Bernard Spitz

Maternal serum levels of macrophage colony-stimulating factor are associated with adverse pregnancy outcome.

Objective: The aim of this study was the measurement of maternal serum levels of M-CSF throughout pregnancy, in a low risk obstetrical population, to examine the relationship of M-CSF and pregnancy outcome. Study design: Maternal serum was obtained at various stages of pregnancy and post partum, M-CSF levels were measured by ELISA, pertinent clinical data tabulated, and pregnancy outcome was determined. Results: In 564 pregnancies studied, 22% of 260 nulliparous pregnancies and 10% of 304 multiparous pregnancies were hypertensive. Preeclampsia occurred in 1.5% of nulliparous and in 1% of the multiparous women. In apparently normal pregnancies with good outcome, M-CSF levels rose throughout pregnancy. No cases of preeclampsia occurred if maternal serum M-CSF levels increased more than 100% throughout pregnancy. Conclusions: This study suggests that absolute levels and relative changes in maternal serum M-CSF levels during pregnancy are associated with adverse pregnancy outcomes.

Do biphasic uterine contractions imply poor uterine function

In a retrospective study of 362 cardiotocographic recordings of primigravidae in labour we found 8% biphasic or coupled uterine contractions. In augmented labour, biphasic contractions occurred almost twice as often as in spontaneous and induced labour. The duration of labour complicated with biphasic contractions was increased significantly in all types of labour. Therefore biphasic contractions may reflect uneffective uterine function. Contrary to other studies, the appearance of biphasic contractions showed no correlation with epidural analgesia and the incidence of instrumental deliveries or caesarean sections was not increased.

Predictive Models for Long Term Survival after Premature Rupture of Membranes

Premature rupture of the membranes complicates 30 to 40% of the preterm deliveries. The purpose of this study is to assess the outcome of preterm prelabor rupture of the membranes (PPROM) before 26 weeks of gestation and to develop a predictive model for survival. We apply four statistical methods in order to construct a predictive model: Coxs proportional hazards model, logistic regression, least squares - support vector machines and generalized estimating equations. The obtained predictive models are tested on a prospective set and have a very good performance of > 95% for the area under the ROC-curve