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Oral Concurrent Session 7Saturday, February 6, 2010 • 8:00 am – 10:00 am • International Ballroom North, Hilton Chicago

NFECTIOUS DISEASES/INTRAPARTUM ASSESSMENT

bstracts 71 – 78

oderators: Mary Norton, MD; William Grobman, MD

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71 Cytomegalovirus DNA load in amnioticuid and neonatal outcomehiara Puccetti1, Brunella Guerra2, Francesca Cervi3,onia Vagnoni3, Tiziana Lazzarotto4, Liliana Gabrielli5,arcello Lanari6, Maria Paola Landini5, Nicola Rizzo2

Department of Obstetrics and Gynecology, St. Orsola Malpighi Hospital,niversity of Bologna, Bologna, Italy, BOLOGNA, Italy, 2University ofologna, Department of Obstetrics and Gynecology, St. Orsola Malpighiospital, Italy, 3Department of Obstetrics and Gynecology, St. Orsolaalpighi Hospital, University of Bologna, Bologna, Italy, Italy, 4University of

ologna, Department of Clinical and Experimental Medicine (Section oficrobiology), St. Orsola Malpighi Hospital, Italy, 5Department of Clinical

nd Experimental Medicine, Section of Microbiology, St. Orsola Malpighiospital, University of Bologna, Bologna, Italy, Italy, 6Department ofediatrics and Neonatology, La Scaletta Hospital, Imola-Bologna, Italy, ItalyBJECTIVE: The Cytomegalovirus (CMV) infection is the most commonause of intrauterine infection of the fetus. Ultrasound monitoring andMV determination in the amniotic fluid (AF) are widely employed in

he management of pregnant women with suspected primary infection.he study sought to determine the diagnostic reliability and prognostic

ignificance of the quantification of CMV in AF.TUDY DESIGN: We retrospectively reviewed the results of 603 amni-tic fluid samples that had been tested for CMV by a quantitativeeal-time PCR. The amniocentesis was performed between 20 and 21eeks of gestation and at least 6 weeks (range: 6-16; mean values: 11,6)

fter maternal infection. The outcome was documented in 545 new-orns and 59 fetuses.ESULTS: Fewer than 500 copies were detected in 497 AF samples; noongenital CMV infection was identified in 468 cases while 29 new-orns were infected without symptoms at birth or during subsequentonitoring. Among the 106 cases with �500 copies we had 48 in-

ected newborns and 59 infected fetuses. A total of 77 newborns werenfected. The symptoms (mental retardation, sensorineural deafness,hrombocytopenia, single or multiorgan infection) was found in 20ewborns. Among symptomatic and asymptomatic newborns, the vi-al load was significantly higher (�100.000) in symptomatic new-orns (p�0,05) On post-mortem examination, CMV was isolatedrom various organs (brain, liver, lungs, kidneys, thyroid, adrenalsnd placenta) in all of 59 infected fetuses. Intrauterine death occurredn two of 59 fetuses infected. 56 (95%) of 59 fetuses had a viral loadigher than 100.000.ONCLUSION: Positive PCR in AF at the appropriate times identifiesMV infected fetuses and a high viral load seems to be related with

ongenital symptomatic CMV infections. Low viral load (�500) inhe AF can rule out fetal/neonatal damage.002-9378/$ – see front matter • doi:10.1016/j.ajog.2009.10.086

72 In utero inflammation alters vascularunction in adult offspring mice

ichel Makhlouf1, Phyllis Gamble2, Esther Tamayo2,ncizar Betancourt1, Monica Longo1, George R. Saade1

The University of Texas Medical Branch, Galveston, Texas, 2The Universityf Texas Medical Branch, Obstetrics and Gynecology, Galveston, TexasBJECTIVE: The effect of the uterine environment on adult vascular func-

ion has been well documented. The effect of infection and inflammationn pregnancy on adult vascular function has not been studied. We testedhe hypothesis that exposure to inflammatory insult during late gestation

ffects adult vascular and immune function in mice.

Suppleme

TUDY DESIGN: CD-1 mice at day 16 of gestation were given 800 �g/kgf Salmonella enteritidis endotoxin (LPS) or saline (CON) intraperi-oneally. Their pups were weighed at birth and allowed to grow. Theemale offspring were euthanized at 20 weeks of life, and the carotidrtery responses to phenylephrine, serotonin, acetylcholine, sodiumitroprusside, and isoproterenol were recorded using a wire myo-raph. Heparinized whole blood from adult offspring was incubatedith 100 ng/ml LPS for 8 hours and TNF levels were measured.NOVA was used for analysis (significance: P�0.05).ESULTS: Administration of LPS resulted in 75% preterm delivery ratend loss of the resulting pups. Mice born to LPS-exposed dams thatelivered at term were similar in weight to those from control dams,oth at birth and in adulthood. There were no differences in the re-ponses to phenylephrine, acetylcholine, sodium nitroprusside or iso-roterenol between the 2 groups. Carotid arteries from adult offspringorn to LPS-exposed dams showed increased contractile response toerotonin (Figure). There was a trend towards decreased LPS-stimu-ated TNF production in the LPS group offspring, but the differenceid not reach significance (Figure).

ONCLUSION: Exposure to a significant inflammatory insult at day 16estation in mice alters in vitro vascular reactivity to serotonin in thedult offspring, even if they were born at term. This effect may havemplications for fetal programming of adult hypertension.002-9378/$ – see front matter • doi:10.1016/j.ajog.2009.10.087

73 Evidence for intersection between the angiogenic andnflammatory pathways in preterm labor and preterm PROMun Kwon Kim1, Roberto Romero1, Tinnakorn Chaiworapongsa2,uan Pedro Kusanovic2, Shali Mazaki-Tovi2, Edi Vaisbuch2,ooja Mittal2, Giovanna Ogge1, Zeynep Alpay-Savasan2,chchha Madan2, Zhong Dong1, Lami Yeo2, Sonia S. Hassan2

Perinatology Research Branch, NICHD/NIH/DHHS,ethesda, Maryland, and Detroit, Michigan, 2Waynetate University School of Medicine, Detroit, MichiganBJECTIVE: Cross talk between the angiogenic pathway and inflamma-ion has been recently reported (Nature Medicine, 2006). The purposef this study was to examine whether preterm labor and pretermROM (with and without inflammation) are associated with changes

n the markers of inflammation and anti-angiogenesis.TUDY DESIGN: A cross-sectional study was conducted in 367 patientsn the following groups: 1) midtrimester (MT) (n�20); 2) pretermabor (PTL) with term delivery (n�95); 3) PTL leading to pretermelivery with (n�40) and without IAI (n�46); 4) preterm prelaborupture of membranes (PPROM) with (n�37) and without IAIn�37); 5) term in labor (n�48); and 8) term not in labor (TNL)

nt to DECEMBER 2009 American Journal of Obstetrics & Gynecology S41