The clinical role of amniocentesis in the management of pregnancies that are complicated by preterm premature rupture of the membranes remains unclear. The indiscriminant use of expectant management, corticosteroids, and empiric antibiotic therapy without knowledge of the presence or absence of intra-amniotic infection poses underappreciated risks to the fetus. This clinical opinion presents the argument that amniocentesis should be an integral part of the management of patients with preterm premature rupture of the membranes. The technical aspects of amniocentesis, the associations between subclinical infection and neonatal morbidity, and the limitations of current interventions are reviewed, and suggestions for future studies that are sorely needed are offered.
Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Wayne State University, Detroit, Michigan, USA
Correspondence to Stanley M. Berry, MD, Hutzel Hospital, Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, 4707 St. Antoine Boulevard, Detroit, Michigan 48201, USA. Tel: +1 313 745 7619; fax: +1 313 993 2683; e-mail: email@example.com