Cervical insufficiency, amniotic fluid sludge, intra-amniotic infection, and maternal bacteremia: the need for a point-of-care test to assess inflammation and bacteria in amniotic fluid

Management of Pregnancy with Cervical Shortening: Real-Life Clinical Challenges

“…In any case, we anticipate that the diagnosis of IA infection and sterile inflammation will be based on a more precise diagnostic approach, so antibacterial therapy could be reserved for cases with strict indications, thus reducing an unjustified antibacterial therapy and its associated complications. Currently, the gold standard to confirm IA infection/inflammation is based on objective laboratory evidence of infection/inflammation markers in the amniotic fluid obtained by an amniocentesis [10,27]. The implementation of amniocentesis as a diagnostic tool into routine clinical practice could facilitate an indication-based antibacterial therapy, also tailor making personalised treatment specifically to the causative microorganisms possible [27].…”

“…Currently, the gold standard to confirm IA infection/inflammation is based on objective laboratory evidence of infection/inflammation markers in the amniotic fluid obtained by an amniocentesis [10,27]. The implementation of amniocentesis as a diagnostic tool into routine clinical practice could facilitate an indication-based antibacterial therapy, also tailor making personalised treatment specifically to the causative microorganisms possible [27]. However, amniocentesis constitutes an invasive technique with known associated risks; therefore, the procedure has not received widespread acceptance in all patients, and less invasive and more rapid tests to detect an infection or inflammatory process are required [27].…”