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Amniotic fluid volume in intra-amniotic inflammation with and without culture-proven amniotic fluid infection in preterm premature rupture of membranes.

AbstractOBJECTIVE:
Previous studies reported that the clinical significance of intra-amniotic inflammation with a negative amniotic fluid (AF) culture is similar to that of intra-amniotic inflammation with microbiologically-proven AF infection. However, the magnitude of the fetal inflammatory response in these two conditions is different as gauged by umbilical cord C-reactive protein (CRP) concentrations. We undertook this study to determine if the frequency of oligohydramnios is different in these two conditions.
METHODS:
The amniotic fluid index (AFI) was measured in 205 patients with preterm premature rupture of membranes (PROM) (<or=35 weeks). AF was cultured for aerobic and anaerobic bacteria and genital mycoplasmas. Intra-amniotic inflammation was defined as an elevated AF matrix metalloproteinase-8 (MMP-8) concentration (>23 ng/mL). Patients were divided into three groups according to the results of AF culture and the presence or absence of intra-amniotic inflammation: 1) without intra-amniotic inflammation and a negative culture (n=109); 2) with intra-amniotic inflammation and a negative culture (n=44); and 3) a positive culture (n=52).
RESULTS:
Patients with a positive culture had a higher frequency of oligohydramnios and a lower median AFI than those with a negative culture but with intra-amniotic inflammation (P<0.01). However, there was no significant difference in the median AFI or in the frequency of oligo-hydramnios according to the presence or absence of intra-amniotic inflammation among patients with a negative culture (P>0.1).
CONCLUSION:
Oligohydramnios was more frequent in patients with culture-proven AF infection than in those with intra-amniotic inflammation and a negative AF culture.
AuthorsSi Eun Lee, Roberto Romero, Seung Mi Lee, Bo Hyun Yoon
JournalJournal of perinatal medicine (J Perinat Med) Vol. 38 Issue 1 Pg. 39-44 ( 2010) ISSN: 1619-3997 [Electronic] Germany
PMID19708825 (Publication Type: Journal Article, Research Support, N.I.H., Intramural, Research Support, Non-U.S. Gov't)
Topics
  • Adult
  • Amniotic Fluid (microbiology)
  • Chorioamnionitis (microbiology)
  • Female
  • Fetal Diseases (etiology)
  • Humans
  • Oligohydramnios (microbiology)
  • Pregnancy
  • Systemic Inflammatory Response Syndrome (etiology)
  • Young Adult

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