The Relationship between Intra-Amniotic Sludge and the Amniotic Fluid Proteome in a Cohort of Pregnant Women with Acute Cervical Insufficiency: A Pilot Study
Bibliographic record
Abstract
Background: We aim to determine the relationship between intra-amniotic sludge and the amniotic fluid proteome in cases of acute cervical insufficiency. Methods: This was a secondary analysis of data from an existing prospective cohort of women with acute cervical insufficiency. Amniotic fluid had previously been analyzed by Gram stain, culture and proteomics perioperatively. Post-processing review of stored ultrasound images to evaluate for the presence of intra-amniotic sludge (IAS) was performed by two blinded and independent observers. Results, lab, clinical, proteomic and outcome data were compared between groups with and without sludge. Results: Ten participants with acute cervical insufficiency from the initial cohort were included [IAS group (n = 4) and non-IAS group (n = 6)]. 75% of participants with sludge had negative Gram stain and culture compared to 17% amongst cases without sludge. 18 proteins (3.3%) were differentially abundant between the 2 groups (p < 0.07): the non-IAS group demonstrated increased immune, stress and inflammatory signatures with decreased signatures of keratinization relative to the IAS group (p < 0.05). Conclusions: These preliminary findings suggest that proteomic profiles of amniotic fluid with and without sludge tend to differ. Sludge is associated with an abundance of keratinizing proteins while inflammatory proteins predominate in the absence of sludge. The exploratory nature of this study illustrates the need for future large-scale prospective studies to determine the utility of intra-amniotic sludge and proteomics as markers of intra-amniotic infection in the management of acute cervical insufficiency.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".