Amniotic fluid inflammatory score is associated with pregnancy outcome in patients with mid trimester short cervix.

OBJECTIVE: We propose a novel amniotic fluid inflammatory score from a comprehensive cytokine analysis of patients with mid-trimester short cervix. STUDY DESIGN: Amniotic fluid from singleton gestations (n = 44) with a cervical length of <= 25 mm between 16-24 weeks was assayed for 25 inflammatory mediators. Patient data were stratified according to gestational age at delivery (<34 vs >= 34 weeks). Mediators that reached statistical significance were included in the amniotic fluid inflammatory score. Patients were assigned 1 point for each significant mediator if their level was in the upper quartile. The amniotic fluid inflammatory score was determined, and its relationship to other clinical characteristics was examined. RESULTS: Fourteen mediators met the criteria. A score of >= 8 was predictive of delivery at <34 weeks' gestation (sensitivity, 87.0%; specificity, 100%; positive predictive value, 100%; negative predictive value, 87.5%). Twenty patients had a high inflammatory score (>= 8); 24 patients had a low score. All patients with a high inflammatory score delivered at <30 weeks' gestation. CONCLUSION: The amniotic fluid inflammatory score is related to delivery outcome and clinical characteristics.