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

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.