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- W2998367501 abstract "Intra-amniotic infection is present in 50% of patients with pPROM. Intra-amniotic inflammation is a risk factor for a short interval-to-delivery, early preterm delivery, and neonatal complications. We developed a cervical amniotic fluid collector that allows collection of amniotic fluid (AF) noninvasively from the cervical canal. The objective was to determine if a point-of-care test (POCT) based on IL-8 determinations in cervical AF obtained by the cervical AF collector can be used to reliably diagnose intra-amniotic inflammation. AF was retrieved through both amniocentesis and a cervical AF collector, cultured for aerobic and anaerobic bacteria and genital mycoplasmas, and assayed for MMP-8 by ELISA and AF WBC count. Intra-amniotic inflammation was defined as an elevated AF MMP-8 concentration (>23 ng/ml). IL-8 was measured using the POCT (can be performed bedside in 20 minutes) in cervical AF obtained by the collector. The diagnostic indices, predictive values, and likelihood ratios were determined. 1) Cervical AF IL-8 concentrations ≥9.5 ng/ml determined by the POCT had a sensitivity of 98% (56/57), specificity of 64% (40/54), positive predictive value of 80% (56/70), negative predictive value of 98% (40/41), positive likelihood ratio of 3.79 and negative likelihood ratio of 0.02 (prevalence 51%) in the identification of intra-amniotic inflammation; 2) cervical AF IL-8 concentrations ≥9.5 ng/ml had significantly higher sensitivity than a trans-abdominally obtained AF WBC count in the identification of intra-amniotic inflammation (98% vs 84%; p< 0.05) and higher sensitivity and accuracy than AF WBC count in the identification of intra-amniotic inflammation/infection (gold standard: positive culture for bacteria or an MMP-8 >23ng/mL, p< 0.05 for each). The POCT (IL-8) in AF retrieved with a cervical AF collector was predictive of intra-amniotic infection/inflammation. The analysis of cervically-obtained fluid by this POCT may be used to noninvasively monitor intra-amniotic inflammation in patients with pPROM." @default.
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- W2998367501 date "2020-01-01" @default.
- W2998367501 modified "2023-10-15" @default.
- W2998367501 title "338: Monitoring intra-amniotic inflammation in pPROM with a new noninvasive point-of-care test" @default.
- W2998367501 doi "https://doi.org/10.1016/j.ajog.2019.11.354" @default.
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