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Case Reports
. 2007 Oct;30(5):793-8.
doi: 10.1002/uog.5173.

What is amniotic fluid 'sludge'?

R Romero  1 , J P Kusanovic, J Espinoza, F Gotsch, C L Nhan-Chang, O Erez, C J Kim, N Khalek, P Mittal, L F Goncalves, C Schaudinn, S S Hassan, J W Costerton
Affiliations
Case Reports

What is amniotic fluid 'sludge'?

R Romero et al. Ultrasound Obstet Gynecol. 2007 Oct.
No abstract available

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Figures

Figure 1
Figure 1
Rendered three-dimensional transvaginal ultrasound image demonstrating the presence of amniotic fluid ‘sludge’ in close proximity to the cervix.
Figure 2
Figure 2
Two-dimensional ultrasound image showing amniotic fluid ‘sludge’ in a patient with a short cervix and a cervical funnel. acute necrotizing chorioamnionitis (Figure 5a) and acute funisitis (Figure 5b). The newborn was admitted to the neonatal intensive care unit and developed metabolic acidosis and respiratory distress syndrome that resolved in the first week of postnatal life. There was no evidence of pneumonia, the result of a neurosonogram was normal, andmicrobial cultures of the cerebrospinal fluid and blood were negative. However, the neonate was treated with ampicillin and gentamycin because of suspected sepsis. After 45 days, the infant was discharged home in good condition.
Figure 3
Figure 3
Photograph showing the appearance of amniotic fluid ‘sludge’, aspirated during a transvaginal needle amniotomy under transabdominal ultrasound guidance.
Figure 4
Figure 4
Gram stain of amniotic fluid ‘sludge’ demonstrating the presence of epithelial cells and many Gram-positive cocci; neutrophils are also evident.
Figure 5
Figure 5
Histological sections of (a) the fetal membranes, demonstrating marked ‘acute necrotizing chorioamnionitis’ and (b) the umbilical cord, showing acute funisitis.
Figure 5
Figure 5
Histological sections of (a) the fetal membranes, demonstrating marked ‘acute necrotizing chorioamnionitis’ and (b) the umbilical cord, showing acute funisitis.
See this image and copyright information in PMC

References

    1. Espinoza J, Goncalves LF, Romero R, Nien JK, Stites S, Kim YM, Hassan S, Gomez R, Yoon BH, Chaiworapongsa T, Lee W, Mazor M. The prevalence and clinical significance of amniotic fluid “sludge” in patients with preterm labor and intact membranes. Ultrasound Obstet Gynecol. 2005;25:346–352. - PubMed
    1. Bujold E, Pasquier JC, Simoneau J, Arpin MH, Duperron L, Morency AM, Audibert F. Intra-amniotic sludge, short cervix, and risk of preterm delivery. J Obstet Gynaecol Can. 2006;28:198–202. - PubMed
    1. Kusanovic JP, Espinoza J, Romero R, Goncalves LF, Nien JK, Soto E, Khalek N, Camacho N, Hendler I, Mittal P, Friel LA, Gotsch F, Erez O, Than NG, Mazaki-Tovi S, Schoen ML, Hassan SS. Clinical significance of the presence of amniotic fluid ‘sludge’ in asymptomatic patients at high risk for spontaneous preterm delivery. Ultrasound Obstet Gynecol. 2007;30:706–714. - PMC - PubMed
    1. Romero R, Gonzalez R, Baumann P, Behnke E, Rittenhouse L, Barberio D, Cotton DB, Mitchell MD. Topographic differences in amniotic fluid concentrations of prostanoids in women in spontaneous labor at term. Prostaglandins Leukot Essent Fatty Acids. 1994;50:97–104. - PubMed
    1. Baumann P, Romero R, Gonzales R, Cotton DB, Mammen E. Evidence of topographic differences in amniotic fluid plasminogen activator/plasminogen activator inhibitor concentrations during spontaneous active labor at term. Am J Obstet Gynecol. 1994;170:270.

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