Hasegawa I, Murakawa H, Utsumi T, Imai T, Tanaka K, Fujimori R
Division of Obstetrics and Gynecology, Akita Red Cross Hospital.
Nihon Sanka Fujinka Gakkai Zasshi. 1994 Mar;46(3):235-9.
For the rapid and accurate prediction of the presence of chorioamnionitis (CAM) in preterm labor, amniotic fluid analyses were performed in 46 women with preterm labor between 24 to 34 weeks' pregnancy. Ultrasound-guided transabdominal amniocentesis was performed on admission and the amniotic fluid was subjected to the measurement of cell count, glucose, protein and chlorine concentration according to cerebrospinal fluid and neutrophil esterase analysis. The data demonstrated that the amniotic fluid glucose concentration was significantly lower in women with preterm birth/CAM(+) than that with preterm birth/CAM(-) and term birth (19.0 +/- 9.1, 28.0 +/- 7.6, 51.6 +/- 14.5 mg/dl, respectively). All of the women with a glucose concentration of 20mg/dl or less showed signs of CAM. By setting up a cut off value of 25mg/dl, both high sensitivity (81.8%) and specificity (91.4%) for the prediction of CAM were obtained. Positive predictive values for CAM of a glucose concentration of 20mg/dl or less and 25mg/dl or less were 100% and 75% respectively. It was concluded that amniotic fluid glucose concentration measurement is useful for the prediction of CAM. The presence of CAM should be considered when the amniotic fluid glucose concentration is 25mg/dl or less.
