To determine amniotic fluid prostaglandin E2 concentrations in women preterm prelabor rupture of the membranes (PPROM) with respect to microbial invasion of the amniotic cavity (MIAC), intraamniotic inflammation (IAI),... more
To determine amniotic fluid prostaglandin E2 concentrations in women preterm prelabor rupture of the membranes (PPROM) with respect to microbial invasion of the amniotic cavity (MIAC), intraamniotic inflammation (IAI), microbial-associated IAI, histological chorioamnionitis, and short-term neonatal morbidity. One hundred forty-five women with singleton pregnancies were included in this study. Amniotic fluid samples were obtained by transabdominal amniocentesis and were assayed for prostaglandin E2 concentrations by ELISA. IAI was defined as amniotic fluid interleukin-6 > 745 pg/mL. Microbial-associated IAI was defined as the presence of both MIAC and IAI. No differences in prostaglandin E2 concentrations were found between women with and without MIAC (p=0.27). Women with IAI (p=0.0008) and microbial-associated IAI (p=0.01) had higher prostaglandin E2 concentrations than women without these complications. Women with histological chorioamnionitis had higher prostaglandin E2 concent...
We compared the incidence and type of levator ani avulsion diagnosed by translabial ultrasound evolution in primiparous women 6 months after vacuum-assisted or spontaneous vaginal delivery. This retrospective observational study was... more
We compared the incidence and type of levator ani avulsion diagnosed by translabial ultrasound evolution in primiparous women 6 months after vacuum-assisted or spontaneous vaginal delivery. This retrospective observational study was performed between January 2011 and December 2013. Primiparous women 6 months after vacuum-assisted vaginal delivery and after spontaneous vaginal delivery underwent translabial ultrasound evaluation. The distance between the urethra and fibers of the musculus levator ani puborectalis (levator-urethra gap) was measured. Distance >25 mm was considered a musculus levator ani avulsion. In total, 184 women participated in the study. Among them, 92 had vacuum extraction and 92 had uncomplicated spontaneous delivery. A longer levator-urethra gap on both sides of the pubic bone was found in women after vacuum-assisted vaginal delivery (p < 0.0001 for both sides). Musculus levator ani avulsion was identified in 20 women (unilateral in 16 cases and bilateral in four cases). No difference in an incidence of musculus levator ani avulsion was identified in women after vacuum-assisted vaginal delivery [11/92 (12%)] compared to spontaneous delivery [9/92 (10%); p = 0.81]. Vacuum-assisted vaginal delivery in primiparous women is associated with a longer levator-urethra gap but not with a higher frequency of avulsion of the musculus levator ani.
Infectious inflammation, caused by microbial invasion of the amniotic cavity followed by histological chorioamnionitis (MIAC/HCA), complicates a significant portion of preterm prelabour rupture of membranes (PPROM) pregnancies. The... more
Infectious inflammation, caused by microbial invasion of the amniotic cavity followed by histological chorioamnionitis (MIAC/HCA), complicates a significant portion of preterm prelabour rupture of membranes (PPROM) pregnancies. The colonization of the intrauterine environment may evoke an excessive response of fetal immune system and lead to a fetal inflammatory response syndrome with severe consequences. Robust tools for prompt detection of MIAC/HCA are required to improve management of PPROM pregnancies, particularly in low-gestational ages. Amniotic fluid is a dynamic milieu closest to fetus. In addition to water, metabolites and electrolytes, proteins and peptides are present in this unique fluid, making it an attractive analytical material for new biomarker discovery using the state-of-the-art proteomic analysis. Our recent proteomic study revealed dysregulation in a large number of amniotic fluid proteins potentially associated with MIAC/HCA in PPROM, including several distinc...
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The authors present a short summary of placental pathology for the general pathologist. Practical tips for macroscopic examination of formalin-fixed material are listed and several cases are presented for illustration of the theoretical... more
The authors present a short summary of placental pathology for the general pathologist. Practical tips for macroscopic examination of formalin-fixed material are listed and several cases are presented for illustration of the theoretical text.
