Yohei Maki1, Seishi Furukawa2, Yuki Kodama3, Hiroshi Sameshima4, Tsuyomu Ikenoue5. 1. Faculty of Medicine, Department of Obstetrics and Gynecology, Center for Perinatal Medicine, University of Miyazaki, Japan. Electronic address: yohei_maki@med.miyazaki-u.ac.jp. 2. Faculty of Medicine, Department of Obstetrics and Gynecology, Center for Perinatal Medicine, University of Miyazaki, Japan. Electronic address: seishi_furukawa@mcpsed.miyazaki-u.ac.jp. 3. Faculty of Medicine, Department of Obstetrics and Gynecology, Center for Perinatal Medicine, University of Miyazaki, Japan. Electronic address: yuki_kodama@med.miyazaki-u.ac.jp. 4. Faculty of Medicine, Department of Obstetrics and Gynecology, Center for Perinatal Medicine, University of Miyazaki, Japan. Electronic address: hsameshima@med.miyazaki-u.ac.jp. 5. Faculty of Medicine, Department of Obstetrics and Gynecology, Center for Perinatal Medicine, University of Miyazaki, Japan. Electronic address: tsuyomu_ikenoue@med.miyazaki-u.ac.jp.
Abstract
BACKGROUND: It remains unclear whether performing amniocentesis to detect intra-amniotic infection is useful for improving neonatal outcomes. AIMS: To determine the efficacy of amniocentesis on the neonatal outcomes in women exhibiting threatened preterm labor and intact membranes. STUDY DESIGN: Retrospective cohort study SUBJECTS: A total of 174 women with threatened preterm labor and intact membranes at 22 to 33 weeks of gestation. Women with obvious clinical chorioamnionitis, multifetal pregnancy and/or major anomalies were excluded. OUTCOME MEASURES: Neonatal short- and long-term outcomes RESULTS: Sixty-seven women underwent amniocentesis (Tap group), while the remaining 107 did not. The prevalence of a positive Gram stain or a positive culture result was 10% in the Tap group. The overall outcomes were not statistically different between the two groups, with the exception of borderline significance (p=0.052) in long-term outcomes, favoring the Tap group. We performed a subgroup analysis focusing on infants born at 22-28 weeks of gestation. Consequently, the Tap group had better neonatal outcomes than the no-Tap group with respect to both short-term (OR 0.19, 95%CI 0.07-0.55) and long-term (OR 0.15, 0.05-0.46) outcomes. A multivariate analysis revealed that after adjusting confounding factors, the gestational age at delivery (OR 0.4, 0.3-0.7) and amniocentesis (OR 0.1, 0.02-0.3) remained significantly different. CONCLUSIONS: Amniocentesis is useful for improving neonatal outcomes in infants born at 22-28 weeks of gestation to women exhibiting preterm labor and intact membranes.
BACKGROUND: It remains unclear whether performing amniocentesis to detect intra-amniotic infection is useful for improving neonatal outcomes. AIMS: To determine the efficacy of amniocentesis on the neonatal outcomes in women exhibiting threatened preterm labor and intact membranes. STUDY DESIGN: Retrospective cohort study SUBJECTS: A total of 174 women with threatened preterm labor and intact membranes at 22 to 33 weeks of gestation. Women with obvious clinical chorioamnionitis, multifetal pregnancy and/or major anomalies were excluded. OUTCOME MEASURES: Neonatal short- and long-term outcomes RESULTS: Sixty-seven women underwent amniocentesis (Tap group), while the remaining 107 did not. The prevalence of a positive Gram stain or a positive culture result was 10% in the Tap group. The overall outcomes were not statistically different between the two groups, with the exception of borderline significance (p=0.052) in long-term outcomes, favoring the Tap group. We performed a subgroup analysis focusing on infants born at 22-28 weeks of gestation. Consequently, the Tap group had better neonatal outcomes than the no-Tap group with respect to both short-term (OR 0.19, 95%CI 0.07-0.55) and long-term (OR 0.15, 0.05-0.46) outcomes. A multivariate analysis revealed that after adjusting confounding factors, the gestational age at delivery (OR 0.4, 0.3-0.7) and amniocentesis (OR 0.1, 0.02-0.3) remained significantly different. CONCLUSIONS: Amniocentesis is useful for improving neonatal outcomes in infants born at 22-28 weeks of gestation to women exhibiting preterm labor and intact membranes.
Authors: T Myntti; L Rahkonen; A Pätäri-Sampo; M Tikkanen; T Sorsa; J Juhila; O Helve; S Andersson; J Paavonen; V Stefanovic Journal: J Perinatol Date: 2016-09-01 Impact factor: 2.521
Authors: Tarja Myntti; Leena Rahkonen; Irmeli Nupponen; Anu Pätäri-Sampo; Minna Tikkanen; Timo Sorsa; Juuso Juhila; Sture Andersson; Jorma Paavonen; Vedran Stefanovic Journal: Dis Markers Date: 2017-01-12 Impact factor: 3.434