The antenatal identification of funisitis with a rapid MMP-8 bedside test.
OBJECTIVE
The purpose of this study was to determine if a bedside test, the MMP-8 PTD Check, can be of value in the antenatal identification of funisitis. This test can be performed in 15 min without any laboratory equipment.


METHODS
The relationship between the presence or absence of funisitis and the results of an MMP-8 PTD Check was examined in 139 patients who delivered preterm singleton neonates (gestational age <35 weeks) within 72 h of amniocentesis. Amniotic fluid (AF) was cultured for aerobic and anaerobic bacteria and for genital mycoplasmas. AF was analyzed for white blood cell (WBC) count, interleukin-6 (IL-6) and an MMP-8 PTD Check. The IL-6 concentration was also determined in umbilical cord plasma collected at birth. Funisitis was diagnosed in the presence of neutrophil infiltration into the umbilical vessel walls or Wharton's jelly.


RESULTS
1) Funisitis was present in 27% (38/139) of cases; 2) A positive MMP-8 PTD Check had a sensitivity of 97% (37/38), a specificity of 63% (64/101), a positive predictive value of 50% (37/74) and a negative predictive value of 99% (64/65) in the identification of funisitis; 3) Among cases without funisitis, patients with a positive MMP-8 PTD Check had a significantly higher median AF IL-6 concentration, AF WBC count, and umbilical cord plasma IL-6 concentration at birth than those with a negative MMP-8 PTD Check (P<0.05 for each).


CONCLUSIONS
The MMP-8 PTD Check is a rapid, simple and sensitive bedside test which allows assessment of the risk of funisitis.
Park
Chan-Wook
CW
Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Korea.
Lee
Seung Mi
SM
Park
Joong Shin
JS
Jun
Jong Kwan
JK
Romero
Roberto
R
Yoon
Bo Hyun
BH
D000328:Adult; D000649:Amniocentesis; D000653:Amniotic Fluid / Q000737:chemistry*; D002821:Chorioamnionitis / Q000175:diagnosis*; D004796:Clinical Enzyme Tests / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007958:Leukocyte Count; D020784:Matrix Metalloproteinase 8 / Q000032:analysis*; D019095:Point-of-Care Systems / Q000706:statistics & numerical data; D011237:Predictive Value of Tests; D011247:Pregnancy; D047928:Premature Birth / Q000201:enzymology; D011296:Prenatal Diagnosis / Q000379:methods*
D020784:Matrix Metalloproteinase 8