Amniotic fluid glucose and intraamniotic infection.

Area of Science:

• Obstetrics and Gynecology
• Maternal-Fetal Medicine
• Infectious Diseases in Pregnancy

Background:

• Intraamniotic infection (IAI) is a significant complication in preterm labor and preterm premature rupture of membranes (PPROM).
• Accurate and timely diagnosis of IAI is crucial for appropriate management and improved perinatal outcomes.
• Current diagnostic methods like Gram's stain and culture have limitations in sensitivity and specificity.

Purpose of the Study:

• To evaluate the diagnostic utility of amniotic fluid glucose determination for intraamniotic infection.
• To compare the sensitivity and specificity of amniotic fluid glucose levels with Gram's stain in diagnosing IAI.
• To assess the correlation between amniotic fluid glucose levels and the timing of delivery.

Main Methods:

• Transabdominal amniocentesis was performed on 39 patients with premature labor and/or PPROM.
• Amniotic fluid was analyzed for culture and sensitivity, Gram's stain, and glucose determination.
• Amniotic fluid glucose levels were compared between patients with and without intraamniotic infection.

Main Results:

• All 9 patients with confirmed intraamniotic infection had amniotic fluid glucose < 10 mg/dl.
• Mean amniotic fluid glucose was significantly lower in patients with IAI (5 +/- 2.4 mg/dl) compared to those without (39.8 +/- 18.42 mg/dl).
• Amniotic fluid glucose < 10 mg/dl demonstrated higher sensitivity and specificity than Gram's stain for IAI diagnosis.

Conclusions:

• Amniotic fluid glucose determination is a valuable, sensitive, and specific tool for diagnosing intraamniotic infection.
• Low amniotic fluid glucose levels (< 10 mg/dl) are strongly associated with intraamniotic infection and predict delivery within 72 hours.
• Amniotic fluid glucose testing offers a reliable method to aid in the management of pregnancies complicated by preterm labor or PPROM.