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Book Review: Hinde on Commercial Leases
This article reviews the book: “Hinde on Commercial Leases”, by G.W. Hinde
Identifying metabolite markers for preterm birth in cervicovaginal fluid by magnetic resonance spectroscopy
Introduction Preterm birth (PTB) may be preceded by
changes in the vaginal microflora and metabolite profiles.
Objectives We sought to characterise the metabolite
profile of cervicovaginal fluid (CVF) of pregnant women
by 1H NMR spectroscopy, and assess their predictive value
for PTB.
Methods A pair of high-vaginal swabs was obtained from
pregnant women with no evidence of clinical infection and
grouped as follows: asymptomatic low risk (ALR) women
with no previous history of PTB, assessed at 20–22 gestational
weeks, g.w., n = 83; asymptomatic high risk
(AHR) women with a previous history of PTB, assessed at
both 20–22 g.w., n = 71, and 26–28 g.w., n = 58; and
women presenting with symptoms of preterm labor (PTL)
(SYM), assessed at 24–36 g.w., n = 65. Vaginal secretions
were dissolved in phosphate buffered saline and scanned
with a 9.4 T NMR spectrometer.
Results Six metabolites (lactate, alanine, acetate, glutamine/glutamate,
succinate and glucose) were analysed. In
all study cohorts vaginal pH correlated with lactate integral
(r = -0.62, p\0.0001). Lactate integrals were higher in
the term ALR compared to the AHR (20–22 g.w.) women
(p = 0.003). Acetate integrals were higher in the preterm
versus term women for the AHR (20–22 g.w.) (p = 0.048)
and SYM (p = 0.003) groups; and was predictive of
PTB\37 g.w. (AUC 0.78; 95 % CI 0.61–0.95), and
delivery within 2 weeks of the index assessment (AUC
0.84; 95 % CI 0.64–1) in the SYM women, whilst other
metabolites were not.
Conclusion High CVF acetate integral of women with
symptoms of PTL appears predictive of preterm delivery,
as well as delivery within 2 weeks of presentation
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