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The value of amniotic fluid analysis in patients with suspected clinical chorioamnionitis

  • Elif E. Gultekin-Elbir , Catherine Ford and Mehmet R. Genç EMAIL logo
Published/Copyright: February 28, 2019
Journal of Perinatal Medicine
From the journal Journal of Perinatal Medicine Volume 47 Issue 5

Abstract

Objective

To assess the value of incorporating amniotic fluid (AF) analysis in the management of patients with clinical chorioamnionitis.

Methods

This was a retrospective cohort study of all women carrying a singleton fetus and managed at our center between 2000 and 2009. We included only those women suspected of chorioamnionitis based on one or more of the following: (1) uterine tenderness, (2) maternal fever, (3) maternal and/or fetal tachycardia and (4) purulent discharge. The management was deemed to be justified if (1) pregnancy was terminated <24 weeks and histology confirmed chorioamnionitis; (2) delivery was performed expeditiously after initial assessment and histology confirmed chorioamnionitis; (3) delivery was delayed for 2–7 days and the patient completed a course of antenatal steroids before 34 weeks; and (4) delivery was delayed ≥7 days and histology was not indicative of chorioamnionitis, or delivery occurred after 37 weeks. Univariate and logistic regression analyses were used as appropriate.

Results

Of the 77 women with suspected chorioamnionitis, AF analysis was performed in 43 (55.8%) cases, and the management was justified in 63 (81.8%) cases based on the aforementioned criteria. Stepwise regression analysis confirmed AF analysis as a predictor of justified management. The rates of composite morbidity, neonatal sepsis, neonatal death and admissions to neonatal intensive care unit were lower in the justified management group.

Conclusion

Incorporation of AF analysis into clinical assessment does improve the management of suspected chorioamnionitis.

Keywords: amniotic fluid analysis; chorioamnionitis; clinical assessment; composite morbidity; maternal fever; maternal morbidity; maternal sepsis; neonatal morbidity; neonatal sepsis

  1. Author contributions: All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission.

  2. Research funding: None declared.

  3. Employment or leadership: None declared.

  4. Honorarium: None declared.

  5. Competing interests: The funding organization(s) played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.

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Supplementary Material

The online version of this article offers supplementary material (https://doi.org/10.1515/jpm-2018-0306).

Received: 2018-09-14
Accepted: 2019-01-21
Published Online: 2019-02-28
Published in Print: 2019-07-26

©2019 Walter de Gruyter GmbH, Berlin/Boston

Articles in the same Issue

  1. Frontmatter
  2. Editorial
  3. Preterm premature rupture of membranes (PPROM)
  4. Original Articles – Obstetrics
  5. The value of amniotic fluid analysis in patients with suspected clinical chorioamnionitis
  6. Patients with acute cervical insufficiency without intra-amniotic infection/inflammation treated with cerclage have a good prognosis
  7. Maternal serum endocan concentrations are elevated in patients with preterm premature rupture of membranes
  8. The earlier the gestational age, the greater the intensity of the intra-amniotic inflammatory response in women with preterm premature rupture of membranes and amniotic fluid infection by Ureaplasma species
  9. Assessment of maternal GBS colonization and early-onset neonatal disease rate for term deliveries: a decade perspective
  10. Clinical importance of the 75-g glucose tolerance test (GTT) in the prediction of large for gestational age (LGA) fetuses in non-diabetic pregnancies
  11. Expression of genes involved in inflammation and growth – does sampling site in human full-term placenta matter?
  12. Impact of cell-free fetal DNA on invasive prenatal diagnostic tests in a real-world public setting
  13. Perinatal outcome in gestational diabetes according to different diagnostic criteria
  14. Original Articles – Fetus
  15. Change in fetal behavior in response to vibroacoustic stimulation
  16. Diagnostic accuracy of isolated clubfoot in twin compared to singleton gestations
  17. Original Article – Newborn
  18. Usefulness of transcutaneous bilirubin assessment measured in non-photo-exposed skin to guide the length of phototherapy: an observational study
  19. Letters to the Editor
  20. Methodological issues on the clinical importance of the 75-g glucose tolerance test (GTT) in the prediction of large for gestational age (LGA) fetuses in non-diabetic pregnancies
  21. Reply to the Letter to the Editor: methodological issues on the clinical importance of the 75-g glucose tolerance test (GTT) in the prediction of large-for-gestational-age (LGA) fetuses in non-diabetic pregnancies
https://doi.org/10.1515/jpm-2018-0306
Keywords for this article
amniotic fluid analysis; chorioamnionitis; clinical assessment; composite morbidity; maternal fever; maternal morbidity; maternal sepsis; neonatal morbidity; neonatal sepsis

Articles in the same Issue

  1. Frontmatter
  2. Editorial
  3. Preterm premature rupture of membranes (PPROM)
  4. Original Articles – Obstetrics
  5. The value of amniotic fluid analysis in patients with suspected clinical chorioamnionitis
  6. Patients with acute cervical insufficiency without intra-amniotic infection/inflammation treated with cerclage have a good prognosis
  7. Maternal serum endocan concentrations are elevated in patients with preterm premature rupture of membranes
  8. The earlier the gestational age, the greater the intensity of the intra-amniotic inflammatory response in women with preterm premature rupture of membranes and amniotic fluid infection by Ureaplasma species
  9. Assessment of maternal GBS colonization and early-onset neonatal disease rate for term deliveries: a decade perspective
  10. Clinical importance of the 75-g glucose tolerance test (GTT) in the prediction of large for gestational age (LGA) fetuses in non-diabetic pregnancies
  11. Expression of genes involved in inflammation and growth – does sampling site in human full-term placenta matter?
  12. Impact of cell-free fetal DNA on invasive prenatal diagnostic tests in a real-world public setting
  13. Perinatal outcome in gestational diabetes according to different diagnostic criteria
  14. Original Articles – Fetus
  15. Change in fetal behavior in response to vibroacoustic stimulation
  16. Diagnostic accuracy of isolated clubfoot in twin compared to singleton gestations
  17. Original Article – Newborn
  18. Usefulness of transcutaneous bilirubin assessment measured in non-photo-exposed skin to guide the length of phototherapy: an observational study
  19. Letters to the Editor
  20. Methodological issues on the clinical importance of the 75-g glucose tolerance test (GTT) in the prediction of large for gestational age (LGA) fetuses in non-diabetic pregnancies
  21. Reply to the Letter to the Editor: methodological issues on the clinical importance of the 75-g glucose tolerance test (GTT) in the prediction of large-for-gestational-age (LGA) fetuses in non-diabetic pregnancies
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