Effect of Antibiotic Treatment of Amniotic Fluid Sludge
| Autor: | Rosalea Taam, Roger B. Newman, Evelyn Bruner, Scott Sullivan, Ryan D. Cuff, Sanjay Patwardhan, Elliott Carter, Eugene Y. Chang |
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| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
Neonatal intensive care unit Amniotic fluid Sewage business.industry Obstetrics Infant Newborn Gestational age General Medicine Amniotic Fluid medicine.disease Chorioamnionitis Anti-Bacterial Agents Pregnancy Premature birth medicine Humans Premature Birth Gestation Rupture of membranes Female business Premature rupture of membranes Retrospective Studies |
| Zdroj: | American Journal of Obstetrics & Gynecology MFM. 2:100073 |
| ISSN: | 2589-9333 |
| DOI: | 10.1016/j.ajogmf.2019.100073 |
| Popis: | BACKGROUND Amniotic fluid sludge refers to the sonographic presence of echogenic, free-floating aggregates of debris located within the amniotic cavity near the internal cervical os of women with intact membranes. Clinically, it is independently associated with increased obstetric, infectious, and neonatal morbidity, including: short cervix, chorioamnionitis, and an increased risk of preterm birth. It is thought to be infectious in nature and has been described as an intrauterine bacterial biofilm. There is little evidence on the impact of treatment with antibiotics on outcome. OBJECTIVE To determine whether outpatient antibiotics administered to women with amniotic fluid sludge would reduce preterm birth risk compared to no antibiotic treatment. MATERIALS AND METHODS This was a retrospective cohort study of all patients diagnosed with amniotic fluid sludge by transvaginal sonography between 15 and 25 weeks' gestation in the outpatient ultrasound unit at a single academic center between 2010 and 2017. Patients were segregated according to whether they were treated with oral antibiotics at the time of diagnosis. Women with multiple gestation, fetal anomalies, preterm rupture of membranes prior to initial diagnosis of amniotic fluid sludge, and active preterm labor placenta previa and/or suspected accreta were excluded from analysis. Primary outcome of preterm birth at less than 37 weeks' gestation was compared by univariate and regression analysis to control for potential co-linear and/or confounding variables. Additional outcomes were compared by univariate analysis. RESULTS A total of 181 patients were initially identified, and 97 patients met inclusion criteria. Of these patients, 51 were treated with oral antibiotics (46 azithromycin and 5 moxifloxacin), and 46 were not treated. The overall incidence of preterm birth at |
| Databáze: | OpenAIRE |
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