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KMID : 0358420110540020079
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Korean Journal of Obstetrics and Gynecology
2011 Volume.54 No. 2 p.79 ~ p.85
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THE RELATIONSHIP BETWEEN AMNIOTIC FLUID WHITE BLOOD CELL COUNT AND INFLAMMATORY LESIONS OF THE PLACENTA IN WOMEN WITH PRETERM PREMATURE RUPTURE OF MEMBRANES
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Jeong Eun-Ha
Park Kyo-Hoon
Oh Kyung-Joon
Lee Sung-Youn
Kim Shi-Nae
Jung Hee-Jung
Lee Jeong-Yeun
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Abstract
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Objective : To examine the relationship between amniotic fluid (AF) white blood cell (WBC) count and the presence and severity of infl ammatory lesions of the placenta in women with preterm premature rupture of membranes (PPROM).
Methods: This retrospective cohort study included 90 consecutive women with PPROM (24.0-35.6 weeks) who met the following criteria: singleton gestation; transabdominal amniocentesis performed to obtain AF for culture and WBC count; delivery within 72 hours of amniocentesis; placental histologic examination after preterm delivery.
Results: The prevalence of histologic chorioamnionitis was 32% (29/90) and that of positive amniotic fluid culture was 21% (19/90). Patients with histologic chorioamnionitis had a signifi cantly higher AF WBC count than those without this lesion. Logistic regression analysis demonstrated that AF WBC count had a significant relationship with histologic chorioamnionitis after controlling for gestational age and AF culture. The median AF WBC count increased signifi cantly according to the higher severity of infl ammation in each type of placental histologic section. According to receiver operating characteristic curve analysis, the best cut-off value of AF WBC count for predicting histological chorioamnionitis was 25 cells/mm3, with a sensitivity of 62% and a specifi city of 77%.
Conclusion: Both the presence and greater severity of infl ammatory lesions of the placenta are associated with an elevated AF WBC count. AF WBC count is an important and independent predictor for infl ammatory lesions of the placenta in women with PPROM.
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KEYWORD
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Amniotic fl uid, White blood cell, Placenta, Infl ammatory lesions, Preterm premature rupture of membranes
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