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Authordc.contributor.authorRomero, Roberto 
Authordc.contributor.authorChaemsaithong, Piya 
Authordc.contributor.authorKorzeniewski, Steven J. 
Authordc.contributor.authorKusanovic, Juan Pedro 
Authordc.contributor.authorDocheva, Nikolina 
Authordc.contributor.authorMartínez Varea, Alicia 
Authordc.contributor.authorAhmed, Ahmed I. 
Authordc.contributor.authorYoon, Bo Hyun 
Authordc.contributor.authorHassan, Sonia S. 
Authordc.contributor.authorChaiworapongsa, Tinnakorn 
Authordc.contributor.authorYeo, Lami 
Admission datedc.date.accessioned2016-05-16T16:19:58Z
Available datedc.date.available2016-05-16T16:19:58Z
Publication datedc.date.issued2016
Cita de ítemdc.identifier.citationJournal of Perinatal Medicine. 2016; 44(1): 23–32en_US
Identifierdc.identifier.otherDOI: 10.1515/jpm-2015-0044
Identifierdc.identifier.urihttps://repositorio.uchile.cl/handle/2250/138332
General notedc.descriptionArtículo de publicación ISIen_US
Abstractdc.description.abstractObjective: The diagnosis of clinical chorioamnionitis is based on a combination of signs [fever, maternal or fetal tachycardia, foul-smelling amniotic fluid (AF), uterine tenderness and maternal leukocytosis]. Bacterial infections within the amniotic cavity are considered the most frequent cause of clinical chorioamnionitis and an indication for antibiotic administration to reduce maternal and neonatal morbidity. Recent studies show that only 54% of patients with the diagnosis of clinical chorioamnionitis at term have bacteria in the AF and evidence of intra-amniotic inflammation. The objective of this study was to examine the performance of the clinical criteria for the diagnosis of chorioamnionitis to identify patients with microbial-associated intra-amniotic inflammation (also termed intra-amniotic infection). Materials and methods: This retrospective cross-sectional study included 45 patients with the diagnosis of clinical chorioamnionitis at term, whose AF underwent analysis for: 1) the presence of microorganisms using both cultivation and molecular biologic techniques [polymerase chain reaction (PCR) with broad primers], and 2) interleukin (IL)-6 concentrations by enzyme-linked immunosorbent assay. The diagnostic performance (sensitivity, specificity, accuracy, and likelihood ratios) of each clinical sign and their combination to identify clinical chorioamnionitis were determined using microbial-associated intra-amniotic inflammation [presence of microorganisms in the AF using cultivation or molecular techniques and elevated AF IL-6 concentrations (>= 2.6 ng/mL)] as the gold standard. Results: The accuracy of each clinical sign for the identification of microbial-associated intra-amniotic inflammation (intra-amniotic infection) ranged between 46.7% and 57.8%. The combination of fever with three or more clinical criteria did not substantially improve diagnostic accuracy. Conclusion: In the presence of a fever during labor at term, signs used to diagnose clinical chorioamnionitis do not accurately identify the patient with proven intra-amniotic infection (i.e., those with microorganisms detected by culture or molecular microbiologic techniques and an associated intra-amniotic inflammatory response).en_US
Lenguagedc.language.isoenen_US
Publisherdc.publisherWalter De Gruyter GMBHen_US
Type of licensedc.rightsAtribución-NoComercial-SinDerivadas 3.0 Chile*
Link to Licensedc.rights.urihttp://creativecommons.org/licenses/by-nc-nd/3.0/cl/*
Keywordsdc.subjectAmniocentesisen_US
Keywordsdc.subjectFeveren_US
Keywordsdc.subjectFoul-smelling amniotic fluiden_US
Keywordsdc.subjectFunisitisen_US
Keywordsdc.subjectHistological chorioamnionitisen_US
Keywordsdc.subjectIntra-amniotic inflammationen_US
Keywordsdc.subjectMaternal leukocytosisen_US
Keywordsdc.subjectPreterm birthen_US
Keywordsdc.subjectSterile inflammationen_US
Keywordsdc.subjectTachycardiaen_US
Keywordsdc.subjectUterine tendernessen_US
Títulodc.titleClinical chorioamnionitis at term III: how well do clinical criteria perform in the identification of proven intra-amniotic infection?en_US
Document typedc.typeArtículo de revista


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Atribución-NoComercial-SinDerivadas 3.0 Chile
Except where otherwise noted, this item's license is described as Atribución-NoComercial-SinDerivadas 3.0 Chile