Chorioamnionitis: A harbinger of dystocia

Satin, Andrew J.; Maberry, Mark C.; Leveno, Kenneth J.; Sherman, M. L.; Kline, D. M.

doi:10.1016/0020-7292(93)90426-w

Cited by 28 publications

(19 citation statements)

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“…17 Moreover, Satin et al reported that chorioamnionitis diagnosed before labor stimulation does not increase the risk of cesarean, whereas that diagnosed after oxytocin stimulation may be a sign of abnormal labor, as it was associated with a marked increase in cesarean delivery for dystocia. 31 Regretfully, we could not confirm this association between clinical chorionamnionitis and cesarean delivery for dystocia in current study because our sample size is too small to find a difference in clinical chorioamnionitis rates. However, the results of our study regarding maternal fever during labor indicated that it was not associated with an increased risk of cesarean delivery for failure to progress, after controlling for known fetal and maternal factors.…”

Section: Discussioncontrasting

confidence: 68%

Comparative study of induction of labor in nulliparous women with premature rupture of membranes at term compared to those with intact membranes: Duration of labor and mode of delivery

Park

Hong

et al. 2006

J of Obstet and Gynaecol

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Section: Discussioncontrasting

confidence: 68%

Comparative study of induction of labor in nulliparous women with premature rupture of membranes at term compared to those with intact membranes: Duration of labor and mode of delivery

Park

Hong

et al. 2006

J of Obstet and Gynaecol

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“…This also resulted in the exclusion of primiparous women whose first viable pregnancy resulted in a cesarean delivery for an alternative reason, such as dystocia. Satin et al 19 in 1992 suggested that women with chorioamnionitis may have some preexisting disposition to dystocia and abnormal labor. The structure of this cohort eliminates that potential bias.…”

Section: Discussionmentioning

confidence: 98%

Recurrence of Clinical Chorioamnionitis in Subsequent Pregnancies

Laibl

Sheffield

Roberts

et al. 2006

Obstetrics & Gynecology

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“…This condition is associated with substantial maternal and neonatal morbidity, including maternal sepsis (95), dysfunctional labor (16, 96), postpartum endomyometritis (15) and hemorrhage (5, 96), early-onset neonatal sepsis (19, 95, 97-99), and cerebral palsy (100-103). Currently, the diagnosis of clinical chorioamnionitis is based on maternal clinical signs that have only about a 50% accuracy for the identification of proven intra-amniotic infection (8).…”

Section: Discussionmentioning

confidence: 99%

Clinical chorioamnionitis at term VIII: a rapid MMP-8 test for the identification of intra-amniotic inflammation

Chaiyasit

Romero

Chaemsaithong

et al. 2017

Journal of Perinatal Medicine

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Objective Clinical chorioamnionitis is the most common infection/inflammatory process diagnosed in labor and delivery units worldwide. The condition is a syndrome that can be caused by: 1) intra-amniotic infection; 2) intra-amniotic inflammation without demonstrable microorganisms (i.e., sterile intra-amniotic inflammation); and 3) maternal systemic inflammation that is not associated with intra-amniotic inflammation. The presence of intraamniotic inflammation is a risk factor for adverse maternal and neonatal outcomes in a broad range of obstetrical syndromes that includes clinical chorioamnionitis at term. Although the diagnosis of intra-amniotic infection has relied on culture results, such information is not immediately available for patient management. Therefore, the diagnosis of intra-amniotic inflammation could be helpful as a proxy for intra-amniotic infection, while results of microbiologic studies are pending. A rapid test is now available for the diagnosis of intraamniotic inflammation, based on the determination of neutrophil collagenase or matrix metalloproteinase-8 (MMP-8). The objectives of this study were to 1) evaluate the diagnostic indices of a rapid MMP-8 test for the identification of intra-amniotic inflammation/infection in patients with the diagnosis of clinical chorioamnionitis at term; and 2) compare the diagnostic performance of a rapid MMP-8 test to that of a conventional enzyme-linked immunosorbent assay (ELISA) interleukin (IL)-6 test for patients with clinical chorioamnionitis at term. Materials and Methods A retrospective cohort study was conducted. A transabdominal amniocentesis was performed in patients with clinical chorioamnionitis at term (n=44). Amniotic fluid was analyzed using cultivation techniques (for aerobic and anaerobic bacteria as well as genital Mycoplasmas) and broad-range polymerase chain reaction (PCR) coupled with electrospray ionization mass spectrometry (PCR/ESI-MS). Amniotic fluid IL-6 concentrations were determined by ELISA, and rapid MMP-8 results were determined by Yoon's MMP-8 Check®. Intra-amniotic inflammation was defined as an elevated amniotic fluid IL-6 concentration ≥2.6 ng/mL, and intra-amniotic infection was diagnosed by the presence of microorganisms in the amniotic fluid accompanied by intra-amniotic inflammation. The diagnostic indices of Yoon's MMP-8 Check® for the identification of intra-amniotic inflammation were calculated. In order to objectively compare Yoon's MMP-8 Check® to the ELISA IL-6 test for the identification of intra-amniotic inflammation, we used an amniotic fluid white blood cell (WBC) count ≥50 cells/mm3 to define intra-amniotic inflammation. Results 1) A positive rapid MMP-8 test had a sensitivity of 82.4% (28/34), specificity of 90% (9/10), positive predictive value of 96.6% (28/29), negative predictive value of 60% (9/15), positive likelihood ratio 8.2 (95% CI 1.3-53.2), and negative likelihood ratio 0.2 (95% CI 0.1-0.4) for the identification of intra-amniotic inflammation (prevalence 77.3%); 2) a positive rapid MMP-...

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Chorioamnionitis: A harbinger of dystocia

Cited by 28 publications

References 0 publications

Comparative study of induction of labor in nulliparous women with premature rupture of membranes at term compared to those with intact membranes: Duration of labor and mode of delivery

Comparative study of induction of labor in nulliparous women with premature rupture of membranes at term compared to those with intact membranes: Duration of labor and mode of delivery

Recurrence of Clinical Chorioamnionitis in Subsequent Pregnancies

Clinical chorioamnionitis at term VIII: a rapid MMP-8 test for the identification of intra-amniotic inflammation

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