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A rapid matrix metalloproteinase-8 bedside test for the detection of intraamniotic inflammation in women with preterm premature rupture of membranes.
Am J Obstet Gynecol. 2007 Sep; 197(3):292.e1-5.AJ

Abstract

OBJECTIVE

To examine whether the MMP-8 PTD Check (SK Pharma Co, Ltd, Kyunggi-do, Korea), a rapid bedside test that can be performed in 15 minutes, is of value in the identification of intraamniotic infection and/or inflammation and in the assessment of the likelihood of adverse pregnancy outcome in patients with preterm premature rupture of membranes (PPROM).

STUDY DESIGN

Amniotic fluid was retrieved by transabdominal amniocentesis in 141 women with PPROM (<35 weeks' gestation). Fluid was cultured for aerobic and anaerobic bacteria and genital mycoplasmas; the remaining amniotic fluid was stored. The stored amniotic fluid was analyzed for interleukin-6 and MMP-8 PTD Check test. Intraamniotic infection/inflammation was defined as a positive amniotic fluid culture and/or elevated amniotic fluid interleukin-6 concentration (>2.6 ng/mL). Nonparametric and survival analysis were used.

RESULTS

The prevalence of intraamniotic infection/inflammation was 43% (60/141 women) and that of proven amniotic fluid infection was 18% (25/141 women). Patients with a positive MMP-8 PTD Check test result had a significantly higher rate of intraamniotic infection/inflammation (77% [54/70 women] vs 9% [6/71 women]; P < .001); proven amniotic fluid infection (33% [23/70 women] vs 3% [2/71 women]; P < .001), and adverse outcome than those with a negative MMP-8 PTD Check test result. Adverse outcome included shorter interval to delivery and higher rate of preterm delivery, histologic chorioamnionitis, funisitis, low Apgar scores, and significant neonatal morbidity. A positive MMP-8 PTD Check test result had a sensitivity of 90%, a specificity of 80%, a positive predictive value of 77%, and a negative predictive value of 92% in the identification of intraamniotic infection/inflammation, and was an independent predictor of interval to delivery (hazards ratio, 3.7; 95% CI, 2.4-5.9) and significant neonatal morbidity (odds ratio, 3.1; 95% CI, 1.2-7.9).

CONCLUSION

The MMP-8 PTD Check test is a rapid, simple, and sensitive bedside test to detect intraamniotic infection/inflammation and to predict adverse outcome that includes short latency, chorioamnionitis, and significant neonatal morbidity in patients with PPROM. The results of this study bring the rapid detection of intraamniotic infection/inflammation to the bedside in clinical obstetrics.

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 availableNo affiliation info available

Pub Type(s)

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

Language

eng

PubMed ID

17826425

Citation

Kim, Kun Woo, et al. "A Rapid Matrix Metalloproteinase-8 Bedside Test for the Detection of Intraamniotic Inflammation in Women With Preterm Premature Rupture of Membranes." American Journal of Obstetrics and Gynecology, vol. 197, no. 3, 2007, pp. 292.e1-5.
Kim KW, Romero R, Park HS, et al. A rapid matrix metalloproteinase-8 bedside test for the detection of intraamniotic inflammation in women with preterm premature rupture of membranes. Am J Obstet Gynecol. 2007;197(3):292.e1-5.
Kim, K. W., Romero, R., Park, H. S., Park, C. W., Shim, S. S., Jun, J. K., & Yoon, B. H. (2007). A rapid matrix metalloproteinase-8 bedside test for the detection of intraamniotic inflammation in women with preterm premature rupture of membranes. American Journal of Obstetrics and Gynecology, 197(3), e1-5.
Kim KW, et al. A Rapid Matrix Metalloproteinase-8 Bedside Test for the Detection of Intraamniotic Inflammation in Women With Preterm Premature Rupture of Membranes. Am J Obstet Gynecol. 2007;197(3):292.e1-5. PubMed PMID: 17826425.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A rapid matrix metalloproteinase-8 bedside test for the detection of intraamniotic inflammation in women with preterm premature rupture of membranes. AU - Kim,Kun Woo, AU - Romero,Roberto, AU - Park,Hyun Soo, AU - Park,Chan-Wook, AU - Shim,Soon-Sup, AU - Jun,Jong Kwan, AU - Yoon,Bo Hyun, PY - 2007/03/13/received PY - 2007/05/25/revised PY - 2007/06/24/accepted PY - 2007/9/11/pubmed PY - 2007/9/20/medline PY - 2007/9/11/entrez SP - 292.e1 EP - 5 JF - American journal of obstetrics and gynecology JO - Am J Obstet Gynecol VL - 197 IS - 3 N2 - OBJECTIVE: To examine whether the MMP-8 PTD Check (SK Pharma Co, Ltd, Kyunggi-do, Korea), a rapid bedside test that can be performed in 15 minutes, is of value in the identification of intraamniotic infection and/or inflammation and in the assessment of the likelihood of adverse pregnancy outcome in patients with preterm premature rupture of membranes (PPROM). STUDY DESIGN: Amniotic fluid was retrieved by transabdominal amniocentesis in 141 women with PPROM (<35 weeks' gestation). Fluid was cultured for aerobic and anaerobic bacteria and genital mycoplasmas; the remaining amniotic fluid was stored. The stored amniotic fluid was analyzed for interleukin-6 and MMP-8 PTD Check test. Intraamniotic infection/inflammation was defined as a positive amniotic fluid culture and/or elevated amniotic fluid interleukin-6 concentration (>2.6 ng/mL). Nonparametric and survival analysis were used. RESULTS: The prevalence of intraamniotic infection/inflammation was 43% (60/141 women) and that of proven amniotic fluid infection was 18% (25/141 women). Patients with a positive MMP-8 PTD Check test result had a significantly higher rate of intraamniotic infection/inflammation (77% [54/70 women] vs 9% [6/71 women]; P < .001); proven amniotic fluid infection (33% [23/70 women] vs 3% [2/71 women]; P < .001), and adverse outcome than those with a negative MMP-8 PTD Check test result. Adverse outcome included shorter interval to delivery and higher rate of preterm delivery, histologic chorioamnionitis, funisitis, low Apgar scores, and significant neonatal morbidity. A positive MMP-8 PTD Check test result had a sensitivity of 90%, a specificity of 80%, a positive predictive value of 77%, and a negative predictive value of 92% in the identification of intraamniotic infection/inflammation, and was an independent predictor of interval to delivery (hazards ratio, 3.7; 95% CI, 2.4-5.9) and significant neonatal morbidity (odds ratio, 3.1; 95% CI, 1.2-7.9). CONCLUSION: The MMP-8 PTD Check test is a rapid, simple, and sensitive bedside test to detect intraamniotic infection/inflammation and to predict adverse outcome that includes short latency, chorioamnionitis, and significant neonatal morbidity in patients with PPROM. The results of this study bring the rapid detection of intraamniotic infection/inflammation to the bedside in clinical obstetrics. SN - 1097-6868 UR - https://www.unboundmedicine.com/medline/citation/17826425/A_rapid_matrix_metalloproteinase_8_bedside_test_for_the_detection_of_intraamniotic_inflammation_in_women_with_preterm_premature_rupture_of_membranes_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0002-9378(07)00816-2 DB - PRIME DP - Unbound Medicine ER -