Introduction Amniotic fluid is a dynamic substance providing an ideal milieu for fetal development. In addition to water, metabolites and electrolytes, proteins and peptides complete this unique fluid, making it an attractive analytical... more
Introduction Amniotic fluid is a dynamic substance providing an ideal milieu for fetal development. In addition to water, metabolites and electrolytes, proteins and peptides complete this unique fluid, making it an attractive analytical material for new biomarker discovery. These could predict pathological processes such as preterm prelabour rupture of membranes (PPROM) often complicated by intraamniotic infection and inflammation (IAI), which may result in severe neonatal morbidity and mortality. Our recent proteomic study revealed dysregulation in a large number of amniotic fluid proteins potentially associated with IAI in PPROM, including several distinct proteases (Tambor et al., Plos ONE 2012). The presence of up-regulated proteases in amniotic fluid suggests that endogenous peptides might be generated due to increased protease activity related to the ongoing pathological process. Hence, the aim of this work was to develop a protocol for the enrichment of endogenous peptides fr...
Objective: To determine whether umbilical cord blood concentrations of soluble Toll-like receptor (sTLR2) is of value in the diagnosis of histological chorioamnionitis (HCA) and funisitis in pregnancies complicated by preterm premature... more
Objective: To determine whether umbilical cord blood concentrations of soluble Toll-like receptor (sTLR2) is of value in the diagnosis of histological chorioamnionitis (HCA) and funisitis in pregnancies complicated by preterm premature rupture of membranes.Design: Retrospective study.Setting: Charles University in Prague, Faculty of Medicine and University Hospital, Hradec Kralove, Department of Clinical Immunology and Allergy, Department of Obstetric and Gynecology.Methods: Eighty six women with PPROM between gestation ages 24 and 36 weeks were included in the study. The samples of the umbilical cord blood were taken from the clamped umbilical cord immediately after delivery of the newborn. The placenta, fetal membranes and umbilical cord were evaluated for the presence of inflammatory changes. The concentrations of sTLR2 in the umbilical cord blood were measured by ELISA method.Results: Women with HCA did not have different umbilical cord blood sTLR2 levels than women without HCA ...
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This review aimed to identify, synthesize, and analyze the findings of studies on proteomic biomarkers for spontaneous preterm birth (PTB). Three electronic databases (Medline, Embase, and Scopus) were searched for studies in any language... more
This review aimed to identify, synthesize, and analyze the findings of studies on proteomic biomarkers for spontaneous preterm birth (PTB). Three electronic databases (Medline, Embase, and Scopus) were searched for studies in any language reporting the use of proteomic biomarkers for PTB published between January 1994 and December 2012. Retrieved citations were screened, and relevant studies were selected for full-text reading, in triplicate. The search yielded 529 citations, 51 were selected for full-text reading and 8 studies were included in the review. A total of 64 dysregulated proteins were reported. Only 14-3-3 protein sigma, annexin A5, protein S100-A8, protein S100-A12, and inter-α-trypsin inhibitor heavy chain H4 were reported in more than 1 study, but results could not be combined due to heterogeneity in type of sample and analytical platform. In conclusion, according to the existing literature, there are no specific proteomic biomarkers capable of accurately predicting PTB.
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Lysyl oxidase (LOX) and LOX like enzymes (LOXL1-4) physiologically remodel extracellular matrix and pathologically contribute to cellular senescence under oxidative stress (OS). We characterized LOX and LOXL expressions and activity in... more
Lysyl oxidase (LOX) and LOX like enzymes (LOXL1-4) physiologically remodel extracellular matrix and pathologically contribute to cellular senescence under oxidative stress (OS). We characterized LOX and LOXL expressions and activity in human fetal membranes. Human fetal membranes from women with uncomplicated pregnancies at term, preterm birth with intact membranes (PTB) or preterm prelabor rupture of membranes (pPROM), and in vitro fetal membranes stimulated with water-soluble cigarette smoke extract (CSE), an OS inducer, were analyzed by real-time PCR and immunohistochemistry for LOX and LOXL (1-4) expression and localization. LOX activity was measured by fluorometric assay. LOX gene expression was ∼2.5-fold higher in fetal membranes from pPROM compared to PTB and term (P=0.02). LOX and LOXL1, 2 and 4 were localized to both amniotic and chorionic cells, whereas LOXL3 was limited to chorion. LOX and LOXL isoform expressions were not different between CSE treated and untreated group...
