title: Optimized amniotic fluid analysis in patients suspected of intrauterine infection/inflammation.
abstract: OBJECTIVE
  To determine the combination of amniotic fluid (AF) tests with the best diagnostic accuracy for predicting intrauterine infection/inflammation (IUI) in patients with clinical suspicion of chorioamnionitis.
  
  
  METHODS
  This is a retrospective study of 34 pregnant women who presented with uterine tenderness, maternal fever, maternal tachycardia, and/or fetal tachycardia and underwent AF analysis. IUI diagnosis was based on placental histology, positive AF bacterial cultures, and/or Gram stain.
  
  
  RESULTS
  Logistic regression analysis revealed a significant relationship between IUI and AF glucose. Glucose is more sensitive than culture or Gram stain (64% vs. 40% and 20%, respectively). Culture and glucose combined achieved the best diagnostic accuracy (sensitivity, 71%; specificity, 100%; positive and negative predictive values, 100-83%, respectively).
  
  
  CONCLUSIONS
  Positive AF Gram stain or glucose <15 mg/dL strongly suggests IUI in symptomatic patients. If both tests are negative, the result of culture should aid the management.
authors.affiliation: Harvard School of Public Health, Boston, MA, USA.
authors.forename: Catherine
authors.initials: C
authors.lastname: Ford
authors.forename: Mehmet R
authors.initials: MR
authors.lastname: Genç
mesh_terms: D000328:Adult; D000653:Amniotic Fluid / Q000737:chemistry*; D002821:Chorioamnionitis / Q000175:diagnosis*; D005260:Female; D005840:Gentian Violet; D005947:Glucose / Q000032:analysis; D006801:Humans; D016015:Logistic Models; D010619:Phenazines; D011247:Pregnancy; D012189:Retrospective Studies; D055815:Young Adult
chemical_list: C035863:Gram's stain; D010619:Phenazines; D005947:Glucose; D005840:Gentian Violet