A tow vaginal "pool" amniotic fluid glucose measurement is a predictive but not a sensitive marker for infection in women with preterm premature rupture of membranes
A tow vaginal "pool" amniotic fluid glucose measurement is a predictive but not a sensitive marker for infection in women with preterm premature rupture of membranes
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DOI：
10.1016/j.ajog.2005.07.070
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发表时间：
2006-02-01
影响因子：
9.8
通讯作者：
Buhimschi, IA
中科院分区：
文献类型：
--
作者：
Buhimschi, CS;Sfakianaki, AK;Buhimschi, IA
目的：探讨阴道羊水(VAF)血糖测定在预测早产胎膜早破(PPROM)患者经腹羊水穿刺术(AAF)羊水感染中的作用。研究设计：连续35例PPROM患者经腹式羊水穿刺术(AAF)取液，经临床诊断为羊水穿刺术排除羊膜内感染/炎症，并顺利完成。对AAF进行需氧细菌、厌氧细菌、解脲支原体和支原体的培养。AAF的临床实验室分析包括血糖浓度、革兰氏染色、乳酸脱氢酶、白细胞和红细胞计数。仅对VAF进行血糖浓度分析。配对的腹部-阴道房颤样本(AAF-VAF)的血糖浓度是通过成熟的临床和研究实验室方法测定的。在登记结束时，我们将患者分成两组：(1)微生物培养阳性(+)AFC组(n=17，胎龄：27.3+/-0.7周)或(2)微生物培养阴性组(-)AFC(n=18，GA：31.3+/-0.5周)。Cohen kappa一致性测量和受试者工作特征(ROC)曲线分析用于测试阴道“池”血糖测量区分房颤培养阳性或阴性的妇女的能力。结果：与(-)AFC组相比，(+)AFC组破裂并在较早的GA分娩(P
Objective: We Sought to identify the use of vaginal amniotic fluid (vAF) glucose measurements in predicting infection of the amniotic fluid retrieved by transabdominal amniocentesis (aAF) in women with preterm premature rupture of the membranes (PPROM)Study design: Fluid was retrieved by aAF was retreived from 35 consecutive women with PPROM on whom an amniocentesis was clinically indicated to rule out intra-amniotic infection/inflammation and successfully completed. aAF was cultured for aerobic, anaerobic bacteria, Ureaplasma and Mycoplasma species. Clinical laboratory analysis for aAF included glucose concentration, Gram stain, lactate dehydrogenase, and white and red blood cell count. vAF was analyzed only for glucose concentration. Glucose concentration for the paired abdominal-vaginal AF samples (aAF-vAF) was determined by using well-established clinical and research laboratory methods. At the end of enrollment we stratified our patients into 2 groups: (1) positive microbial cultures ( + )AFC(n = 17, gestational age [GA]: 27.3 +/- 0.7 weeks) or (2) negative microbial cultures (-)AFC (n = 18, GA: 31.3 +/- 0.5 weeks). Cohen kappa measure of concordance and receiver operating characteristic (ROC) curve analysis were used to test the ability of the vaginal "pool" glucose measurements to discriminate between women with positive or negative AF Cultures.Results: Women with (+)AFC ruptured and delivered at an earlier GA compared with the (-)AFC group(p