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C-reactive protein concentration in vaginal fluid as a marker for intra-amniotic inflammation/infection in preterm premature rupture of membranes.
J Matern Fetal Neonatal Med. 2005 Dec; 18(6):417-22.JM

Abstract

OBJECTIVE

The purpose of this study was to determine whether C-reactive protein (CRP) concentrations in vaginal fluid can identify patients with intra-amniotic inflammation/infection (IAI) and predict adverse outcome in preterm premature rupture of membranes (PROM).

METHODS

The study population consisted of 121 singleton pregnant women with preterm PROM (36 weeks of gestation) who had an amniocentesis and vaginal fluid collection. A Dacron polyester-tipped applicator was soaked with vaginal fluid for 10 seconds and diluted with 1 mL buffer solution. Amniotic fluid was cultured for aerobic and anaerobic bacteria, as well as mycoplasmas. Vaginal fluid CRP and amniotic fluid matrix metalloproteinase-8 (MMP-8) were determined by specific immunoassays. IAI was defined as an amniotic fluid MMP-8 concentration >23 ng/mL and/or a positive amniotic fluid culture. Nonparametric tests and survival techniques were used for statistical analysis.

RESULTS

Patients with IAI had a significantly higher median vaginal fluid CRP concentration than those without IAI (median (range), 7.8 (0.1-1310.1) ng/mL vs. 1.0 (0.1-319.4) ng/mL, p < 0.005). The median amniotic fluid white blood cell (WBC) count was significantly higher in patients with a vaginal fluid CRP concentration of >10 ng/mL than in those with a lower concentration (median (range), 82.5 (0-8640) cells/mm3 vs. 2 (0->1000) cells/mm3, p < 0.001). Patients with vaginal fluid CRP concentration of >10 ng/mL had a significantly shorter sampling-to-delivery interval and higher rates of preterm delivery within five days, funisitis, and histologic chorioamnionitis than did those with a vaginal fluid CRP concentration below this cut-off. A vaginal fluid CRP cut-off of 10 ng/mL had a specificity of 89% and a sensitivity of 45% in the identification of IAI.

CONCLUSION

An elevated CRP concentration in vaginal fluid collected by polyester-tipped applicator is a risk factor for intra-amniotic inflammation/infection and impending preterm delivery in preterm PROM.

Authors+Show Affiliations

Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Korea.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

16390808

Citation

Shim, Soon-Sup, et al. "C-reactive Protein Concentration in Vaginal Fluid as a Marker for Intra-amniotic Inflammation/infection in Preterm Premature Rupture of Membranes." The Journal of Maternal-fetal & Neonatal Medicine : the Official Journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians, vol. 18, no. 6, 2005, pp. 417-22.
Shim SS, Romero R, Jun JK, et al. C-reactive protein concentration in vaginal fluid as a marker for intra-amniotic inflammation/infection in preterm premature rupture of membranes. J Matern Fetal Neonatal Med. 2005;18(6):417-22.
Shim, S. S., Romero, R., Jun, J. K., Moon, K. C., Kim, G., & Yoon, B. H. (2005). C-reactive protein concentration in vaginal fluid as a marker for intra-amniotic inflammation/infection in preterm premature rupture of membranes. The Journal of Maternal-fetal & Neonatal Medicine : the Official Journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians, 18(6), 417-22.
Shim SS, et al. C-reactive Protein Concentration in Vaginal Fluid as a Marker for Intra-amniotic Inflammation/infection in Preterm Premature Rupture of Membranes. J Matern Fetal Neonatal Med. 2005;18(6):417-22. PubMed PMID: 16390808.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - C-reactive protein concentration in vaginal fluid as a marker for intra-amniotic inflammation/infection in preterm premature rupture of membranes. AU - Shim,Soon-Sup, AU - Romero,Roberto, AU - Jun,Jong Kwan, AU - Moon,Kyung Chul, AU - Kim,Gilja, AU - Yoon,Bo Hyun, PY - 2006/1/5/pubmed PY - 2007/5/26/medline PY - 2006/1/5/entrez SP - 417 EP - 22 JF - The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians JO - J Matern Fetal Neonatal Med VL - 18 IS - 6 N2 - OBJECTIVE: The purpose of this study was to determine whether C-reactive protein (CRP) concentrations in vaginal fluid can identify patients with intra-amniotic inflammation/infection (IAI) and predict adverse outcome in preterm premature rupture of membranes (PROM). METHODS: The study population consisted of 121 singleton pregnant women with preterm PROM (36 weeks of gestation) who had an amniocentesis and vaginal fluid collection. A Dacron polyester-tipped applicator was soaked with vaginal fluid for 10 seconds and diluted with 1 mL buffer solution. Amniotic fluid was cultured for aerobic and anaerobic bacteria, as well as mycoplasmas. Vaginal fluid CRP and amniotic fluid matrix metalloproteinase-8 (MMP-8) were determined by specific immunoassays. IAI was defined as an amniotic fluid MMP-8 concentration >23 ng/mL and/or a positive amniotic fluid culture. Nonparametric tests and survival techniques were used for statistical analysis. RESULTS: Patients with IAI had a significantly higher median vaginal fluid CRP concentration than those without IAI (median (range), 7.8 (0.1-1310.1) ng/mL vs. 1.0 (0.1-319.4) ng/mL, p < 0.005). The median amniotic fluid white blood cell (WBC) count was significantly higher in patients with a vaginal fluid CRP concentration of >10 ng/mL than in those with a lower concentration (median (range), 82.5 (0-8640) cells/mm3 vs. 2 (0->1000) cells/mm3, p < 0.001). Patients with vaginal fluid CRP concentration of >10 ng/mL had a significantly shorter sampling-to-delivery interval and higher rates of preterm delivery within five days, funisitis, and histologic chorioamnionitis than did those with a vaginal fluid CRP concentration below this cut-off. A vaginal fluid CRP cut-off of 10 ng/mL had a specificity of 89% and a sensitivity of 45% in the identification of IAI. CONCLUSION: An elevated CRP concentration in vaginal fluid collected by polyester-tipped applicator is a risk factor for intra-amniotic inflammation/infection and impending preterm delivery in preterm PROM. SN - 1476-7058 UR - https://www.unboundmedicine.com/medline/citation/16390808/C_reactive_protein_concentration_in_vaginal_fluid_as_a_marker_for_intra_amniotic_inflammation/infection_in_preterm_premature_rupture_of_membranes_ L2 - https://www.tandfonline.com/doi/full/10.1080/14786430500362231 DB - PRIME DP - Unbound Medicine ER -