Document Detail


Cervical length in women in preterm labor with intact membranes: relationship to intra-amniotic inflammation/microbial invasion, cervical inflammation and preterm delivery.
MedLine Citation:
PMID:  17042035     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: Intra-amniotic infection, diagnosed by microbial invasion of the amniotic cavity (MIAC) and/or the presence of intra-amniotic inflammation (IAI), is related to adverse perinatal outcome in women with preterm labor. Due to the subclinical nature of IAI, a correct diagnosis depends on amniocentesis, which is an invasive method not performed as a clinical routine. The aim of this study was to evaluate if cervical length measured by transvaginal sonography could assist in the identification of women at high risk for IAI. METHODS: Cervical length was assessed by transvaginal sonography in 87 women with singleton pregnancies in preterm labor (<34 weeks of gestation). Cervical (n=87) and amniotic (n=55) fluids were collected. Polymerase chain reactions for Ureaplasma urealyticum and Mycoplasma hominis, and culture for aerobic and anaerobic bacteria, were performed. Interleukin (IL)-6 and IL-8 were analyzed by enzyme-linked immunosorbent assay. RESULTS: IAI was present in 25/55 (45%) of the patients presenting with preterm labor who underwent amniocentesis. Women with IAI had a significantly shorter cervical length (median, 10 (range, 0-34) mm) than had those without IAI (median, 21 (range, 11-43) mm) (P<0.0001). Receiver-operating characteristics curve analysis showed that a cervical length (cut-off of 15 mm) predicted IAI (relative risk, 3.6; CI, 1.9-10.0) with a sensitivity of 72%, specificity of 83%, positive predictive value of 78% and negative predictive value of 78%. Cervical length was also significantly associated with preterm birth up to 7 days from sampling and at <or=34 weeks. CONCLUSION: Cervical length assessed by transvaginal sonography predicts IAI as well as preterm birth and could thereby be a useful clinical tool in the management of patients in preterm labor.
Authors:
R-M Holst; B Jacobsson; H Hagberg; U-B Wennerholm
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology     Volume:  28     ISSN:  0960-7692     ISO Abbreviation:  Ultrasound Obstet Gynecol     Publication Date:  2006 Nov 
Date Detail:
Created Date:  2006-10-30     Completed Date:  2007-09-27     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9108340     Medline TA:  Ultrasound Obstet Gynecol     Country:  England    
Other Details:
Languages:  eng     Pagination:  768-74     Citation Subset:  IM    
Copyright Information:
Copyright (c) 2006 ISUOG.
Affiliation:
Perinatal Center, Department of Obstetrics and Gynecology, Institute for the Health of Women and Children, Sahlgrenska Academy, Sahlgrenska University Hospital/East, Göteborg, Sweden. rose-marie.holst@vgregion.se
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MeSH Terms
Descriptor/Qualifier:
Adult
Amniocentesis / methods
Cervix Uteri / pathology,  ultrasonography*
Chorioamnionitis / microbiology,  pathology,  ultrasonography*
Cohort Studies
Female
Humans
Interleukin-6 / metabolism
Interleukin-8 / metabolism
Obstetric Labor, Premature / microbiology,  pathology,  ultrasonography*
Pregnancy
Pregnancy Complications, Infectious / microbiology,  pathology,  ultrasonography*
Pregnancy Outcome
Prospective Studies
Uterine Cervicitis / microbiology,  pathology,  ultrasonography*
Chemical
Reg. No./Substance:
0/Interleukin-6; 0/Interleukin-8

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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