Assessment of fetal activity and amniotic fluid volume in the prediction of intrauterine infection in preterm prelabor amniorrhexis

OBJECTIVE: Our purpose was to assess fetal activity, fetal heart rate patterns, and amniotic fluid volume in the prediction of intrauterine infection in pregnancies complicated by preterm prelabor amniorrhexis. STUDY DESIGN: A prospective study was performed on 89 patients with preterm prelabor amniorrhexis undergoing fetal blood and amniotic fluid sampling for microbiologic investigations. Within 2 hours before cordocentesis and amniocentesis, computerized fetal heart rate monitoring was carried out and ultrasonographic examination was performed for assessment of biophysical profile and amniotic fluid volume. RESULTS: In the pregnancies with microbiologic evidence of intrauterine infection compared with those with no infection, there was a tendency for a lower biophysical profile score and amniotic fluid index and an increased fetal heart rate. However, in the majority of pregnancies with positive amniotic fluid or fetal blood cultures the results of the various tests were normal. CONCLUSION: In pregnancies complicated by preterm prelabor amniorrhexis assessment of fetal activity and amniotic fluid volume do not provide useful prediction of intrauterine infection.