Volume 164 I'\umbcr 1. Pa rt 2

181 !HE LEUK01AXIS .;SSAY AND IDIOPATHIC PRETERK LAB OR:

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IDENlIFlCATION OF THREE DISTINCT GROUPS. Peter H. Cherouny, Glenn A. Pankuch x

, John J. Botti, Peter C. Appelbaum". The )epts. of OB/GYN and Pathology, Unmrsity Hospi:al, Penn State Unmrsity, Hershey, PA. 17033. Supprted by Karch of Dms Research Gr ant 16-548

Fifty-one amnioti c flUid (AFI specmns from 51 patients dlagnosej with pretm onset of labor and considered tocolytic ca:ldidates were enluated by Gram stain, culture and leukotaxis assay (LeuAl (AJOG 1919;161:802). Three groups were identified: 29 (57% 1 had uniformly n=gative AF Gram stm, culture, and LeuA (group 11 . Eight patients (16% 1 having uni formly positive AF Gram stain, culture , and LeuA (group 2) were no longer considered tocOlytlc candidates and were treated for lntraamotic lnfectl~n. Fourteen patmts (27%: had 1-1 AF Gram stm 2nd (t) LeuA (group 3); all subsequently showed hlstologic chonoamnionltls. FJur of these patients had a positive AF cu:ture subsequent to delivery wh ich did not affect management of the:r preterm labor. Groups 1 and 3 are indistingUlShable without the LeuA and are therefore compared. Twenty-seven (93% 1 of patients in group 1 had successful In iti al tocOlytlc therapy vs.l (7%1 from group 3 (p<.005). Groups 1 and 3 differed in gestational age on admiSSion, previous pre term birtns, WBC count, bath weight, neonatal hospltallZation, and amniocentesIs to de imry in terva: (peD51 . ThiS data suggests; 11 LeuA (-) group 1 IS successfully managed with the tocolytic protocols presently usee. 2: GroJp 3 represents an unique subset of patlfTIts With early Infection who may benefit from the addition of antiblo:lCS to the present tOCOlytlc regimen.

rHE LEUKOTAXlS ASSAY AS A ?RRDICTOR OF CLINICAL CHORIOAKNIONITIS IN PATIENTS WITH IDIOFATHIC PRETUM LABOR. Peter H. Cherouny, Glenn A. Pankuch x

, John J. Botti, Peter C. Appelbaum". The Depts. of OB/GYN and Pathology, University Hospital, Penn State University, HerShey, PA. 17033. Supported by Karch of Dimes Birth Defects Foundation Grant 16-548.

Elghty-m patients admitted with IdiopathiC pretm labor unde rwent .mnlocenteslS for Gram stain, culture and leukotaxis assay ILeuAIlAJOG 1989;161:802 ). Hight pat ients developed cImcal chorioamnionltis ICC) dUring the ir management; 6 had (t)LeuA and 2 had 1-)LeuA. Fm of the 6 patleTIts With a (t)LeuA had a It) Gram stain and were treated for lntraamotic lnfection. The sixth patient had tocolytlCS stopped due to advanced ce rVical dilation and an t ibiot ics were added In the active phase cf labor due to CC .. ~ll SIX patients had stage 3!severe histologic chorioamnionitis. Two patients developed CC having a I-I LeuA; one had tocolytics stopped due to advanced cervical dilation while the other underwent induction of labor and antaicroblal therapy because of the diagnoSlS of CC. Nelther patient had histologic evidence of infection; the pathol ogy of the latter patient revealed abruptiO placenta. This data suggests; 11 The diagnosis of CC does not alter management in patients WIth a (t)LeuA. 2) The LeuA IS a more accurate predictor of intrmniotic Infection than the climal dlagnms and 3) Patients with cc and a (-) LeuA represent a unique group in which tocolytic and antib iot ic therapy Bay be ~on sldered.

SPO Abstracts 297

183 AMNIOTIC FLUID LEUKOTAXlS ASSAY AS AN EARLY INDICA70R OF :HORIOAMNIONITIS IN PATIENTS WITH IDIOPATHIC PRETERK LABOR. Peter H. Cherouny, Glenn A. Pankuch x

, John J . Botti, Peter C. Appelbaum" . The Depts. of OB/GYN and Pathology, University Hospital, Penn state unmrsity, Hershey, PA. 17033. Suppcrted by Harch of Dim Research Grant ,6-548

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The accuracy of an amniotic fluid (AP) leuko tax is assay I LeuA) in predicting histologic chonoamonitls has been prmously ,eported lAm J Obstet Gynecol 1989;161:802). We tested the hypothesis that; I) AF from patients without an identifiable cause of li diopathic) pretm labor With intact melbranes contms leukoattractant5 identi fiable by the LeuA and 2) A positm ass ay is an accu rate predictor of his tolog ic chorioamnionitis in th is populatlOTI . AF was collected by amniocentesis from 86 pat ients in idiopathic preterm labor, with intact membranes and without evidence of infection. The fluids were assessed by Gram stain, culture, gas-llquld chromatography for the presence of bacterial metabolites, and LeuA. 45 patients delivered within 48 hours of amniocentesis; 38 placenta s revealed histologic cborioamnionitis. A pos it ive leukotactlc response was a better pred ictor of histologic chorioamnlonltis (91%) than was a It) Gm stm (46%), a (t) AF culture 162%) , (t) gas-liquid chromatography (m) or a cOlbination of these three methods (62%). The results extend and support m previous findings and suggest that the leukotaxis assay is an earlier and more sensitive predictor of chomamnioni tis in patient s with idiopathic pretm labor than is currently available.

DETERMINANTS OF HIV TEST TAKING: Daniel Faustin, Jim Jaccard~ Howard Minkoff, Robert Endiasxi SUNY-HSC at Brooklyn, NY

We studied sociocultural and psychological factors influencing HIV test taking behavior among 1000 sexually active, low socioeconomic women. While sexual risks did not influence intent to take the test the use of illegal drugs within 30 days prior to the interview was associated with positive intent_Fear of AIDS correlated with negative intent to test while the advantages of knowledge of serostatus were unrelated to test taking intent.In conclusion, educational campaigns which stress the dangers of AIDS may have the undesirable effect of reducing willing­ness to take an HIV test_Women are more aware of the association of illicit drug use and the risk of HIV than of sexual risk taking and HIV_Therefore more effort may be necessary to explain the sexual transmission of HIV and the advantages of knowing one's serostatus as a means of preventing the spread of the infection and its long term consequences_