-Original-

Effect of Urinary Trypsin Inhibitor on Preterm Labor with High Granulocyte Elastase Concentration in Cervical Secretions

Masako Hayashi, Atsuko Oya, Hidehiko Miyake, Akihito Nakai and Toshiyuki Takeshita

Division of Reproductive Medicine, Perinatology and Gynecologic Oncology, Graduate School of Medicine, Nippon Medical School

Aims: To explore whether intravaginal treatment with urinary trypsin inhibitor (UTI) prevents preterm delivery in patients in preterm labor with increased levels of granulocyte elastase in cervical secretions.
Methods: The subjects were patients in preterm labor with increased levels of granulocyte elastase in cervical secretions from 16 to 33 weeks gestation. Maternal and neonatal outcomes were compared between patients receiving UTI treatment (UTI group; n=33) and those not receiving UTI treatment (control group; n=40).
Results: In patients receiving UTI, the mean gestational age at delivery was greater than that in the control group (37.8 vs. 35.6 weeks, p=0.003), and the rates of premature delivery before 34 and 37 weeks gestation were lower (3% vs. 20%, p=0.028; and 18% vs. 47%, p=0.008, respectively). The percentage of neonates weighing more than 2,500 g was significantly higher in the UTI group, with no neonates weighing less than 1,500 g. The neonatal hospitalization rate was lower in the UTI group (9% vs. 42%, p=0.001).
Conclusion: In patients in preterm labor with a high elastase concentration in cervical secretions, treatment with UTI reduced the risk of preterm delivery and improved neonatal outcomes.

J Nippon Med Sch 2010; 77: 80-85

Keywords
preterm labor, urinary trypsin inhibitor, granulocyte elastase

Correspondence to
Masako Hayashi, MD, Department of Obstetrics and Gynecology, Nippon Medical School, Tama Nagayama Hospital, 1-7-1 Nagayama, Tama, Tokyo 206-8512, Japan
yamaguchi1126@yahoo.co.jp

Received, April 30, 2009
Accepted, September 1, 2009