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Updated: May 29, 2026
Isolation of Leukocytes from the Human Maternal-fetal Interface
Published on: May 21, 2015
Optimized amniotic fluid analysis in patients suspected of intrauterine infection/inflammation
Catherine Ford1, Mehmet R Genç
1Harvard School of Public Health, Boston, MA, USA.
Objective:
To determine the combination of amniotic fluid (AF) tests with the best diagnostic accuracy for predicting intrauterine infection/inflammation (IUI) in patients with clinical suspicion of chorioamnionitis.
Study Design:
This is a retrospective study of 34 pregnant women who presented with uterine tenderness, maternal fever, maternal tachycardia, and/or fetal tachycardia and underwent AF analysis. IUI diagnosis was based on placental histology, positive AF bacterial cultures, and/or Gram stain.
Result:
Logistic regression analysis revealed a significant relationship between IUI and AF glucose. Glucose is more sensitive than culture or Gram stain (64% vs. 40% and 20%, respectively). Culture and glucose combined achieved the best diagnostic accuracy (sensitivity, 71%; specificity, 100%; positive and negative predictive values, 100-83%, respectively).
Conclusion:
Positive AF Gram stain or glucose <15 mg/dL strongly suggests IUI in symptomatic patients. If both tests are negative, the result of culture should aid the management.
