title: Advances in medical diagnosis of intra-amniotic infection.
abstract: BACKGROUND
  Intrauterine infection is a global problem and a significant contributor to morbidity and perinatal death. The host response to infection causes an inflammatory state that acts synergistically with microbial insult to induce preterm birth and fetal damage. Prompt and accurate diagnosis of intra-amniotic infection in the asymptomatic stage of the disease is critical for improved maternal and neonatal outcomes.
  
  
  METHODS
  This article provides an overview of the most recent progress, challenges, and opportunities for discovery and clinical implementation of various maternal serum, cervicovaginal, and amniotic fluid biomarkers in pregnancies complicated by intra-amniotic infection.
  
  
  CONCLUSIONS
  Clinically relevant biomarkers are critical to the accurate diagnostic of intrauterine infection. Front-end implementation of such biomarkers will also translate in lower incidence of early-onset neonatal sepsis (EONS) which is an important determinant of neonatal morbidity and mortality associated with prematurity. However, of the hundreds of differentially expressed proteins, only few may have clinical utility and thus function as biomarkers. The small number of validation studies along with barriers to implementation of technological innovations in the clinical setting are current limitations.
authors.affiliation: Yale University, Department of Obstetrics, Gynecology & Reprod. Science, New Haven, CT 06520, USA. irina.buhimschi@yale.edu
authors.forename: Irina A
authors.initials: IA
authors.lastname: Buhimschi
authors.forename: Unzila A
authors.initials: UA
authors.lastname: Nayeri
authors.forename: Christine A
authors.initials: CA
authors.lastname: Laky
authors.forename: Sonya-Abdel
authors.initials: SA
authors.lastname: Razeq
authors.forename: Antonette T
authors.initials: AT
authors.lastname: Dulay
authors.forename: Catalin S
authors.initials: CS
authors.lastname: Buhimschi
mesh_terms: D000650:Amnion / Q000382:microbiology*; D000653:Amniotic Fluid / Q000382:microbiology; D001431:Bacteriological Techniques / Q000379:methods; D005260:Female; D005315:Fetal Diseases / Q000175:diagnosis*; D006801:Humans; D025202:Molecular Diagnostic Techniques / Q000379:methods; D010922:Placenta Diseases / Q000175:diagnosis*; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000175:diagnosis*