Infection and labor. V. Prevalence, microbiology, and clinical significance of intraamniotic infection in women with preterm labor and intact membranes

Roberto Romero, Marina Sirtori, Enrique Oyarzun, Cecilia Avila, Moshe Mazor, Robert Callahan, Virginia Sabo, Apostolos P. Athanassiadis, John C. Hobbins

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616 Citas (Scopus)

Resumen

Amniotic fluid was retrieved by amniocentesis from 264 patients with preterm labor and intact membranes admitted to Yale-New Haven Hospital from Jan. 1, 1985, to July 31, 1988. The prevalence of a positive amniotic fluid culture was 9.1% ( 24 264). A total of 111 patients (42%) delivered preterm neonates, and 24 (21.6%) of those had positive amniotic fluid cultures. The diagnostic indexes of the Gram stain of amniotic fluid in the prediction of a positive amniotic fluid culture were as follows: sensitivity, 79.1%; specificity, 99.6%; positive predictive value, 95%; and negative predictive value, 98%. Endotoxin was detected with the limulus amebocyte lysate assay in 4.9% ( 13 264) of patients with preterm labor. All patients with endotoxin in the amniotic fluid delivered preterm neonates. The three most frequently isolated organisms were Ureaplasma urealyticum (n = 6), Fusobacterium species (n = 5), and Mycoplasma hominis (n = 4). Clinical chorioamnionitis was present in only 12.5% of the patients with positive amniotic fluid cultures. Women with positive amniotic fluid cultures had lower gestational ages and more advanced cervical dilatation on admission than women with negative cultures. Preterm infants born to mothers with positive amniotic fluid cultures had a higher incidence of respiratory distress syndrome and infectious complications than preterm neonates born after negative amniotic fluid cultures. These data underscore the frequency and importance of intraamniotic infections in women with preterm labor.
Idioma originalInglés estadounidense
Páginas (desde-hasta)817-824
Número de páginas8
PublicaciónAmerican Journal of Obstetrics and Gynecology
Volumen161
N.º3
DOI
EstadoPublicada - 1 ene. 1989
Publicado de forma externa

Palabras clave

  • amniotic fluid
  • Gram stain
  • intraamniotic infection
  • limulus amebocyte lysate
  • lipopolysaccharide
  • prematurity
  • Preterm labor

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