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C-reactive protein concentration in vaginal fluid as a marker for intra-amniotic inflammation/infection in preterm premature rupture of membranes.
- Source :
-
Journal of Maternal-Fetal & Neonatal Medicine . Dec2005, Vol. 18 Issue 6, p417-422. 6p. 5 Graphs. - Publication Year :
- 2005
-
Abstract
- Objective . The purpose of this study was to determine whether C-reactive protein (CRP) concentrations in vaginal fluid can identify patients with intra-amniotic inflammation/infection (IAI) and predict adverse outcome in preterm premature rupture of membranes (PROM). Methods . The study population consisted of 121 singleton pregnant women with preterm PROM (⩽36 weeks of gestation) who had an amniocentesis and vaginal fluid collection. A Dacron polyester-tipped applicator was soaked with vaginal fluid for 10 seconds and diluted with 1 mL buffer solution. Amniotic fluid was cultured for aerobic and anaerobic bacteria, as well as mycoplasmas. Vaginal fluid CRP and amniotic fluid matrix metalloproteinase-8 (MMP-8) were determined by specific immunoassays. IAI was defined as an amniotic fluid MMP-8 concentration >23 ng/mL and/or a positive amniotic fluid culture. Nonparametric tests and survival techniques were used for statistical analysis. Results . Patients with IAI had a significantly higher median vaginal fluid CRP concentration than those without IAI (median (range), 7.8 (0.1–1310.1) ng/mL vs. 1.0 (0.1–319.4) ng/mL, p 10 ng/mL than in those with a lower concentration (median (range), 82.5 (0–8640) cells/mm 3 vs. 2 (0–>1000) cells/mm 3 , p 10 ng/mL had a significantly shorter sampling-to-delivery interval and higher rates of preterm delivery within five days, funisitis, and histologic chorioamnionitis than did those with a vaginal fluid CRP concentration below this cut-off. A vaginal fluid CRP cut-off of 10 ng/mL had a specificity of 89% and a sensitivity of 45% in the identification of IAI. Conclusion . An elevated CRP concentration in vaginal fluid collected by polyester-tipped applicator is a risk factor for intra-amniotic inflammation/infection and impending preterm delivery in preterm PROM. [ABSTRACT FROM AUTHOR]
Details
- Language :
- English
- ISSN :
- 14767058
- Volume :
- 18
- Issue :
- 6
- Database :
- Academic Search Index
- Journal :
- Journal of Maternal-Fetal & Neonatal Medicine
- Publication Type :
- Academic Journal
- Accession number :
- 19302542
- Full Text :
- https://doi.org/10.1080/14786430500362231