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Specific detection of 16 micro-organisms in amniotic fluid by polymerase chain reaction and its correlation with
E Oyarzún1, M Yamamoto, S Kato
1Perinatal Unit, Department of Obstetrics and Gynecology, School of Medicine, P. Universidad Católica de Chile, Santiago, Chile.
Objective:
Our purpose was to develop a specific polymerase chain reaction detection method for 16 micro-organisms in amniotic fluid and to correlate its performance with bacterial cultures and preterm delivery occurrence.
Study Design:
The study group was made up of 50 patients with preterm labor and intact membranes. The control group consisted of 23 patients not in labor and undergoing amniocentesis for either karyotype or lung maturity studies. Polymerase chain reaction and bacterial cultures were assayed in amniotic fluid of all patients. Results were correlated with pregnancy outcome.
Results:
Polymerase chain reaction identified micro-organisms in 23 cases in the study group (46%), whereas cultures identified only 6 (12%). All control samples were negative for polymerase chain reaction and cultures. The sensitivity of polymerase chain reaction and cultures for the identification of patients delivering before 34 weeks' gestation was 64% and 18%, respectively.
Conclusion:
A polymerase chain reaction gene amplification method was developed to identify 16 micro-organisms in amniotic fluid. Compared with bacterial cultures, polymerase chain reaction amplification in amniotic fluid appears to be more sensitive in identifying patients delivering prematurely.
Insights
A new polymerase chain reaction (PCR) method detects more micro-organisms in amniotic fluid than traditional cultures. This PCR test is more sensitive for identifying patients likely to deliver prematurely.
Area of Science:
- Microbiology
- Molecular Biology
- Obstetrics & Gynecology
Background:
- Preterm delivery is a significant concern in obstetrics.
- Accurate identification of intra-amniotic infections is crucial for managing preterm labor.
- Current diagnostic methods like bacterial cultures have limitations in sensitivity.
Purpose of the Study:
- To develop a specific polymerase chain reaction (PCR) assay for detecting 16 different micro-organisms in amniotic fluid.
- To compare the performance of PCR with bacterial cultures in identifying micro-organisms in amniotic fluid.
- To correlate PCR findings with the occurrence of preterm delivery.
Main Methods:
- A cohort of 50 patients with preterm labor and intact membranes was studied.
- A control group of 23 patients not in labor underwent amniocentesis.
- Amniotic fluid samples from all participants were analyzed using both PCR and bacterial cultures.
Main Results:
- PCR identified micro-organisms in 46% of the preterm labor group, compared to only 12% with bacterial cultures.
- All samples from the control group tested negative by both methods.
- PCR sensitivity for identifying patients delivering before 34 weeks' gestation was 64%, significantly higher than the 18% sensitivity of cultures.
Conclusions:
- A novel PCR gene amplification method was successfully developed for detecting 16 micro-organisms in amniotic fluid.
- PCR demonstrates superior sensitivity compared to bacterial cultures for identifying micro-organisms in amniotic fluid.
- The enhanced sensitivity of PCR may improve the identification of patients at risk for premature delivery.