Corioamnionitis subclínica: un reto diagnóstico. A propósito de un caso

Abstract

Diagnosis of subclinical chorioamnionitis in patients with premature rupture of membranes in preterm gestation is a challenge. If intraamniotic infection is ruled out by amniocentesis, it is not clear–in the expectant management of the pregnancy and until the fetus has reached a gestational age allowing active management–when the test should be repeated, or whether it should be repeated. In the case reported herein, expectant management of pregnancy was adopted after intra-amniotic infection had been excluded by amniocentesis. However, because of changes in the number of leukocytes and an increase in acute phase reactants in the absence of infection at another site, we decided to repeat the test. Despite early diagnosis of subclinical chorioamnionitis, fetal involvement had already occurred due to the inflammation-infection process. It is therefore essential to obtain an early maternal serum marker of intra-amniotic infection.