Application of telethermography in the evaluation of preterm premature rupture of the fetal membranes.
ABSTRACT The development of chorioamnionitis is a serious complication associated with preterm premature rupture of the fetal membranes (PPROM). There is no reliable early indicator of this infection. The objective of this study was to determine the sensitivity of telethermography (TTG) in the detection of subclinical chorioamnionitis in women with PPROM. Fourteen pregnant women with PPROM between 23 and 34 weeks' gestation were the subjects of the study. Serial frontal-abdominal TTG scans were obtained up to the time of delivery using the MARK-1026 telethermography imager. Following delivery, placental cultures and pathology results were obtained and infant sepsis evaluation was performed. Images were analyzed for temperature differences between umbilical, inguinal, four-quadrant average, and abdominal-wall hot spots. Data were compared with norms obtained from 12 pregnant women with intact membranes who served as gestational age-matched controls. Of five patients with pathology-proven chorioamnionitis and TTG scans within three days of delivery, four demonstrated significant increases in temperature differences between umbilical and abdominal-wall hot spots versus inguinal and four-quadrant averages (z-scores > or = 2.0). All three patients with negative pathology and cultures as well as scans within three days of delivery showed no increase in temperature differences of the above variables. No patient had any overt clinical sign of chorioamnionitis. This limited but consistent evidence demonstrates that telethermography is a sensitive, noninvasive diagnostic method for detecting subclinical chorioamnionitis in pregnant women with preterm rupture of the fetal membranes.