The use of amniocentesis in patients with premature rupture of membranes.

TLDR

The study assessed whether amniocentesis could predict occult or impending intrauterine infection and evaluate fetal maturity in patients with premature rupture of membranes. In a prospective cohort of 59 PROM patients (28–35 weeks), amniocentesis was performed, with amniotic fluid Gram stains, cultures, and lecithin/sphingomyelin ratio measurements. Amniocentesis succeeded in 51% of cases; 15 of 30 patients had mature L/S ratios and were delivered without respiratory distress, while 9 of 30 had positive cultures and subsequent amnionitis, and 19 of 21 with negative cultures had no infectious morbidity, demonstrating its utility for selecting mature fetuses and predicting infection.

Abstract

A prospective study was conducted to evaluate the usefulness of amniocentesis in patients with premature rupture of membranes (PROM) for the prediction of occult or impending intrauterine infection and the assessment of fetal maturity. Fifty-nine patients with PROM between 28 and 35 weeks' gestation, without apparent infection, were evaluated sonographically for possible amniocentesis. Thirty patients had successful amniocenteses for a success rate of 51%. Fifteen patients had a mature lecithin/sphingomyelin (L/S) ratio and were delivered immediately without respiratory distress syndrome (RDS) or other neonatal complications. All amniotic fluids were evaluated by Gram stains and cultures. Nine of the 30 patients had positive cultures, with a high incidence of subsequent development of amnionitis and other infectious morbidity. In the 21 patients with negative cultures, there were 19 without any infectious morbidity. Amniocentesis appears in this study to be a useful method for selecting the patients who have mature fetuses and/or who are more likely to develop amnionitis.