Fetal fibronectin as a predictor of preterm birth in patients with symptoms: a multicenter trial.

Objective: Our aim was to determine whether the presence of fetal fibronectin in vaginal secretions of patients with symptoms suggestive of preterm labor predicts preterm delivery.

Study Design: Patients who were examined at the hospital between 24 weeks' and 34 weeks 6 days' gestation with intact membranes, no prior tocolysis, symptoms suggestive of preterm labor, and cervical dilation < 3 cm were recruited at 10 sites. Swabs of the posterior fornix were assayed for the presence of fetal fibronectin by monoclonal antibody assay, with a positive result defined as > or = 50 ng/ml.

The value of amniotic fluid interleukin-6 determination in patients with preterm labor and intact membranes in the detection of microbial invasion of the amniotic cavity.

Objectives: Our purpose was to (1) determine the value of amniotic fluid interleukin-6 determination in the detection of microbial invasion of the amniotic cavity and (2) compare interleukin-6 to other rapid tests in the evaluation of preterm labor.

Study Design: Amniotic fluid interleukin-6 was determined quantitatively by enzyme-linked immunosorbent assay in 91 amniotic fluid specimens obtained by amniocentesis in 89 patients with preterm labor. Amniotic fluid cultures for aerobes, anaerobes, and mycoplasma species were performed.

Evaluation of rapid diagnostic tests in the detection of microbial invasion of the amniotic cavity.

Objective: We sought to determine and compare the value of several rapid diagnostic tests in the detection of intraamniotic infection.

Study Design: Gram stain, intraamniotic glucose level determination, leukocyte esterase assay, and the Limulus amebocyte lysate assay were performed on 144 amniotic fluid specimens retrieved by transabdominal amniocentesis in 136 patients with preterm premature rupture of the membranes or preterm labor. Diagnostic indices for a positive amniotic fluid culture and the development of clinical infection were calculated for each rapid test.

Prenatal diagnosis of Candida albicans chorioamnionitis.

The use of diagnostic amniocentesis has been proposed for the evaluation of patients with clinical suspicion of chorioamnionitis, such as those with premature rupture of membranes and premature labor. We describe a patient in whom the diagnosis of Candida chorioamnionitis was made after diagnostic amniocentesis with the assistance of a simple and rapidly performed potassium hydroxide smear.

The perinatal management of pregnancy complicated by massive intracerebral hemorrhage.

A pregnancy complicated by massive intracerebral hemorrhage with resultant maternal and fetal problems is presented. Aggressive maternal care, fetal surveillance, and perinatal management resulted in a successful outcome.