{
    "abstract": "In neonates, blood flow to the brain as measured by peak systolic velocity (PSV) in the middle cerebral artery (MCA) is altered in pregnancies affected by chorioamnionitis.\nWe aim to\u00a0determine whether PSV and other measures of flow in the MCA in the fetus are altered prior to the development of clinical chorioamnionitis following preterm prelabor rupture of membranes (PPROM).\n\u00a0This was a prospective observational study. Fifty patients from one institution were recruited after being diagnosed with PPROM between 23 weeks zero days and 33 weeks six days gestation.\u00a0We performed measurements of the PSV in the fetal MCA on a weekly basis following PPROM\u00a0and used the value taken closest to the time of delivery for our statistical analysis.\u00a0The primary outcome assessed was clinical chorioamnionitis, and the exposure of interest was MCA PSV.\u00a0Additional independent variables of interest were other Doppler measures of the MCA.\u00a0Secondary outcomes included histological chorioamnionitis and other measures of neonatal health, including sepsis, days in the neonatal intensive care unit\u00a0(NICU), and death.\nOf the 50 patients recruited to our study, eight (16%) developed clinical chorioamnionitis, similar to previously reported values in the general population.\u00a0The PSV in the MCA was not significantly associated with the development of clinical chorioamnionitis. However, an elevated MCA pulsatility index (PI), a measure of resistance to flow, was associated with a higher probability of developing clinical chorioamnionitis.\n\u00a0There does not appear to be a difference in the PSV of the MCA of fetuses in pregnancies following PPROM with impending chorioamnionitis.\u00a0However, elevated PI in the MCA could be a marker of impending chorioamnionitis in PPROM. Larger studies are needed to confirm these findings.",
    "authors": [
        {
            "affiliation": "Obstetrics and Gynecology, Robert Wood Johnson (RWJ) Barnabas Health, Eatontown, USA.",
            "firstname": "Julie M",
            "initials": "JM",
            "lastname": "Leizer"
        },
        {
            "affiliation": "Pathology, University of Miami Miller School of Medicine, Miami, USA.",
            "firstname": "Ammoura M",
            "initials": "AM",
            "lastname": "Ibrahim"
        },
        {
            "affiliation": "Pathology, Albany Medical Center, Albany, USA.",
            "firstname": "Llewellyn A",
            "initials": "LA",
            "lastname": "Foulke"
        },
        {
            "affiliation": "Neonatology, Albany Medical Center, Albany, USA.",
            "firstname": "Kate A",
            "initials": "KA",
            "lastname": "Tauber"
        },
        {
            "affiliation": "Neuroscience and Experimental Therapeutics, Albany Medical College, Albany, USA.",
            "firstname": "Paul",
            "initials": "P",
            "lastname": "Feustel"
        },
        {
            "affiliation": "Obstetrics and Gynecology, Albany Medical Center, Albany, USA.",
            "firstname": "Craig M",
            "initials": "CM",
            "lastname": "Zelig"
        }
    ],
    "conclusions": "\u00a0There does not appear to be a difference in the PSV of the MCA of fetuses in pregnancies following PPROM with impending chorioamnionitis.\u00a0However, elevated PI in the MCA could be a marker of impending chorioamnionitis in PPROM. Larger studies are needed to confirm these findings.",
    "copyrights": "Copyright \u00a9 2023, Leizer et al.",
    "doi": "10.7759/cureus.41508",
    "journal": "Cureus",
    "keywords": [
        "chorioamnionitis",
        "mca doppler",
        "pprom",
        "rupture of membranes",
        "ultrasound"
    ],
    "methods": null,
    "publication_date": "2023-08-08",
    "pubmed_id": "37551247\n12517665\n26855098\n28859768\n11293640\n7070724\n10908758\n15846196\n22682965\n17318946\n10620643\n29470342\n31332850\n7788493\n24457257\n15784760\n36549567\n31676738",
    "results": "Of the 50 patients recruited to our study, eight (16%) developed clinical chorioamnionitis, similar to previously reported values in the general population.\u00a0The PSV in the MCA was not significantly associated with the development of clinical chorioamnionitis. However, an elevated MCA pulsatility index (PI), a measure of resistance to flow, was associated with a higher probability of developing clinical chorioamnionitis.",
    "title": "Using Middle Cerebral Artery Doppler Ultrasound to Predict Clinical Chorioamnionitis After Preterm Prelabor Rupture of Membranes.",
    "xml": "<Element 'PubmedArticle' at 0x78850434b150>"
}