| A short cervix in women with preterm labor and intact membranes: a risk factor for microbial invasion of the amniotic cavity. | |
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MedLine Citation:
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PMID: 15746658 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: The purpose of this study was to determine whether there was a relationship between sonographic cervical length and the presence of culture-proven microbial invasion of the amniotic cavity in women with preterm labor and intact membranes. STUDY DESIGN: Ultrasonography and amniocentesis were performed in 401 patients admitted with preterm labor (22-35 weeks) and cervical dilatation of < or = 3 cm, as assessed by digital examination. Cervical length was determined by transvaginal ultrasound at admission. Outcome variables were the presence of microbial invasion of the amniotic cavity (defined as a positive amniotic fluid culture) and the occurrence of preterm delivery before 35 weeks. Contingency tables, chi2 test, receiver-operator characteristic (ROC) curves, and logistic regression were used for statistical analysis. RESULTS: The prevalence of microbial invasion of the amniotic cavity was 7% (28/401). Spontaneous preterm delivery (< or = 35 weeks) occurred in 21.4% (82/384) of patients. ROC curve analysis showed a significant relationship between the frequency of microbial invasion of the amniotic cavity and the length of the uterine cervix (area under the curve: 0.77; P < .005). Patients with a cervical length < 15 mm had a higher rate of a positive amniotic fluid culture than patients with a cervical length > or = 15 mm (26.3% [15/57] vs. 3.8% [13/344], respectively; P < .05). Moreover, patients with a short cervix (defined as < 15 mm) were more likely to deliver spontaneously before 35 weeks, 32 weeks, within 7 days, and within 48 hours of admission ( P < .05 for all comparisons). Forty percent of patients (161/401) had a cervical length > or = 30 mm. These patients had a very low risk of microbial invasion of the amniotic cavity (1.9% [3/161]), spontaneous delivery < or = 35 weeks (4.5% [7/154]), < or = 32 weeks (2.6% [2/76]), within 7 days (1.9% [3/154]), and within 48 hours (0% [0/154]) of admission. CONCLUSION: Endovaginal ultrasonographic examination of the uterine cervix in women with preterm labor identifies patients at increased risk for intrauterine infection. |
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Authors:
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Ricardo Gomez; Roberto Romero; