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Evaluation of Intra-Amniotic Infection Detection Based on Available Diagnostic Methods.

Magda Nawceniak-Balczerska1, Andrzej Torbé2, Piotr Tousty3

  • 1Department of Obstetrics and Gynecology, Multi-Specialist Provincial Hospital in Gorzów Wlkp., 66-400 Gorzów Wielkopolski, Poland.

Medicina (Kaunas, Lithuania)
|December 31, 2025
PubMed
Summary

Predicting intra-amniotic infection (IAI) is challenging. Amniotic fluid glucose and vaginal fluid interleukin-6 (IL-6) show the best predictive value for IAI confirmed by histopathology.

Keywords:
C-reactive proteincervical canal swabchorioamnionitisearly-onset neonatal infectionglucoseinterleukin-6intraamniotic infectionprocalcitonin

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Area of Science:

  • Obstetrics and Gynecology
  • Infectious Diseases
  • Pathology

Background:

  • Intra-amniotic infection (IAI) lacks a clear prediction scheme despite medical advancements.
  • Histopathological confirmation is the gold standard for diagnosing IAI.

Purpose of the Study:

  • To evaluate potential predictors of histopathologically confirmed intra-amniotic infection (IAI).
  • To identify reliable biomarkers for early IAI detection in cesarean section patients.

Main Methods:

  • Compared biomarkers (CRP, IL-6, PCT) in maternal blood, vaginal discharge, amniotic fluid, and cord blood between IAI-positive and IAI-negative groups.
  • Utilized histopathological examination of placental tissue and fetal membranes to confirm IAI.
  • Included cultures and PCR for various pathogens in vaginal swabs and amniotic fluid.

Main Results:

  • Maternal serum C-reactive protein (CRP) and procalcitonin (PCT) have poor diagnostic value for predicting IAI.
  • Amniotic fluid glucose levels demonstrated significant predictive value for IAI.
  • Vaginal fluid interleukin-6 (IL-6) concentration was a strong predictor of histopathologically confirmed IAI.

Conclusions:

  • Amniotic fluid glucose and vaginal fluid IL-6 are the most effective predictors for diagnosing intra-amniotic infection (IAI) confirmed by histopathology.
  • Serum markers like CRP and PCT are unreliable for IAI prediction in this context.