| Cervical length in women in preterm labor with intact membranes: relationship to intra-amniotic inflammation/microbial invasion, cervical inflammation and preterm delivery. | |
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MedLine Citation:
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PMID: 17042035 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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R-M Holst; B Jacobsson; H Hagberg; U-B Wennerholm |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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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:
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Created Date: 2006-10-30 Completed Date: 2007-09-27 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9108340 Medline TA: Ultrasound Obstet Gynecol Country: England |
Other Details:
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Languages: eng Pagination: 768-74 Citation Subset: IM |
Copyright Information:
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Copyright (c) 2006 ISUOG. |
Affiliation:
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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:
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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:
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0/Interleukin-6; 0/Interleukin-8 |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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