Clinical significance of oligohydramnios in patients with preterm labor and intact membranes.

Abstract

OBJECTIVE:

To determine the frequency and clinical significance of oligohydramnios in patients with preterm labor and intact membranes.

STUDY DESIGN:

An amniotic fluid index (AFI) was determined before amniocentesis (<24 h) in 272 patients with preterm labor and intact membranes (<35 weeks of gestation). Amniotic fluid (AF) was cultured for aerobic and anaerobic bacteria and genital mycoplasmas, and assayed for matrix metalloproteinase-8 (MMP-8). Non-parametric statistical techniques and survival analysis were used.

RESULTS:

1) The overall prevalence of oligohydramnios (AFI of ≤5 cm) in patients with preterm labor and intact membranes was 2.6% (7/272); 2) patients with oligohydramnios had a higher frequency of AF infection and/or inflammation than those without oligohydramnios [85.7% (6/7) vs. 32.8% (87/265); P<0.01]; 3) patients with oligohydramnios had a higher median AF MMP-8 concentration than those without oligohydramnios [median 664.2 (range 16.6-3424.7) ng/mL vs. median 2.3 (range <0.3-6142.6) ng/mL; P<0.01]; 4) women with preterm labor and oligohydramnios had a shorter interval to delivery than those without oligohydramnios [median 18 h (range 0-74 h) vs. median 311 h (range 0-3228 h); P<0.01], and this difference remained significant after adjusting for gestational age and the presence or absence of AF infection/inflammation.

CONCLUSION:

Patients with preterm labor and oligohydramnios are at increased risk for impending preterm delivery and intra-amniotic inflammation and, therefore, may benefit from careful surveillance.

• Authors: Byoung Jae Kim, Roberto Romero, Seung Mi Lee, Chan-Wook Park, Joong Shin Park, Jong Kwan Jun, Bo Hyun Yoon
• Journal: Journal of perinatal medicine (J Perinat Med) Vol. 39 Issue 2 Pg. 131-6 (03 2011) ISSN: 1619-3997 [Electronic] Germany
• PMID: 21265728 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• MMP8 protein, human
• Matrix Metalloproteinase 8

Topics

• Adult
• Amniocentesis
• Amniotic Fluid (diagnostic imaging, enzymology)
• Chorioamnionitis (diagnosis, etiology)
• Extraembryonic Membranes (diagnostic imaging)
• Female
• Gestational Age
• Humans
• Infant, Newborn
• Infant, Premature
• Infant, Small for Gestational Age
• Matrix Metalloproteinase 8 (metabolism)
• Obstetric Labor, Premature (diagnostic imaging, etiology, physiopathology)
• Oligohydramnios (diagnostic imaging, etiology, physiopathology)
• Pregnancy
• Republic of Korea
• Risk Factors
• Ultrasonography, Prenatal