Amniotic Fluid Concentrations of Adrenomedullin in Preterm Labor

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In Brief Objective To determine whether adrenomedullin levels in amniotic fluid were associated with preterm labor. Methods We measured immunoreactive adrenomedullin in amniotic fluid collected by amniocentesis from 36 women with clinical diagnosis of preterm labor or preterm premature rupture of membranes (PROM) and from 18 normal pregnant women. Results Amniotic fluid from cases of PROM and failure to respond to tocolysis were associated significantly with higher amniotic fluid adrenomedullin concentrations (177.0 ± 22.5 pg/mL and 182.7 ± 22.0 pg/mL, respectively, P < .01) than that from uncomplicated pregnancies (101.2 ± 28.1 pg/mL) or preterm labor responsive to tocolysis (102.3 ± 26.8 pg/mL). Conclusion Amniotic fluid adrenomedullin is higher than normal in cases of PROM and preterm labor unresponsive to tocolysis, perhaps indicating enhanced synthesis from placenta or fetal membranes being stimulated by bacterial products. Adrenomedullin concentrations in amniotic fluid are higher in women with preterm labor, no response to tocolysis, or premature rupture of membranes than in women with normal pregnancy.

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