Amniotic fluid nitric oxide in pregnant women with intraamniotic mycoplasma infections: a pilot study

OBJECTFVE: Nitric oxide production increases with bacterial infection. However, the relevance of nitric oxide to mycoplasma infection remains undetermined. We determined the amniotic fluid nitric oxide levels in pregnant women complicated with intraamniotic mycoplasma infection. STUDY DESIGN: Seventy-six amniotic fluid samples were studied: 7 intraamniotic mycoplasma infections, 8 intraamniotic aerobic/anaerobic infections, and 61 uninfected controls. As nitric oxide is unstable and breaks down rapidly to nitrite and nitrate, we measured total nitrite and nitrate (NOx) in the amniotic fluid using aspergillus nitrate reductase. Gram stain, glucose, neutrophil counts, leukocyte esterase activity, creatinine, pH, and specific gravity were also performed. Amniotic fluid NOx level was expressed in jj.mol/rng creatinine. Data were analyzed by contingency table method, analysis of variance, and post hoc by Bonferroni/Dunn lest. RESULTS: Amniotic fluid NOx level in mycoplasma infection was significantly lower than in aerobic/anaerobic infection (2.02 ±Ü.40 vs. 3.34 ±0.74 (imol/mg creatinine, p = 0.0082), but not in uninfected controls (2.03 ±0.41 vs 1.78 ±0.08 jjtmol/mg creatinine, p = 0.5195). Intraamniotic aerobic/anaerobic infection, but not intraamniotic mycoplasma infections, had a significantly higher incidence of amniotic fluid gram stain, leukocyte esterase activity, leukocyte counts, and a significantly lower amniotic fluid glucose levels than those of uninfected controls. CONCLUSIONS: Our data indicate that intraamniotic mycoplasma infections differs from intraamniotic aerobic/anaerobic infections in the pathogenesis of intraamniotic infection. Whether different clinical information should be sought in the management of pregnant women complicated with intraamniotic mycoplasma infection or aerobic/anaerobic infection awaits further investigation.