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To identify characteristic risk factors of preterm birth in Central and Eastern Europe and explore the differences from other developed countries. Data on 33 794 term and 3867 preterm births (<37 wks.) were extracted in a retrospective... more
To identify characteristic risk factors of preterm birth in Central and Eastern Europe and explore the differences from other developed countries. Data on 33 794 term and 3867 preterm births (<37 wks.) were extracted in a retrospective study between January 1, 2007 and December 31, 2009. The study took place in 6 centers in 5 countries: Czech Republic, Hungary (two centers), Romania, Slovakia, and Ukraine. Data on historical risk factors, pregnancy complications, and special testing were gathered. Preterm birth frequencies and relevant risk factors were analyzed using Statistical Analysis System (SAS) software. All the factors selected for study (history of smoking, diabetes, chronic hypertension, current diabetes, preeclampsia, progesterone use, current smoking, body mass index, iron use and anemia during pregnancy), except the history of diabetes were predictive of preterm birth across all participating European centers. Preterm birth was at least 2.4 times more likely with smo...
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The purpose of this study was to focuse on recent developments on the evolving field of biomarker discovery and validation techniques using proteomics platforms for ovarian cancer. Review. Department of Obstetrics and Gynecology Medical... more
The purpose of this study was to focuse on recent developments on the evolving field of biomarker discovery and validation techniques using proteomics platforms for ovarian cancer. Review. Department of Obstetrics and Gynecology Medical Faculty Charles University Hradec Kralove. Institute of Molecular Pathology. Faculty of Military Health Sciences, University of Defense, Hradec Kralove. The last decade has seen major changes in the technologies used to identify markers for diagnosing early stages of ovarian cancer. Currently the major developments were made in three distinct areas: protein profilig, highthroughput validation techniques and solid and liquid phase protein microarray platforms for analyzing candidate markers across stages hold significant of ovarian cancer. These new technologies hold significant promise in identifying more robust markers for ovarian cancer. The present review summarizes the results of clinical and experimental research on biomarkers of ovarian cancer.
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The purpose of this study was to determinate the changes of amniotic fluid HSP 70 concentrations in patiens with preterm premature rupture of the membranes, and in the presence of intraamniotic infection and histological changes of... more
The purpose of this study was to determinate the changes of amniotic fluid HSP 70 concentrations in patiens with preterm premature rupture of the membranes, and in the presence of intraamniotic infection and histological changes of inflammations. Prospective study. Department of Obstetrics and Gynecology Medical Faculty Charles University Hradec Králové. We studied 30 women between 24 and 36 weeks of gestation with preterm premature rupture of the membranes. Samples of amniotic fluid were collected by transabdominal amniocentesis. These patients were divided into 2 groups. In group 1 were patiens with intraamniotic infection. In group 2 were patiens without intraamniotic infection. Among 76% (35/30) patients placenta were collected and assessed for presence or absence acute inflammatory lesions. HSP70 concentration in amniotic fluid were determined using a sensitive and specific diagnostic kit Hsp 70- ELISA kit manufactered Assay Desings, USA. There was no significant difference in ...
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To draw a comparison between spontaneous vaginal delivery and vacuum-assisted vaginal delivery in relation to the incidence and the type of levator ani avulsion in primiparas. Retrospective observational study.Settimg: Department of... more
To draw a comparison between spontaneous vaginal delivery and vacuum-assisted vaginal delivery in relation to the incidence and the type of levator ani avulsion in primiparas. Retrospective observational study.Settimg: Department of Obstetrics and Gynaecology, University Hospital of Ostrava. In the study, the primiparas who were from 6 to 12 months after spontaneous vaginal delivery (group A, n = 52) or after childbirth with vacuum extraction (group B, n = 51) underwent translabial 3D ultrasound. The obstetric data had been obtained from the hospital database. Translabial 3D ultrasound examination were performed by two sonographists. The monitored parameter was the distance between urethra and fibres of musculus levator ani - levator urethra gap [6]. The distance longer than 25 mm was considered an avulsion injury [6, 22]. Other parameters assessed in relation to the avulsion were: women´s age, BMI, epidural analgesia, episiotomy performance, the length of the first and the second s...
