title: Intra-amniotic infection/inflammation as a risk factor for subsequent ruptured membranes after clinically indicated amniocentesis in preterm labor.
abstract: The aim of this study was to determine whether intra-amniotic infection/inflammation (IAI) was associated with subsequent ruptured membranes in women with preterm labor and intact membranes who had a clinically indicated amniocentesis. This retrospective cohort study included 237 consecutive women with preterm labor (20-34.6 weeks) who underwent amniocentesis. The clinical and laboratory parameters evaluated included demographic variables, gestational age, C-reactive protein (CRP) and amniotic fluid (AF) white blood cell, interleukin-6 (IL-6) and culture results. IAI was defined as a positive AF culture and/or an elevated AF IL-6 level (>2.6 ng/mL). The primary outcome was ruptured membranes in the absence of active labor occurring within 48 hours of amniocentesis. Preterm premature rupture of membranes subsequently developed in 10 (4.2%) women within 48 hr of amniocentesis. Multivariate analysis demonstrated that only IAI was independently associated with the ruptured membranes occurring within 48 hr of amniocentesis. In the predictive model based on variables assessed before amniocentesis, only CRP level was retained. IAI is an independent risk factor for subsequent ruptured membranes after clinically indicated amniocentesis in preterm labor. Prior to amniocentesis, measurement of serum CRP level can provide a risk assessment for the subsequent development of ruptured membranes after the procedure.
authors: Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.
authors: Sung Youn
authors: SY
authors: Lee
authors: Kyo Hoon
authors: KH
authors: Park
authors: Eun Ha
authors: EH
authors: Jeong
authors: Kyung Joon
authors: KJ
authors: Oh
authors: Aeli
authors: A
authors: Ryu
authors: Ahra
authors: A
authors: Kim
mesh_terms: D000328:Adult; D000649:Amniocentesis / Q000009:adverse effects*; D000650:Amnion / Q000503:physiopathology; D000653:Amniotic Fluid / Q000166:cytology / Q000378:metabolism / Q000382:microbiology; D001424:Bacterial Infections / Q000209:etiology* / Q000382:microbiology; D002097:C-Reactive Protein / Q000032:analysis; D015331:Cohort Studies; D003710:Demography; D005260:Female; D005865:Gestational Age; D006801:Humans; D007249:Inflammation / Q000209:etiology*; D015850:Interleukin-6 / Q000378:metabolism; D007962:Leukocytes / Q000166:cytology; D015999:Multivariate Analysis; D009174:Mycoplasma / Q000302:isolation & purification; D007752:Obstetric Labor, Premature / Q000209:etiology*; D011247:Pregnancy; D012372:ROC Curve; D012189:Retrospective Studies; D012307:Risk Factors; D016990:Ureaplasma urealyticum / Q000302:isolation & purification
chemical_list: D015850:Interleukin-6; D002097:C-Reactive Protein
keywords: Amniocentesis; C-Reactive Protein; Intra-Amniotic Infection/Inflammation; Obstetric Labor, Premature; Ruptured Membranes
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