Sludge reflects intra-amniotic inflammation with or without microorganisms

Am J Reprod Immunol. 2018 Feb;79(2). doi: 10.1111/aji.12807. Epub 2017 Dec 27.

Abstract

Problem: To investigate whether amniotic fluid (AF) "sludge" in patients with preterm labor (PTL) with intact membranes is related to intra-amniotic infection or inflammation.

Method of study: 105 PTL patients before 29 weeks' gestation were enrolled. AF "sludge" was evaluated by transvaginal sonography. Microorganisms were identified in AF by our newly established PCR method using a eukaryote-made thermostable DNA polymerase.

Results: AF "sludge" was present in 18.1% (19/105) of patients. The results obtained in the AF "sludge" group vs the no "sludge" group were as follows: (i) a similar positive rate of microorganisms in AF by PCR, 31.6% (6/19) vs 38.4% (33/86); (ii) a higher level of AF interleukin-8, 15.2 (0.2-381.5) ng/mL vs 5.8 (0.1-413.7) ng/mL; P = .005); and (3) a higher frequency of histological chorioamnionitis, 52.6% (10/19) vs 23.3% (20/86); P = .010.

Conclusion: The presence of AF "sludge" is related to intra-amniotic inflammation with or without microorganisms.

Keywords: amniotic fluid “sludge”; eukaryote-made thermostable DNA polymerase; infection; inflammation; polymerase chain reaction; preterm labor.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Amniotic Fluid / metabolism*
  • Chorioamnionitis / diagnosis
  • Chorioamnionitis / immunology*
  • Female
  • Gestational Age
  • Humans
  • Infections / diagnosis
  • Infections / immunology*
  • Interleukin-8 / metabolism
  • Mycoplasma / physiology*
  • Obstetric Labor, Premature / diagnosis
  • Obstetric Labor, Premature / immunology*
  • Particulate Matter / metabolism*
  • Polymerase Chain Reaction
  • Pregnancy
  • Retrospective Studies
  • Ultrasonography
  • Ureaplasma / physiology*

Substances

  • Interleukin-8
  • Particulate Matter