OBJECTIVES: To determine the feasibility and the complication rate of amniocentesis in a large cohort of women with preterm prelabor rupture of membranes (PPROM). METHODS: A retrospective cohort study was conducted in all women with singleton gestation complicated by PPROM at between 24+0 and 36+6 weeks admitted to the Department of Obstetrics and Gynecology, University Hospital Hradec Kralove, Czech Republic between May 2008 and July 2016. Amniocentesis was offered as a part of a routine protocol of PPROM for the detection of microbial invasion of the amniotic cavity and intra-amniotic inflammation. Procedure was performed under ultrasound guidance. A successful procedure was defined as obtaining at least 0.5 mL of amniotic fluid. No more than 2 attempts were performed. RESULTS: In total, 590 women with PPROM were included. Amniocentesis was successful in 96% (567/590). Two amniocentesis attempts were necessary in 9% (55/590) and the transplacental approach was used in 13% (76/590). No association between gestational age at sampling and the amniocentesis failure rate was found (Spearman rho -0.12; p = 0.71). The complication rate was 0.7% (4/590). Two umbilical cord punctures and 2 chorionic plate fetal vessel injuries occurred, without fetal morbidity. CONCLUSION: Based on our study population, so far the largest published, amniocentesis is a feasible and safe procedure carrying a very low risk of failure or complications in PPROM.

Department of Obstetrics and Gynecology Charles University Prague Faculty of Medicine in Hradec Kralove University Hospital in Hradec Kralove Hradec Kralove Czech Republic

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Maternal white blood cell count cannot identify the presence of microbial invasion of the amniotic cavity or intra-amniotic inflammation in women with preterm prelabor rupture of membranes