Amniotic fluid glucose and cytokines values in the early diagnosis of amniotic infection in patients with preterm labor and intact membranes.
OBJECTIVE
Our goal was to compare sensitivity, specificity, and predictive values of glucose and cytokines [interleukin-1 (IL-1), interleukin-6 (IL-6), interleukin-8 (IL-8), and tumor necrosis factor (TNF)] in amniotic fluid (AF) to detect an AF-positive culture.


METHODS
Amniocentesis was performed on 113 patients with preterm labour (PTL) and intact membranes. Fluid was cultured for aerobic and anaerobic bacteria, and for mycoplasmas. AF analysis included cytokines and glucose determinations.


RESULTS
The prevalence of positive AF cultures was 11.5% (13/113). Anaerobic bacteria were isolated in 9 patients (69.2%). The glucose <16 mg/dl and cytokines values; IL-1 >640 pg/ml, IL-6 >55,000 pg/ml, IL-8 >1,000 pg/ml, TNF >672 pg/ml, were significantly correlated (P < 0.01) with AF culture result. Glucose had a sensitivity of 69.2% and a specificity of 96% for the prediction of positive AF culture. The sensitivity and specificity of the cytokines ranged from 61.5-53.4% and 79.8-8.99%, respectively.


CONCLUSIONS
In the diagnosis of the AF-positive culture, glucose <16 mg/dl is more sensitive than cytokines.
Department of Obstetrics and Gynecology, Hospital Universitario Materno-Infantil Vall d'Hebron, Barcelona, Spain.
E
E
González-Bosquet
M J
MJ
Cerqueira
C
C
Dominguez
I
I
Gasser
B
B
Bermejo
L
L
Cabero
D000649:Amniocentesis; D000653:Amniotic Fluid / Q000737:chemistry* / Q000382:microbiology; D002821:Chorioamnionitis / Q000150:complications / Q000175:diagnosis*; D016207:Cytokines / Q000032:analysis*; D005260:Female; D005947:Glucose / Q000032:analysis*; D006801:Humans; D007375:Interleukin-1 / Q000032:analysis; D015850:Interleukin-6 / Q000032:analysis; D016209:Interleukin-8 / Q000032:analysis; D007752:Obstetric Labor, Premature / Q000150:complications*; D011237:Predictive Value of Tests; D011247:Pregnancy; D011296:Prenatal Diagnosis; D012680:Sensitivity and Specificity; D014409:Tumor Necrosis Factor-alpha / Q000032:analysis
D016207:Cytokines; D007375:Interleukin-1; D015850:Interleukin-6; D016209:Interleukin-8; D014409:Tumor Necrosis Factor-alpha; D005947:Glucose