title: The clinical significance of a positive Amnisure test in women with preterm labor and intact membranes.
abstract: OBJECTIVE
  This study was conducted to examine the frequency and clinical significance of a positive Amnisure test in patients with preterm labor and intact membranes by sterile speculum exam.
  
  
  METHODS
  A retrospective cohort study was performed including 90 patients with preterm labor and intact membranes who underwent Amnisure tests prior to amniocentesis (< 72 h); most patients (n=64) also underwent fetal fibronectin (fFN) tests. Amniotic fluid (AF) was cultured for aerobic/anaerobic bacteria and genital mycoplasmas and assayed for matrix metalloproteinase-8.
  
  
  RESULTS
  (1) the prevalence of a positive Amnisure test was 19% (17/90); (2) patients with a positive Amnisure test had significantly higher rates of adverse pregnancy and neonatal outcomes (e.g., impending preterm delivery, intra-amniotic infection/inflammation, and neonatal morbidity) than those with a negative Amnisure test; (3) a positive test was associated with significantly increased risk of intra-amniotic infection and/or inflammation, delivery within 7, 14, or 28 days and spontaneous preterm birth (< 35 weeks) among patients with a negative fFN test.
  
  
  CONCLUSIONS
  A positive Amnisure test in patients with preterm labor and intact membranes is a risk factor for adverse pregnancy outcome, particularly in patients with a negative fFN test. A positive Amnisure test in patients without symptoms or signs of ROM should not be taken as an indicator that membranes have ruptured.
authors.affiliation: Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: Seung Mi
authors.initials: SM
authors.lastname: Lee
authors.forename: Roberto
authors.initials: R
authors.lastname: Romero
authors.forename: Jeong Woo
authors.initials: JW
authors.lastname: Park
authors.forename: Sun Min
authors.initials: SM
authors.lastname: Kim
authors.forename: Chan-Wook
authors.initials: CW
authors.lastname: Park
authors.forename: Steven J
authors.initials: SJ
authors.lastname: Korzeniewski
authors.forename: Tinnakorn
authors.initials: T
authors.lastname: Chaiworapongsa
authors.forename: Bo Hyun
authors.initials: BH
authors.lastname: Yoon
mesh_terms: D000328:Adult; D000653:Amniotic Fluid / Q000737:chemistry / Q000378:metabolism / Q000382:microbiology; D002821:Chorioamnionitis / Q000175:diagnosis / Q000382:microbiology; D015331:Cohort Studies; D005321:Extraembryonic Membranes / Q000382:microbiology / Q000502:physiology; D005260:Female; D005322:Premature Rupture of Fetal Membranes / Q000175:diagnosis* / Q000378:metabolism / Q000382:microbiology; D006801:Humans; D018970:Insulin-Like Growth Factor Binding Protein 1 / Q000032:analysis* / Q000378:metabolism; D007752:Obstetric Labor, Premature / Q000175:diagnosis* / Q000378:metabolism / Q000382:microbiology; D011237:Predictive Value of Tests; D011247:Pregnancy; D011296:Prenatal Diagnosis / Q000379:methods; D012189:Retrospective Studies; D012680:Sensitivity and Specificity
chemical_list: C032231:IGFBP1 protein, human; D018970:Insulin-Like Growth Factor Binding Protein 1