Objective: To evaluate Ureaplasma species and Mycoplasma hominis DNA in the cervical fluid and their association with microbial invasion of the amniotic cavity (MIAC) and/or histological chorioamnionitis (HCA) in pregnancies complicated... more
Objective: To evaluate Ureaplasma species and Mycoplasma hominis DNA in the cervical fluid and their association with microbial invasion of the amniotic cavity (MIAC) and/or histological chorioamnionitis (HCA) in pregnancies complicated by preterm prelabor rupture of membranes (PPROM). Study design: A prospective study of 68 women with singleton pregnancies complicated by PPROM between 24(0/7) and 36(6/7) weeks was conducted. Cervical fluid and amniotic fluid were collected from all women at the time of admission. The Ureaplasma species and Mycoplasma hominis DNA in the cervical fluid were identified using specific real-time PCR. Results: Ureaplasma species and Mycoplasma hominis DNA were identified in 59% (40/69) of the cervical fluid samples. Women with the presence of Ureaplasma species DNA with and without Mycoplasma hominis DNA in the cervical fluid had a higher rate of MIAC alone [35% (14/40) versus 11% (3/28); p = 0.02] and a higher rate of the presence of both MIAC and HCA [...
Preterm prelabor rupture of membranes is responsible for approximately one third of all preterm deliveries. The most common complications associated with this pregnancy pathology are microbial invasion of the amniotic cavity,... more
Preterm prelabor rupture of membranes is responsible for approximately one third of all preterm deliveries. The most common complications associated with this pregnancy pathology are microbial invasion of the amniotic cavity, intraamniotic inflammation, intraamniotic infection and histological chorioamnionitis. This article explains these complicatioss and their relation to the optimal management of preterm prelabor rupture of membranes. Overview study. Department of Obstetrics and Gynecology, Charles University in Prague, Faculty of Medicine and University Hospital Hradec Kralove. To analyze current knowledge and our own experiences regarding inflammatory complications of preterm prelabor rupture of membranes. Inflammatory complications of preterm prelabor rupture of membranes are associated with risk of development of early onset sepsis. Nevertheless, gestational age is a main confounder affecting neonatal morbidity and mortality.
The purpose of this study was to determinate the changes of amniotic fluid interleukin 6 (IL-6) concentrations in patients with preterm premature rupture of the membranes (PPROM), and in the presence of microbial invasion of the amniotic... more
The purpose of this study was to determinate the changes of amniotic fluid interleukin 6 (IL-6) concentrations in patients with preterm premature rupture of the membranes (PPROM), and in the presence of microbial invasion of the amniotic cavity (MIAC) and histological chorioamnionitis (HCA). The aim was to examine amniotic fluid IL-6 in relation to MIAC and HCA. Prospective study. Department of Obstetrics and Gynecology Medical Faculty Charles University Hradec Králové. We studied 37 women between 24 and 36 weeks of gestation with PPROM. Samples of amniotic fluid were collected by transabdominal amniocentesis. Polymerase chain reaction for the genital mycoplasmas and culture for aerobic and anaerobic bacteria were performed. Twenty-eight of 37 patients placentas were collected and assessed for presence or absence HCA. IL-6 concentration in amniotic fluid were determined using a sensitive and specific diagnostic kit Human IL-6 Quantikine ELISA manufactured R&D Systems, USA. There was...
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To determine sonographically the transverse diameter of the fetal thymus and present nomogram for the transverse diameter of the fetal thymus in uncomplicated singleton pregnancies between 19 and 38 weeks of gestation. Department of... more
To determine sonographically the transverse diameter of the fetal thymus and present nomogram for the transverse diameter of the fetal thymus in uncomplicated singleton pregnancies between 19 and 38 weeks of gestation. Department of Obstetrics and Gynecology, Charles University in Prague, Faculty of Medicine Hradec Kralove, University Hospital Hradec Kralove, Czech Republic. A prospective study was performed. The transverse diameter of the fetal thymus was measured by the one experienced examiner in 198 healthy fetuses between 19 and 38 weeks of gestation. The transverse diameters of the fetal thymus were obtained from 183 of the 198 subjects. The regression equation was expressed as a function of gestational age: the transverse diameter of the fetal thymus (mm) = 1.001 × gestational age (week) - 0.932 or 0.143 × day - 1.34. Both the correlation coefficients, r=0.91 for weeks and r=0.92 for days were found to be highly statistically significant (p<0.0001). This study presents nor...
