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



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.



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.



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.
Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Korea.
Byoung Jae
BJ
Kim
Roberto
R
Romero
Seung
S
Mi Lee
Chan-Wook
CW
Park
Joong
J
Shin Park
Jong Kwan
JK
Jun
Bo Hyun
BH
Yoon
D000328:Adult; D000649:Amniocentesis; D000653:Amniotic Fluid / Q000000981:diagnostic imaging / Q000201:enzymology; D002821:Chorioamnionitis / Q000175:diagnosis / Q000209:etiology; D005321:Extraembryonic Membranes / Q000000981:diagnostic imaging; D005260:Female; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D007236:Infant, Small for Gestational Age; D020784:Matrix Metalloproteinase 8 / Q000378:metabolism; D007752:Obstetric Labor, Premature / Q000000981:diagnostic imaging / Q000209:etiology* / Q000503:physiopathology; D016104:Oligohydramnios / Q000000981:diagnostic imaging / Q000209:etiology* / Q000503:physiopathology; D011247:Pregnancy; D056910:Republic of Korea; D012307:Risk Factors; D016216:Ultrasonography, Prenatal
C488762:MMP8 protein, human; D020784:Matrix Metalloproteinase 8
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