The antenatal identification of funisitis with a rapid MMP-8 bedside test

Aims: The purpose of this study was to determine if a bedside test, the MMP-8 PTD Check (TM), can be of value in the antenatal identification of funisitis. This test can be performed in 15 min without any laboratory equipment. Methods: The relationship between the presence or absence of funisitis and the results of an MMP-8 PTD Check (TM) was examined in 139 patients who delivered preterm singleton neonates (gestational age <35 weeks) within 72 h of amniocentesis. Amniotic fluid (AF) was cultured for aerobic and anaerobic bacteria and for genital mycoplasmas. AF was analyzed for white blood cell (WBC) count, interleukin-6 (IL-6) and an MMP-8 PTD Check (TM). The IL-6 concentration was also determined in umbilical cord plasma collected at birth. Funisitis was diagnosed in the presence of neutrophil infiltration into the umbilical vessel walls or Wharton's jelly. Results: 1) Funisitis was present in 27% (38/139) of cases; 2) A positive MMP-8 PTD Check (TM) had a sensitivity of 97% (37/38), a specificity of 63% (64/101), a positive predictive value of 50% (37/74) and a negative predictive value of 99% (64/65) in the identification of funisitis; 3) Among cases without funisitis, patients with a positive MMP-8 PTD Check (TM) had a significantly higher median AF IL-6 concentration, AF WBC count, and umbilical cord plasma IL-6 concentration at birth than those with a negative MMP-8 PTD Check (TM) (P<0.05 for each). Conclusions: The MMP-8 PTD Check (TM) is a rapid, simple and sensitive bedside test which allows assessment of the risk of funisitis.