Abstract | 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:
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Authors | A O Odibo, J F Rodis, M M Sanders, A F Borgida, M Wilson, J F Egan, W A Campbell |
Journal | Journal of perinatology : official journal of the California Perinatal Association
(J Perinatol)
Vol. 19
Issue 6 Pt 1
Pg. 407-12
(Sep 1999)
ISSN: 0743-8346 [Print] United States |
PMID | 10685269
(Publication Type: Journal Article)
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Chemical References |
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Topics |
- Adult
- Amnion
(microbiology)
- Amniotic Fluid
(metabolism, microbiology)
- Biomarkers
- Chorioamnionitis
(microbiology)
- Female
- Humans
- Infant Mortality
- Infant, Newborn
- Infections
(metabolism, pathology)
- Inflammation
(metabolism)
- Obstetric Labor, Premature
(metabolism)
- Placenta Diseases
(metabolism)
- Pregnancy
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