Transactions of the Twenty-First Annual Meeting of the Society for Maternal-Fetal Medicine—ContinuedAmniotic fluid matrix metalloproteinase–8 in preterm labor with intact membranes☆
Section snippets
Material and methods
Women who were admitted to Hutzel Hospital from July 1992 to December 1996 with preterm labor and intact membranes were offered an amniocentesis for the diagnosis of IAI and the assessment of fetal lung maturity. Those patients who consented to have an amniocentesis were asked to donate additional amniotic fluid for research purposes. Eligibility criteria for this study included (1) preterm labor with intact membranes, (2) singleton gestation, (3) consent for an amniocentesis, and (4) written
Results
Three hundred seventy-one patients were included in this study. MMP-8 amniotic fluid concentrations were above the assay sensitivity in 88.4% of all samples (328/371).
Overall, IAI was present in 9.2% of patients (34/371). MMP-8 was detectable in all patients with IAI. The rate of preterm delivery in this patient population was 54% (200/371). The most common microbial isolates were Ureaplasma urealyticum (Table I).Empty Cell
Comment
Our data indicate that amniotic fluid MMP-8 concentration identifies patients who are at risk for IAI, impending preterm delivery, and adverse neonatal outcome. MMP-8 was better in the detection of a positive amniotic fluid culture than IL-6 or amniotic fluid white blood cell count and Gram stain. Moreover, MMP-8 had a higher sensitivity for the detection of positive amniotic fluid culture than the combination of Gram stain and amniotic fluid white blood cell count (82.4% vs 60%). However, a
Acknowledgements
The authors wish to acknowledge the contributions of Dr Moshe Mazor, Dr Stanley Berry, Dr Yoram Sorokin, Dr Sonia Hassan, Dr Sean Blackwell, Dr Robert Sokol, Dr Mark Evans, and Dr Mitchell Dombrowski, as well as those of Mr Michael Kruger, Biostatistician at C. S. Mott Center, Wayne State University; the nursing staff of the Detroit Medical Center: Ms Sandy Field, Ms Vicki Ineson, Ms Penny Clinansmith, Ms Mabubeh Mahoudieh, Ms Cindy Urbanik, Ms Jean Thayer-Seitz, Ms Audrey Miliken, Ms Leandra
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Reprint requests: Roberto Romero, MD, Perinatology Research Branch, NICHD, Wayne State University/Hutzel Hospital, Department of Obstetrics and Gynecology, 4707 St Antoine Blvd, Detroit, MI 48201. E-mail: [email protected].