A comparison of rapid amniotic fluid markers in the prediction of microbial invasion of the uterine cavity and preterm delivery☆,☆☆,★
Section snippets
MATERIAL AND METHODS
The study population included all patients with singleton pregnancies with the diagnosis of preterm labor and intact membranes at 23 to 35 weeks' gestation who underwent transabdominal amniocentesis at Westchester County Medical Center from Oct. 2, 1993, through June 30, 1995. Preterm labor was defined as six to eight uterine contractions in 1 hour or four in 20 minutes associated with cervical changes. Gestational ages were based on the last menstrual period or early ultrasound scans obtained
RESULTS
Of 358 women who were eligible, 138 (38.5%) agreed to participate. Seven of these women were excluded because of incomplete amniotic fluid analysis, establishing a study group of 131 women. A comparison of the group of women who chose not to participate with the study group showed no differences in maternal age, gestational age at admission, or delivery ≤36 hours after amniocentesis. The prevalence of positive amniotic fluid cultures was 12.2% (16 of 131). Table I displays the results of the
COMMENT
This study demonstrated that amniotic fluid LDH determination has diagnostic value in detecting microbial invasion of the amniotic cavity and in predicting duration of gestation after amniocentesis. In preterm labor amniotic fluid LDH level is shown to be elevated in the presence of a positive amniotic fluid culture and in patients delivering ≤36 hours after amniocentesis. Amniotic fluid LDH elevation is rarely discussed in the obstetric literature, yet in other medical fields this enzymatic
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Amniotic fluid interleukin-6 and neutrophil gelatinase-associated lipocalin for predicting fetal inflammatory response syndrome based on histological chorioamnionitis and funisitis
2023, Taiwanese Journal of Obstetrics and GynecologyDevelopment and validation of a multivariable prediction model of spontaneous preterm delivery and microbial invasion of the amniotic cavity in women with preterm labor
2020, American Journal of Obstetrics and GynecologyEvidence that antibiotic administration is effective in the treatment of a subset of patients with intra-amniotic infection/inflammation presenting with cervical insufficiency
2019, American Journal of Obstetrics and GynecologyThe combination of maternal blood and amniotic fluid biomarkers improves the predictive accuracy of histologic chorioamnionitis
2019, PlacentaCitation Excerpt :Romero et al. [21] reported that the measurement of interleukin (IL)-6 in amniotic fluid was an indicator of intrauterine infection according to amniotic fluid culture results (area under the curve, 0.927). However, amniotic fluid culture results also have high false-negative rates in the detection of intrauterine infection [20,22]. Several other reports have shown that measurement of neutrophil elastase, IL-6, IL-8, matrix metalloproteinase-9, and TNF-α in amniotic fluid are associated with HC [15,23].
Identification of haptoglobin switch-on status in archived placental specimens indicates antenatal exposure to inflammation and potential participation of the fetus in triggering preterm birth
2018, PlacentaCitation Excerpt :Three neonates died immediately after birth due to prematurity related complications. A diagnosis of amniotic fluid infection was established based on well recognized clinical, biochemical, and microbiological test results for glucose (cutoff ≤15 mg/dL), LDH (cutoff ≥419 U/L), WBC (cutoff ≥50 cells/μL), Gram stain, and bacterial cultures for aerobes, anaerobes, Ureaplasma and Mycoplasma species [19]. Amniotic fluid infection was considered in the presence of positive bacterial culture result and/or positive Gram stain.
Compartmentalization of acute phase reactants Interleukin-6, C-Reactive Protein and Procalcitonin as biomarkers of intra-amniotic infection and chorioamnionitis
2015, CytokineCitation Excerpt :The clinical laboratory assessed the AF glucose, lactate dehydrogenase levels (LDH), and performed a white blood cell count (WBC). A glucose level of ⩽15 mg/dL, LDH activity ⩾419 U/L, WBC count ⩾30 cells/μL were considered indicative of IAI [13,14]. AF was concurrently examined for the presence of infection using Gram staining and culturing methods for aerobic and anaerobic bacteria, Ureaplasma, and Mycoplasma species.
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From the Departments of Obstetrics and Gynecology and Pathology and the Graduate School of Health Sciences, New York Medical College, Westchester County Medical Center.
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Reprint requests: Nergesh Tejani, MD, Westchester County Medical Center, OB/GYN Department, Macy East, 2nd Floor, Valhalla, NY 10595.
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0002-9378/96 $5.00 + 0 6/1/75027