title: Meconium-stained amniotic fluid: a risk factor for microbial invasion of the amniotic cavity.
abstract: The purpose of this study was to determine whether meconium-stained amniotic fluid is a marker for microbial invasion of the amniotic cavity. Amniocentesis was performed on 707 patients presenting with preterm labor and intact membranes. Meconium-stained amniotic fluid was present in 4.2% (30/707) of patients with preterm labor. The prevalence of positive amniotic fluid cultures was significantly higher in women with meconium-stained amniotic fluid than in women with clear fluid (33% [10/30] vs 11% [75/677]; p = 0.001; odds ratio = 4.01; 95% confidence interval = 1.6 to 9.4). Patients with meconium-stained amniotic fluid were also more likely to have failed tocolysis and delivered a preterm neonate more frequently than patients with clear fluid (83% [25/30] vs 38% (258/677); p = 0.0001; odds ratio = 8.1; 95% confidence interval = 2.9 to 24.4). We conclude that meconium-stained amniotic fluid is a risk factor for microbial invasion of the amniotic cavity and preterm delivery in women with preterm labor and intact membranes.
authors.affiliation: Department of Obstetrics and Gynecology, Yale University School of Medicine, New Haven, CT 06510.
authors.forename: R
authors.initials: R
authors.lastname: Romero
authors.forename: S
authors.initials: S
authors.lastname: Hanaoka
authors.forename: M
authors.initials: M
authors.lastname: Mazor
authors.forename: A P
authors.initials: AP
authors.lastname: Athanassiadis
authors.forename: R
authors.initials: R
authors.lastname: Callahan
authors.forename: Y C
authors.initials: YC
authors.lastname: Hsu
authors.forename: C
authors.initials: C
authors.lastname: Avila
authors.forename: J
authors.initials: J
authors.lastname: Nores
authors.forename: C
authors.initials: C
authors.lastname: Jimenez
mesh_terms: D000653:Amniotic Fluid / Q000382:microbiology*; D005260:Female; D006801:Humans; D008089:Listeria monocytogenes / Q000302:isolation & purification; D008470:Meconium; D007752:Obstetric Labor, Premature / Q000209:etiology*; D011247:Pregnancy; D012307:Risk Factors; D014509:Ureaplasma / Q000302:isolation & purification