Publications of Faculty of Medicine:THE DIAGNOSTIC PERFORMANCE OF AMNIOTIC FLUID INTERLEUKIN-6, WHITE BLOOD CELL COUNT, GLUCOSE AND GRAM STAIN IN THE DETECTION OF MICROBIAL INVASION IN PATIENTS WITH PRETERM PREMATURE RUPTURE OF MEMBRANES: A COMPARATIVE STUDY : Abstract

The aim of this study was to compare the value of amniotic fluid tests for the detection of microbial invasion of the amniotic cavity and in the prediction of amniocentesisto-delivery interval and neonatal complications in patients with preterm premature rupture of membranes. Amniotic fluid was obtained by transabdominal amniocentesis from 50 patients with preterm premature rupture of membranes. Fluid was cultured for aerobic and anaerobic bacteria, as well as mycoplasmas. Amniotic fluid analysis included a Gram stain examination, white blood cell count and glucose concentrations as well as interleukin-6 (IL6) determinations. The results of this study showed that (i) the prevalence of positive . amniotic fluid cultures in patients with preterm premature rupture of membranes was 36% (18/50); (ii) patients with microbial invasion had a shorter amniocentesis-to-delivery interval and a higher neonatal complication rate than patients with negative cultures; (iii) the most sensitive test for the detection of microbial invasion of the.amniotic cavity was amniotic fluid IL-6 determinations (sensitivity: for 1-6 83.3%; for white blood cell count 61%; for glucose 61% ; for Gram stain 27.8% (P<0.05) for all comparisons); (iv) the most specific test for the detection of microbial invasion was the Gram stain of amniotic fluid (specificity: for Gram stain 96.8%; for white blood cell count 78.1%; for 1-6 75%; for glucose 75% P<0.05 for all comparisons). We conclude that interleukin-6 determinations in amniotic fluid are better predictors of microbial invasion of the amniotic cavity, amniocentesis-to- delivery interval and neonatal complications than the amniotic fluid Gram stain, glucose or white blood cell count in patients with preterm premature rupture of membranes