Amniotic fluid concentrations of adrenomedullin in preterm labor

Objective: To determine whether adrenomedullin levels in amniotic fluid wer e associated with preterm labor. Methods: We measured immunoreactive adrenomedullin in amniotic fluid collec ted by amniocentesis from 36 women with clinical diagnosis of preterm labor or preterm premature rupture of membranes (PROM) and from 18 normal pregna nt women. Results: Amniotic fluid from cases of FROM and failure to respond to tocoly sis were associated significantly with higher amniotic fluid adrenomedullin concentrations (177.0 +/- 22.5 pg/mL and 182.7 +/- 22.0 pg/mL, respectivel y, P < .01) than that from uncomplicated pregnancies (101.2 +/- 28.1 pg/mL) or preterm labor responsive to tocolysis (102.3 +/- 26.8 pg/mL). Conclusion: Amniotic fluid adrenomedullin is higher than normal in cases of FROM and preterm labor unresponsive to tocolysis, perhaps indicating enhan ced synthesis from placenta or fetal membranes being stimulated by bacteria l products. (Obstet Gynecol 1999;93:964-7. (C) 1999 by The American College of Obstetricians and Gynecologists.)