Correlation Of TLR-2、TLR-4 And Pro-adm With Meconium Stained Amniotic Fluid

Objectives1.To analyze the clinical risk factors for meconium stained amniotic fluid combined with neonatal infection.2.To investigate the correlation of toll-like receptor-2,toll-like receptor-4 and pro-adrenomedullin with meconium stained amniotic fluid.Methods1.Neonatal of meconium stained amniotic fluid Ⅲ degree admitted to Affiliated Hospital of Yanbian University(hereinafter referred to as our hospital)were collected and divided into two groups,namely MSAF combined with infected group and MSAF combined with non-infected group.To analyze the clinical risk factors of meconium stained amniotic fluid combined with neonatal infection.2.Maternal placenta and umbilical cord blood of meconium stained amniotic fluidⅢ degree full term without pregnancy complications were collected as MSAF group born in two hospitals in Yanbian.There are no complications of the full term pregnancy with clear amniotic fluid as control group.The placenta were all routinely stained with HE.The MSAF group was divided into three groups according to different placental inflammatory lesions,namely acute chorioamnionitis group、chronic chorioamnionitis group and no chorioamnionitis group.The expressions of toll-like receptor-2 and toll-like receptor-4 in placenta were observed by immunohistochemistry staining method.The content of pro-adrenomedullin in cord blood was detected by ELISA method.Results1.The 343 newborns with amniotic fluid III degree fecal infection were infected 64 cases,accounting for 18.7%of children with III degree of amniotic fluid.Analysis of risk factors for meconium stained amniotic fluid combined with neonatal infection.There were no significant differences in the birth sex,birth weight,mode of delivery,fetal distress in uterus,abnormal placenta or umbilical cord,1 minute Apgar score<7minutes,unipara,maternal age,pregnancy-induced hypertension syndrome,gestational diabetes mellitus,hypothyroidism and genital infection between the two groups(P>0.05).MSAF neonates with gestational age greater than 41weeks had the highest rate combined with infection(34.9%).And the difference was statistically significant(P<0.05).2.The intensity of expression of toll-like receptor-2 and toll-like receptor-4 in the placenta tissue of meconium stained amniotic fluid group were higher than those in the control group.And there was statistical significance(P<0.05).The level of pro-adrenomedullin in umbilical cord blood was compared between the two groups.There was no statistical significance(P>0.05).3.Among the 53 cases of meconium stained amniotic fluid,meconium stained amniotic fluid combined with placenta abnormalities accounted for 77.4%(10 cases of acute chorioamnionitis,accounting for 18.9%,31 cases of chronic chorioamnionitis,accounting for 58.5%),no chorioamnionitis group 12 cases,accounting for 22.6%.There was no significant difference in umbilical cord blood pro-adrenomedullin levels,the intensity of expression placental tissue toll-like receptor-2、4 in the three groups(P>0.05).Conclusions1.Gestational age>41 weeks may be a clinical risk factor for meconium stained amniotic fluid combined with neonatal infection.2.Toll-like receptor-2 and toll-like receptor-4 are involved in the occurrence of meconium stained amniotic fluid,considering that placental inflammation is one of the reasons of meconium stained amniotic fluid.3.Toll-like receptor-2,toll-like receptor-4 and pro-adrenomedullin were not associated with meconium stained amniotic fluid combined with chorioamnionitis.