Role of amniocentesis for the diagnosis of subclinical intra-amniotic infection in preterm premature rupture of the membranes.

The clinical role of amniocentesis in the management of pregnancies that are complicated by preterm premature rupture of the membranes remains unclear. The indiscriminant use of expectant management, corticosteroids, and empiric antibiotic therapy without knowledge of the presence or absence of intra-amniotic infection poses underappreciated risks to the fetus. This clinical opinion presents the argument that amniocentesis should be an integral part of the management of patients with preterm premature rupture of the membranes. The technical aspects of amniocentesis, the associations between subclinical infection and neonatal morbidity, and the limitations of current interventions are reviewed, and suggestions for future studies that are sorely needed are offered.