Clinical chorioamnionitis criteria are not sufficient for predicting intra-amniotic infection

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  • Yohei Maki
    Department of Obstetrics and Gynecology, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan
  • Seishi Furukawa
    Department of Obstetrics and Gynecology, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan
  • Tetsuo Nakayama
    Department of Obstetrics and Gynecology, Miyazaki Medical Association Hospital, Miyazaki, Japan
  • Masanao Oohashi
    Department of Obstetrics and Gynecology, Miyazaki Medical Association Hospital, Miyazaki, Japan
  • Nozomi Shiiba
    Department of Obstetrics and Gynecology, Miyakonojo Medical Center, National Hospital Organization, Miyazaki, Japan
  • Ken Furuta
    Department of Obstetrics and Gynecology, Miyakonojo Medical Center, National Hospital Organization, Miyazaki, Japan
  • Shuuichi Tokunaga
    Department of Obstetrics and Gynecology, Miyakonojo Medical Center, National Hospital Organization, Miyazaki, Japan
  • Hiroshi Sameshima
    Department of Obstetrics and Gynecology, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan

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To evaluate the diagnostic performance of three conventional clinical chorioamnionitis criteria; including Gibbs, Lencki, and suspected triple I; for the prediction of intra-amniotic infection.A retrospective cohort study was conducted using data from three perinatal centers from 2014 to 2018. Patients with preterm labor or premature prelabor rupture of membranes between 22 and 33 weeks of gestation and those who underwent transabdominal amniocentesis to detect intra-amniotic infection were selected. Intra-amniotic infection was defined as a positive amniotic fluid culture for microorganisms, including genital mycoplasmas, plus low glucose level or leukocytosis in amniotic fluid. Sensitivity, specificity, and positive and negative likelihood ratios were calculated to determine the diagnostic performance of each criterion in predicting intra-amniotic infection.Of 99 pregnant women who met the study inclusion criteria, 13 (13.1%) had intra-amniotic infection confirmed by amniocentesis and 86 (86.9%) had no intra-amniotic infection. Maternal characteristics were not significantly different between groups, except for the higher incidence of preterm, prelabor rupture of membranes in pregnant women with intra-amniotic infection (53.8 versus 14%,The conventional clinical chorioamnionitis criteria are not sensitive for the prediction of intra-amniotic infection in pregnant women with preterm labor and/or preterm prelabor rupture of membranes.

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