Pregnancy Research Branch, Division of Obstetrics and Maternal-Fetal Medicine, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, United States Department of Health and Human Services (NICHD/NIH/DHHS), Bethesda, MD, and Detroit, MI, USA.
Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, MI, USA.
J Perinat Med. 2023 May 17;51(7):886-890. doi: 10.1515/jpm-2022-0604. Print 2023 Sep 26.
This study was conducted to determine whether bacteria, fungi, or archaea are detected in the amniotic fluid of patients who underwent midtrimester amniocentesis for clinical indications.
Amniotic fluid samples from 692 pregnancies were tested by using a combination of culture and end-point polymerase chain reaction (PCR) techniques. Intra-amniotic inflammation was defined as an interleukin-6 concentration >2,935 pg/mL.
Microorganisms were detected in 0.3% (2/692) of cases based on cultivation, 1.73% (12/692) based on broad-range end-point PCR, and 2% (14/692) based on the combination of both methods. However, most (13/14) of these cases did not have evidence of intra-amniotic inflammation and delivered at term. Therefore, a positive culture or end-point PCR in most patients appears to have no apparent clinical significance.
Amniotic fluid in the midtrimester of pregnancy generally does not contain bacteria, fungi, or archaea. Interpretation of amniotic fluid culture and molecular microbiologic results is aided by the assessment of the inflammatory state of the amniotic cavity. The presence of microorganisms, as determined by culture or a microbial signal in the absence of intra-amniotic inflammation, appears to be a benign condition.
本研究旨在确定行中期羊膜穿刺术的患者的羊水样本中是否存在细菌、真菌或古菌。
采用培养与终点聚合酶链反应（PCR）技术相结合的方法检测 692 例妊娠的羊水样本。将白细胞介素-6 浓度>2935pg/ml 定义为宫内炎症。
根据培养结果，有 0.3%（2/692）的病例、根据广谱终点 PCR 结果有 1.73%（12/692）的病例、根据两种方法相结合的结果有 2%（14/692）的病例检测到微生物。然而，这些病例中的大多数（13/14）均无宫内炎症证据且足月分娩。因此，大多数患者的阳性培养或终点 PCR 似乎没有明显的临床意义。
妊娠中期的羊水通常不含有细菌、真菌或古菌。通过评估羊膜腔的炎症状态，可以辅助解读羊水培养和分子微生物学结果。在没有宫内炎症的情况下，通过培养或微生物信号确定的微生物存在似乎是良性的。
