The prevalence and clinical significance of amniotic fluid 'sludge' in patients with preterm labor and intact membranes

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dc.contributor.authorEspinoza, J
dc.contributor.authorGoncalves, LF
dc.contributor.authorRomero, R
dc.contributor.authorNien, JK
dc.contributor.authorStites, S
dc.contributor.authorKim, YM
dc.contributor.authorHassan, S
dc.contributor.authorGomez, R
dc.contributor.authorYoon, BH
dc.contributor.authorChaiworapongsa, T
dc.contributor.authorLee, W
dc.contributor.authorMazor, M
dc.date.accessioned2024-01-10T14:22:06Z
dc.date.available2024-01-10T14:22:06Z
dc.date.issued2005
dc.description.abstractObjective To determine the prevalence and clinical significance of amniotic fluid (AF) 'sludge' observed during transvaginal ultrasound examination of the cervix in patients with preterm labor and intact membranes, and in those with uncomplicated pregnancies.
dc.description.abstractMethods This retrospective study included patients with preterm labor and intact membranes (n = 84) and those with uncomplicated term pregnancies (n = 298). The outcome variables included the occurrence of documented microbial invasion of the amniotic cavity (MIAC), histological chorioamnionitis, examination-to-delivery interval, admission to the neonatal intensive care unit (NICU), a composite neonatal morbidity, perinatal death, and delivery within 48 h, 7 days, and < 35 weeks and < 32 weeks. Statistical analysis included Chi-square test, stepwise logistic regression analysis and survival analysis.
dc.description.abstractResults The prevalence of AF 'sludge' was 1% (3/298) in patients with uncomplicated term pregnancies and 22.6% (19/84) in those with preterm labor and intact membranes. Among patients with preterm labor and intact membranes: (1) cervical length <= 15 mm was present in 58.3% (49/84) of the patients; (2) the prevalence of MIAC and histological chorioamnionitis was 12.1% (7/58) and 32.9% (25/76), respectively; (3) the rate of spontaneous preterm delivery within 48 h, 7 days, and < 32 weeks and < 35 weeks of gestation was 13.6% (8/59), 28.8% (17/59), 39.5% (17/43) and 50.8% (30/59), respectively; (4) patients with AF 'sludge' bad a higher frequency of positive A], cultures [33.3% (6/18) vs. 2.5% (1/40), P = 0.003] and histological chorioamnionitis [77.8% (14/18) vs. 19% (11/58), P < 0.001] than those without AF 'sludge'; (5) a higher proportion of neonates born to patients with AF 'sludge' was admitted to the NICU 164.3% (9/14) vs. 12.9% (8/62), P < 0.01], had a composite neonatal morbidity [36.8% (7/19) vs. 13.8% (9/65), P = 0.04] and died in the perinatal period [36.8% (7/19) vs. 4.6% (3/65), P = 0.001] than those born to women without 'sludge'; (6) a higher proportion of patients with AF 'sludge' had spontaneous delivery within 48 h [42.9% (6/14) vs. 4.4% (2/45), P = 0.001], within 7 days [71.4% (10/14) vs. 15.6% (7/45), P < 0.001], < 32 weeks [75% (9/12) vs. 25.8% (8/31), P = 0.005] and < 35 weeks [92.9% (13/14) vs. 37.8% (17/45), P < 0.001] than those without AF 'sludge'; and (7) patients with AF 'sludge' bad a shorter examination-to-delivery interval than those without AF 'sludge' [AF 'sludge' median, 1 (IQR, 1-5) days vs. no AF 'sludge' median, 33 (IQR, 18-58) days; P < 0.001].
dc.description.abstractConclusion The presence of AF 'sludge' in patients with preterm labor and intact membranes is a risk factor for MIAC, histological chorioamnionitis and impending preterm delivery. Copyright (c) 2005 ISUOG.
dc.description.funderEUNICE KENNEDY SHRIVER NATIONAL INSTITUTE OF CHILD HEALTH & HUMAN DEVELOPMENT
dc.description.funderEUNICE KENNEDY SHRIVER NATIONAL INSTITUTE OF CHILD HEALTH &HUMAN DEVELOPMENT
dc.fechaingreso.objetodigital2024-04-18
dc.format.extent7 páginas
dc.fuente.origenWOS
dc.identifier.doi10.1002/uog.1871
dc.identifier.eissn1469-0705
dc.identifier.issn0960-7692
dc.identifier.pubmedidMEDLINE:15789375
dc.identifier.urihttps://doi.org/10.1002/uog.1871
dc.identifier.urihttps://repositorio.uc.cl/handle/11534/79860
dc.identifier.wosidWOS:000228512200006
dc.information.autorucMedicina;Gómez R;S/I;80926
dc.issue.numero4
dc.language.isoen
dc.nota.accesocontenido parcial
dc.pagina.final352
dc.pagina.inicio346
dc.publisherWILEY
dc.revistaULTRASOUND IN OBSTETRICS & GYNECOLOGY
dc.rightsacceso restringido
dc.subjectamniotic fluid 'sludge'
dc.subjectchorioamnionitis
dc.subjectintrauterine inflammation
dc.subjectmicrobial invasion of the amniotic cavity
dc.subjectpreterm delivery
dc.subjectpreterm labor
dc.subjectultrasound
dc.subjectFREE-FLOATING PARTICLES
dc.subjectCERVICAL-MUCUS PLUG
dc.subjectBLOOD-CELL COUNT
dc.subjectINTRAUTERINE INFECTION
dc.subjectPREMATURE RUPTURE
dc.subjectANTIBACTERIAL PROPERTIES
dc.subjectUREAPLASMA-UREALYTICUM
dc.subjectMICROBIAL INVASION
dc.subjectINTRAAMNIOTIC INFECTION
dc.subjectALPHA-FETOPROTEIN
dc.subject.ods05 Gender Equality
dc.subject.ods03 Good Health and Well-being
dc.subject.odspa05 Igualdad de género
dc.subject.odspa03 Salud y bienestar
dc.titleThe prevalence and clinical significance of amniotic fluid 'sludge' in patients with preterm labor and intact membranes
dc.typeartículo
dc.volumen25
sipa.codpersvinculados80926
sipa.indexWOS
sipa.indexScopus
sipa.trazabilidadCarga SIPA;09-01-2024
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