| Abstract [eng] |
Chorioamnionitis is an acute inflammation of the foetal membranes and placenta. This infection is dangerous for women because it increases the risk of uterine atony and postpartum haemorrhage, endometritis, peritonitis and sepsis. This infection is dangerous to the neonate, because of the increased risk of foetal inflammatory response syndrome, pneumonia, meningitis, sepsis and death. There is still no universally accepted single method for diagnosing chorioamnionitis. Each year, more studies are being carried out to validate a test method that is suitable for the early diagnosis of chorioamnionitis, is quick and easy to perform, and that has a high specificity and sensitivity. The aim of this dissertation is to evaluate the role of inflammatory markers in maternal blood and non-invasively collected amniotic fluid, for the antenatal diagnosis of chorioamnionitis. It was found that NLR has higher diagnostic values than the assessment of leukocyte count and CRP in the diagnosis of histological chorioamnionitis. IL-6, TNF-α, MMP-8 and suPAR in non-invasively collected amniotic fluid are statistically significant diagnostic markers of histological chorioamnionitis. The best diagnostic value for histological chorioamnionitis have TNF-α and MMP-8. The optimal values of inflammatory markers of maternal blood and amniotic fluid for the diagnosis of chorioamnionitis have been determined: NLR – 5,97, CRP – 8,56 mg/l, IL-6 – 1 389,82 pg/ml, TNF-α – 21,17 pg/ml, MMP-8 – 172,53 ng/ml, suPAR – 30,08 mcg/ml. Evaluation of CRP with MMP-8 or TNF-α and NLR with MMP-8 showed a statistically significantly higher diagnostic values than evaluation of CRP or NLR alone. To improve the prediction of chorioamnionitis, it is recommended to assess inflammatory markers in the maternal blood and amniotic fluid together. |