Research Interests: Fetal development, Pregnancy, Humans, Female, Male, and 3 moreRegression Analysis, Fetus, and Gestational Age
The purpose of this study was to focuse on recent developments on the evolving field of biomarker discovery and validation techniques using proteomics platforms for endometrial carcinoma. Review. Department of Obstetrics and Gynecology... more
The purpose of this study was to focuse on recent developments on the evolving field of biomarker discovery and validation techniques using proteomics platforms for endometrial carcinoma. Review. Department of Obstetrics and Gynecology Medical Faculty Charles University Hradec Kralove. The last decade has seen major changes in the technologies used to identify markers for diagnosing endometrial carcinoma. Currently the major developments were made in proteomics area. This new technology hold significant promise in identifying more robust markers for endometrial carcinoma. The present review summarizes the results of clinical and experimental research on biomarkers of endometrial carcinoma.
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The purpose of this study was to evaluate the prevalence of cervical colonization by genital mycoplasmas in patients with preterm premature rupture of the membranes (PPROM). We studied 225 women between 24 and 36 weeks of gestation with... more
The purpose of this study was to evaluate the prevalence of cervical colonization by genital mycoplasmas in patients with preterm premature rupture of the membranes (PPROM). We studied 225 women between 24 and 36 weeks of gestation with PPROM. Cervical swabs were obtained for genital mycoplasmas and standard vaginal smears of bacterial culture were performed at the time of patients' admission. In the control group were 225 women with a normal pregnancy. Ureaplasma urealyticum was detected in 68% (152/225) and Mycoplasma hominis was detected in 28% (63/225) of the patients with PPROM between 24 and 36 weeks of gestation and. In the control group Ureaplasma urealyticum was found in 17% (38/225) and Mycoplasma hominis in 15% (35/225) pregnant women. Our results provide evidence of an association between cervical colonization with genital mycoplasmas and preterm premature rupture of the membranes.
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The purpose of this study was to focus on recent developments in the rapidly evolving field of biomarker discovery and validation techniques using proteomics platform with respect to cervical cancer. Review. Department of Obstetrics and... more
The purpose of this study was to focus on recent developments in the rapidly evolving field of biomarker discovery and validation techniques using proteomics platform with respect to cervical cancer. Review. Department of Obstetrics and Gynecology Medical Faculty Charles University Hradec Kralove. The last decade has seen major changes in the technologies used to identify diagnostic markers for early stages of cervical cancer. Significant advances were achieved in three key areas: protein profilling, multidimensional liquid chromatography combined with cutting edge mass spectrometry and high-throughput validation techniques. These new technologies hold significant promise in identifying more robust, sensitive and specific markers for cervical cancer. The present review summarizes the results of clinical and experimental research on biomarkers of cervical cancer.
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To review the published articles about identification of biomarkers of spontaneous preterm birth using a proteomic approach and to create a list of potential biomarkers. Systematic review of literature. Department of Obstetrics and... more
To review the published articles about identification of biomarkers of spontaneous preterm birth using a proteomic approach and to create a list of potential biomarkers. Systematic review of literature. Department of Obstetrics and Gynecology, Medical Faculty Charles University Hradec Kralove. The following databases were accessed in search of relevant citation: MEDLINE, SCOPUS and PubMed. Totally 101 references were identified and relevant 37 abstracts were screened. As appropriated were pointed 16 studies. Finally, the data were extracted from five articles. The implementation of high-throughput technologies is necessary in the field of spontaneous preterm birth research. A compelling option is the use of proteomics in the area spontaneous preterm birth biomarkers identification in amniotic fluid, maternal serum/plasma, cervical-vaginal fluid and placental tissue. The data was extracted from published articles and a list of 72 proteins was created.
