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 ar e complicated by preterm premature rupture of the membranes remains unclear . The indiscriminant use of expectant management, corticosteroids, and empi ric antibiotic therapy without knowledge of the presence or absence of intr aamniotic infection poses underappreciated risks to the fetus. This clinica l opinion presents the argument that amniocentesis should be an integral pa rt of the management of patients with preterm premature rupture of the memb ranes. The technical aspects of amniocentesis, the associations between sub clinical infection and neonatal morbidity, and the limitations of current i nterventions are reviewed, and suggestions for future studies that are sore ly needed are offered. Curr Opin Obstet Gynecol 11:541-547. (C) 1999 Lippin cott Williams & Wilkins.