AMNIOTIC-FLUID GRAM STAIN AND LEUKOCYTE COUNT IN THE PREDICTION OF INTRAUTERINE INFECTION IN PRETERM PRELABOR AMNIORRHEXIS

The purpose of the study was to examine the sensitivity and specificit y of the amniotic fluid Gram stain and leukocyte count in the predicti on of positive fetal blood and amniotic fluid cultures in 80 patients with preterm prelabour amniorrhexis. Amniocentesis and cordocentesis w ere performed and amniotic fluid and fetal blood were cultured for aer obic and anaerobic bacteria. Amniotic fluid was also cultured for Urea plasma urealyticum and Mycoplasma hominis. The senstivity of the Gram stain in the prediction of positive fetal blood and amniotic fluid cul tures was 50 and 40% and the respective false positive rates were 12 a nd 4%. In the detection of aerobic or anaerobic infection of the amnio tic fluid, the sensitivity and false positive rate of the Gram stain w ere 80 and 3% respectively. This compared favourably with the respecti ve values of 66 and 35% for amniotic fluid leukocyte count >30/mm(3). Positive amniotic fluid Gram stain provides useful prediction of intra -uterine infection with aerobic or anaerobic organisms.