Objective: To determine amniotic fluid total antioxidant capacity (TAC), ferric-reducing antioxidant power (FRAP) and thiobarbituric acid-reacting substances (TBARS), markers of oxidative stress, in pregnancies complicated by preterm... more
Objective: To determine amniotic fluid total antioxidant capacity (TAC), ferric-reducing antioxidant power (FRAP) and thiobarbituric acid-reacting substances (TBARS), markers of oxidative stress, in pregnancies complicated by preterm prelabor rupture of membranes (pPROM) and their correlation to microbial invasion of the amniotic cavity (MIAC) and/or histological chorioamnionitis (HCA). Methods: One-hundred thirty-eight women with singleton pregnancies complicated by pPROM were included in this study. Amniotic fluid was collected by transabdominal amniocentesis at the time of admission and amniotic fluid concentrations of TAC, FRAP and TBARS were measured. Result: The presence of MIAC and/or HCA did not show any significant differences in the amniotic fluid TAC, FRAP and TBARS concentrations. Positive correlations between gestational age at sampling and amniotic fluid TAC and FRAP concentrations were found (TAC: rho = 0.32; p = 0.0002; FRAP: rho = 0.36; p < 0.0001). A negative co...
To determine whether umbilical cord blood concentrations of interleukin-6 (IL-6), interleukin-8 (IL-8), and matrix metalloproteinase-8 (MMP-8) are of value in the diagnosis of histological chorioamnionitis (HCA) and funisitis in patients... more
To determine whether umbilical cord blood concentrations of interleukin-6 (IL-6), interleukin-8 (IL-8), and matrix metalloproteinase-8 (MMP-8) are of value in the diagnosis of histological chorioamnionitis (HCA) and funisitis in patients with preterm premature rupture of membranes (PPROM). Department of Obstetrics and Gynaecology, Charles University in Prague, Faculty of Medicine Hradec Kralove, University Hospital Hradec Kralove, Czech Republic. We compared umbilical cord blood IL-6, IL-8, and MMP-8 concentrations in 83 women with PPROM between 24th and 36th gestational weeks with the presence and the absence of HCA/funisitis using nonparametric tests (Mann-Whitney U test), given the non-normal distribution of analyte. Comparisons of proportions were performed the D'Agostino and Pearson omnibus normality test and the Shapiro-Wilk test. Patients with HCA had a significantly higher median umbilical cord blood IL-6 concentration than patients without histological signs of inflamma...
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Precise temperature measurement is essential in a wide range of applications in the medical environment, however the regarding the problem of temperature measurement inside a simple incubator, neither a simple nor a low cost solution have... more
Precise temperature measurement is essential in a wide range of applications in the medical environment, however the regarding the problem of temperature measurement inside a simple incubator, neither a simple nor a low cost solution have been proposed yet. Given that standard temperature sensors don't satisfy the necessary expectations, the problem is not measuring temperature, but rather achieving the desired sensitivity. In response, this paper introduces a novel hardware design as well as the implementation that increases measurement sensitivity in defined temperature intervals at low cost.
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To investigate the link between infection-related risk factors for cerebral palsy subtypes in children born at term. A case-control study was performed in a population-based series of children with cerebral palsy born at term (n=309)... more
To investigate the link between infection-related risk factors for cerebral palsy subtypes in children born at term. A case-control study was performed in a population-based series of children with cerebral palsy born at term (n=309) matched with a control group (n=618). The cases were divided into cerebral palsy subtypes: spastic hemiplegia, spastic diplegia, spastic tetraplegia, and dyskinetic cerebral palsy. All forms of spastic cerebral palsy were also analyzed together. All records were examined for maternal and neonatal signs of infection. Univariate and adjusted analyses were performed. Infection-related risk factors were shown to be independent risk factors for spastic cerebral palsy in the adjusted analyses. This was especially pronounced in the subgroup with spastic hemiplegia in which bacterial growth in urine during pregnancy (n=11 [7.5%], odds ratio [OR] 4.7, 95% confidence interval [CI] 1.5-15.2), any infectious disease during pregnancy (n=57 [39.0%], OR 2.9, 95% CI 1.7-4.8), severe infection during pregnancy (n=12 [8.2%], OR 15.4, 95% CI 3.0-78.1), antibiotic therapy once during pregnancy (n=33 [22.6%], OR 6.3, 95% CI 3.0-15.2) as well as several times during pregnancy (n=9 [6.2%], OR 15.6, 95% CI 1.8-134.2) constituted strong independent risk factors. However, only neonatal infection (n=11 [9.1%], OR 14.7, 95% CI 1.7-126.5) was independently significantly associated with an increased risk of spastic diplegia and tetraplegia. Infection-related factors are strong independent risk factors for the subgroup with spastic hemiplegia in children with cerebral palsy born at term. The finding is less pronounced in the subgroups with spastic diplegia or tetraplegia. II.