AGA) neonate or in those with pre-eclampsia. It has been proposed that enhanced transfer of visfatin from the foetal to maternal circulation may account for the high concentrations of maternal visfatin observed in patients with an SGA neonate. The aims of this study were: (1) to determine whether cord blood visfatin concentrations differ between normal neonates, SGA neonates and newborns of pre-eclamptic mothers; and (2) to assess the relationship between maternal and foetal circulating visfatin concentrations in patients with an SGA neonate and those with pre-eclampsia.
Maternal Plasma Concentration of the Pro-Inflammatory Adipokine Pre-B-Cell-Enhancing Factor (PBEF)/Visfatin Is Elevated In Pregnant Patients with Acute Pyelonephritis
(WILEY, 2010) Mazaki Tovi, Shali; Vaisbuch, Edi; Romero, Roberto; Kusanovic, Juan Pedro; Chaiworapongsa, Tinnakorn; Kim, Sun Kwon; Nhan Chang, Chia Ling; Gomez, Ricardo; Yoon, Bo H.; Yeo, Lami; Mittal, Pooja; Ogge, Giovanna; Gonzalez, Juan M.; Hassan, Sonia S.
Problem
Should Bilateral Uterine Artery Notching Be Used in the Risk Assessment for Preeclampsia, Small-for-Gestational-Age, and Gestational Hypertension?
(WILEY, 2010) Espinoza, Jimmy; Kusanovic, Juan Pedro; Bahado Singh, Ray; Gervasi, Maria Teresa; Romero, Roberto; Lee, Wesley; Vaisbuch, Edi; Mazaki Tovi, Shali; Mittal, Pooja; Gotsch, Francesca; Erez, Offer; Gomez, Ricardo; Yeo, Lami; Hassan, Sonia S.
Objective. The purpose of this study was to determine the value of bilateral uterine artery notching in the second trimester in the risk assessment for preeclampsia, gestational hypertension, and small-for-gestational-age (SGA) without preeclampsia. Methods. This prospective cohort study included 4190 singleton pregnancies that underwent ultrasound examination between 23 and 25 weeks' gestation. The 95th percentiles of the mean pulsatility index (PI) and resistive index (RI) of both uterine arteries were calculated. Multivariable logistic regression analyses were performed to determine if bilateral uterine artery notching is an independent explanatory variable for the occurrence of preeclampsia, early-onset preeclampsia (<= 34 weeks), late-onset preeclampsia (>34 weeks), gestational hypertension, and delivery of an SGA neonate without preeclampsia, while controlling for confounding factors. Results. (1) The prevalence of preeclampsia, early-onset preeclampsia, late-onset preeclampsia, SGA, and gestational hypertension were 3.4%, 0.5%, 2.9%, 10%, and 7.9%, respectively; (2) 7.2% of the study population had bilateral uterine artery notching; and (3) bilateral uterine artery notching was an independent explanatory variable for the development of preeclampsia (odds ratio [OR] 2.1; 95% confidence interval [CI], 1.28-3.36), early-onset preeclampsia (OR, 4.47; 95% CI, 1.50-13.35), and gestational hypertension (OR, 1.50; 95% CI, 1.02-2.26), but not for late-onset preeclampsia or SGA. Conclusions. Bilateral uterine notching between 23 and 25 weeks' gestation is an independent risk factor for the development of early-onset preeclampsia and gestational hypertension. Thus, bilateral uterine artery notching should be considered in the assessment of risk for the development of these pregnancy complications.
Sterile and microbial-associated intra-amniotic inflammation in preterm prelabor rupture of membranes
(2015) Romero, Roberto; Miranda, Jezid; Chaemsaithong, Piya; Chaiworapongsa, Tinnakorn; Kusanovic, Juan Pedro; Dong, Zhong; Ahmed, Ahmed I.; Shaman, Majid; Lannaman, Kia; Yoon, Bo Huyun; Hassan, Sonia S.; Kim, Chong Jai; Korzeniewski, Steven Jai; Yeo, Lami; Kim, Yeon Mee
The clinical significance of eosinophils in the amniotic fluid in preterm labor
(TAYLOR & FRANCIS LTD, 2010) Romero, Roberto; Kusanovic, Juan Pedro; Gomez, Ricardo; Lamont, Ronald; Bytautiene, Egle; Garfield, Robert E.; Mittal, Pooja; Hassan, Sonia S.; Yeo, Lami
Methods. This retrospective case-control study included women who presented with preterm labor and intact membranes between 24 and 34 weeks of gestation. Patients underwent an amniocentesis shortly after admission for the assessment of the microbiologic status of the amniotic cavity and/or fetal lung maturity. Amniotic fluid was cultured for aerobic and anaerobic bacteria as well as genital mycoplasmas. Cytologic studies included amniotic fluid white blood cell count and differential, which was performed on cytocentrifuged specimens. Patients with microbial invasion of the amniotic cavity and/or an amniotic fluid white blood cell count > 20 cells/mm 20% of eosinophils. Controls were selected among women with an amniotic fluid eosinophil count < 20% and matched for gestational age at amniocentesis. The analysis was conducted with non-parametric statistics.
The pattern and magnitude of "in vivo thrombin generation" differ in women with preeclampsia and in those with SGA fetuses without preeclampsia
(2018) Erez, Offer; Romero, Roberto; Vaisbuch, Edi; Pedro Kusanovic, Juan; Mazaki-Tovi, Shali; Chaiworapongsa, Tinnakorn; Gotsch, Francesca; Mittal, Pooja; Edwin, Samuel S.; Nhan-Chang, Chia-Ling; Than, Nandor Gabor; Kim, Chong Jai; Kim, Sun Kwon; Yeo, Lami; Mazor, Moshe; Hassan, Sonia S.
The prognosis of pregnancy conceived despite the presence of an intrauterine device (IUD)
(WALTER DE GRUYTER GMBH, 2010) Kim, Sun Kwon; Romero, Roberto; Kusanovic, Juan Pedro; Erez, Offer; Vaisbuch, Edi; Mazaki Tovi, Shali; Gotsch, Francesca; Mittal, Pooja; Chaiworapongsa, Tinnakorn; Pacora, Percy; Ogge, Giovanna; Gomez, Ricardo; Yoon, Bo Hyun; Yeo, Lami; Lamont, Ronald F.; Hassan, Sonia S.
Objective: Intrauterine devices (IUDs) are used for contraception worldwide; however, the management of pregnancies with an IUD poses a clinical challenge. The purpose of this study was to determine the outcome of pregnancy in patients with an IUD.
Toward a new taxonomy of obstetrical disease: improved performance of maternal blood biomarkers for the great obstetrical syndromes when classified according to placental pathology
(2022) Romero, Roberto; Jung, Eunjung; Chaiworapongsa, Tinnakorn; Erez, Offer; Gudicha, Dereje W.; Kim, Yeon Mee; Kim, Jung-Sun; Kim, Bomi; Kusanovic, Juan Pedro; Gotsch, Francesca; Taran, Andreea B.; Yoon, Bo Hyun; Hassan, Sonia S.; Hsu, Chaur-Dong; Chaemsaithong, Piya; Gomez-Lopez, Nardhy; Yeo, Lami; Kim, Chong Jai; Tarca, Adi L.
BACKGROUND: The major challenge for obstetrics is the prediction and prevention of the great obstetrical syndromes. We propose that defining obstetrical diseases by the combination of clinical presentation and disease mechanisms as inferred by placental pathology will aid in the discovery of biomarkers and add specificity to those already known.

Browsing by Author "Yeo, Lami"

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