Document Detail

Relationship of amniotic fluid markers of intra-amniotic infection with histopathology in cases of preterm labor with intact membranes.
MedLine Citation:
PMID:  10685269     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To evaluate the correlation of amniotic fluid (AF) markers (AFMs) of intra-amniotic infection with histopathologic findings in cases of preterm labor with intact membranes, between 22 and 36 weeks' gestation. STUDY DESIGN: We reviewed the charts of patients admitted in preterm labor with intact membranes between January 1993 and December 1996. Those having amniocentesis were identified, and AFMs were compared with histopathology in patients who delivered within 48 hours of the amniocentesis. The AFMs evaluated were glucose, polymorphonuclear leukocytes, Gram stain, and culture. All placentae were reviewed by a single pathologist blinded to the AF findings. Histologic evidence of acute inflammation was defined by findings of both subchorial intervillositis and marginating choriodeciduitis. The sensitivities, specificities, and positive and negative predictive values of the various AFMs were calculated. RESULTS: Of 556 women with intact membranes presenting in preterm labor, 181 (32.6%) had amniocentesis and 88 delivered within 48 hours of the amniocentesis. Histopathologic chorioamnionitis was seen in 53 patients (60.2%). The findings (with their sensitivity, specificity, and positive and negative predictive values) were: polymorphonuclear leukocytes at > 10/high-power field (22.6%, 97.2%, 92.3%, and 46.1%), positive Gram stain (26.4%, 94.6%, 87.5%, and 47.3%), culture (28.3%, 92.1%, 83.3%, and 47.9%), and glucose of < 15 mg/dl (28.3%, 94.6%, 88.2%, and 47.9%), respectively. Using a receiver-operator characteristic curve for different level of AF glucose, a glucose level of < 20 mg/dl was the most sensitive AF predictor of histologic chorioamnionitis. CONCLUSION: Histopathologic evidence of chorioamnionitis was present in 60.2% of cases of preterm births due to preterm labor in women who at our institution were offered and accepted amniocentesis and subsequently delivered within 48 hours. AFMs may be useful predictors of histologic chorioamnionitis. The most efficient AFM for chorioamnionitis in this group of patients was glucose at < 20 mg/dl.
A O Odibo; J F Rodis; M M Sanders; A F Borgida; M Wilson; J F Egan; W A Campbell
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of perinatology : official journal of the California Perinatal Association     Volume:  19     ISSN:  0743-8346     ISO Abbreviation:  J Perinatol     Publication Date:  1999 Sep 
Date Detail:
Created Date:  2000-03-08     Completed Date:  2000-03-08     Revised Date:  2005-11-17    
Medline Journal Info:
Nlm Unique ID:  8501884     Medline TA:  J Perinatol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  407-12     Citation Subset:  IM    
Division of Maternal Fetal Medicine, University of Connecticut Health Center, Farmington, USA.
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MeSH Terms
Amnion / microbiology*
Amniotic Fluid / metabolism*,  microbiology
Biological Markers
Chorioamnionitis / microbiology
Infant Mortality
Infant, Newborn
Infection / metabolism*,  pathology*
Inflammation / metabolism
Obstetric Labor, Premature / metabolism*
Placenta Diseases / metabolism
Reg. No./Substance:
0/Biological Markers

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