Aim: Currently, the medical term “preterm preeclampsia (PE)” is not included in the Japan Society of the Study of Hypertension in Pregnancy (JSSHP) classification of hypertensive disorders of pregnancy.

Methods: We searched PubMed for studies using the term “preterm PE” on October 1, 2024, with the following combination of keywords: “preterm preeclampsia” OR “preterm pre-eclampsia.”

Results: A total of 479 articles were identified. The term “preterm PE” first appeared in 1994. From 2011 to 2023, the number of studies using the term “preterm PE” gradually increased, reaching 62 in 2023. The studies using the term “preterm PE” involved prediction of preterm PE (i.e., preterm-delivery PE). Current studies predicting preterm PE focus on competing risks models using maternal factors, biophysical markers, and biomarkers in the first trimester, and an established competing risks model for predicting preterm PE is available on the website of the Fetal Medicine Foundation (FMF). However, the term “preterm PE” has been used with different meanings (preterm-onset vs. preterm-delivery PE).

Conclusions: Both definitions of preterm PE have merits and demerits. Therefore, not only preterm-delivery PE but also preterm-onset PE should be evaluated simultaneously as primary outcomes when predicting preterm PE.

Aim: This study aimed to investigate the role of the chondroitin sulfate (ChS) chain in the anti-inflammatory effect of urinary trypsin inhibitor (UTI), identify ChS structures that enhance the anti-inflammatory activity of UTI, and develop a more effective means of treatment for preterm birth.

Methods: ChS chain-remodeled UTIs were prepared by the hydrolysis and/or transglycosylation reaction of testicular hyaluronidase. Uterine cervical fibroblasts were treated with native or ChS chain-remodeled UTIs and incubated with lipopolysaccharide to induce inflammation. To assess anti-inflammatory effects, interleukin-8 (IL-8) concentrations in culture supernatants were measured by enzyme-linked immunosorbent assay.

Results: Compared with controls without UTI, Ch6S-transferred UTI at the nonreducing terminus significantly suppressed IL-8 release. Other UTIs showed limited suppression.

Conclusion: The Ch6S chain at the nonreducing terminus of UTI enhances the anti-inflammatory activity of UTI. This finding could lead to the development of innovative treatments for preterm birth.

Aim: This retrospective study compared PROPESS and intravenous dinoprost administration in labor induction to determine whether PROPESS use reduced the percentage of women who underwent amniotomy in induced labor under epidural analgesia (the amniotomy rate).

Methods: Of the women who underwent induced labor under epidural analgesia at our hospital, 131 primiparous women with a Bishop score ≤6 were included in this study. The participants were divided into the following two groups to compare the amniotomy rates: (1) PROPESS group (n=72), cases in which labor was induced using PROPESS (between June 2022 and May 2024). (2) Dinoprost group (n=59), cases in which labor was induced using intravenous dinoprost (between June 2019 and May 2022).

Results: Amniotomy rates did not differ between the PROPESS and dinoprost groups. However, amniotomy before the onset of effective labor contractions was significantly less frequent in the PROPESS group than in the dinoprost group (8.8 vs. 44.4%; P<0.001).

Conclusions: The results indicate that the use of PROPESS in induced labor under epidural analgesia may reduce the number of women who undergo amniotomy during the latent phase of the first stage of labor.