Prediction of chorioamnionitis in cases of intraamniotic infection by ureaplasma urealyticum in women with very preterm premature rupture of membranes or preterm labour

Abstract

A significant percentage of cases with intraamniotic detection of Ureaplasma urealyticum shows no pathological signs of histological inflammation. Concentration of Interleukin 6 in amniotic fluid can be useful for the diagnosis of subclinical chorioamnionitis in these cases.

Diagnostic value of Chorioquick for detecting chorioamnionitis in women with premature rupture of membranes

“…Histological chorioamnionitis was prevalent (53.4%) in the present study, and this concurred with findings from previous studies. 5,24,25 Interestingly, for every woman who initially tested positive for the Chorioquick test, all remained positive at repeated assessments.…”

“…Chorioamnionitis may not manifest clinically due to low predictive probability of clinical signs, 3,5 and waiting until the time of delivery to make a histological diagnosis of chorioamnionitis (gold standard) could predispose fetuses to several potential complications. 1,[3][4][5][6] In a recent study, maternal chorioamnionitis was strongly associated with cerebral palsy, regardless of other factors at birth such as birth weight and preterm delivery. 7 Because of the subjective nature of clinical symptoms and signs for chorioamnionitis, experts in the field have put forward the case for more reliable, non-invasive, and quick assays to make a diagnosis of chorioamnionitis with reasonable accuracy.…”

“…13,16 Although IL-6 remains the most studied biomarker for chorioamnionitis, no consensus has been reached regarding which cytokine offers the best sensitivity, specificity, or accuracy. 5 To our knowledge, no studies have used IL-6 bedside tests in a dose-response context to predict or detect sub-clinical chorioamnionitis. A bedside point-of-care IL-6 rapid test (Chorioquick) developed by Biosynex SA (Strasbourg, France) has the potential to use IL-6 in a dose-response context to detect sub-clinical chorioamnionitis.…”

“…According to Higgins et al., chorioamnionitis represents intrauterine infection and/or inflammation, otherwise known as Triple‐I. Chorioamnionitis may not manifest clinically due to low predictive probability of clinical signs, and waiting until the time of delivery to make a histological diagnosis of chorioamnionitis (gold standard) could predispose fetuses to several potential complications . In a recent study, maternal chorioamnionitis was strongly associated with cerebral palsy, regardless of other factors at birth such as birth weight and preterm delivery …”

“…Additionally, the traditional technique of utilization of enzyme‐linked immunosorbent assay for IL‐6 detection is not readily accessible in low‐ to middle‐income countries . Although IL‐6 remains the most studied biomarker for chorioamnionitis, no consensus has been reached regarding which cytokine offers the best sensitivity, specificity, or accuracy …”