Antibiotic treatment of amniotic fluid "sludge" in patients during the second or third trimester with uterine contraction

ObjectiveTo assess the effectiveness of antibiotic treatment in patients with amniotic fluid (AF) "sludge" during the second or third trimester with uterine contractions and intact membranes. MethodsA retrospective cohort study was conducted of women at 15-32 weeks of pregnancy with uterine contractions and intact membranes. Women with AF "sludge" were treated with an antibiotic regimen of ceftriaxone, clarithromycin, and metronidazole. Based on changes in AF "sludge," patients were divided into group A (disappearance of "sludge") and group B (persistent "sludge"). ResultsWomen in group A (n=30) delivered later than those in group B (n=28). Group A showed a smaller initial size of "sludge" than group B (all P<0.05). Women in group A had a lower rate of preterm birth within 7 days, and before 28, 32, and 34 weeks of pregnancy, and composite neonatal morbidity and perinatal death than group B (all P<0.05). ConclusionThe administration of antibiotics may eradicate AF "sludge" in women in the second or third trimester with uterine contractions and intact membranes, which are associated with the initial size of "sludge." Patients with disappearing "sludge" had more favorable pregnancy and neonatal outcomes than those with persistent "sludge." Administration of antibiotics may eradicate amniotic fluid "sludge" in women during the second or third trimester with uterine contractions and intact membranes.