Sludge reflects intra-amniotic inflammation with or without microorganisms

ProblemTo investigate whether amniotic fluid (AF) sludge in patients with preterm labor (PTL) with intact membranes is related to intra-amniotic infection or inflammation. Method of study105 PTL patients before 29weeks' gestation were enrolled. AF sludge was evaluated by transvaginal sonography. Microorganisms were identified in AF by our newly established PCR method using a eukaryote-made thermostable DNA polymerase. ResultsAF sludge was present in 18.1% (19/105) of patients. The results obtained in the AF sludge group vs the no sludge group were as follows: (i) a similar positive rate of microorganisms in AF by PCR, 31.6% (6/19) vs 38.4% (33/86); (ii) a higher level of AF interleukin-8, 15.2 (0.2-381.5) ng/mL vs 5.8 (0.1-413.7) ng/mL; P=.005); and (3) a higher frequency of histological chorioamnionitis, 52.6% (10/19) vs 23.3% (20/86); P=.010. ConclusionThe presence of AF sludge is related to intra-amniotic inflammation with or without microorganisms.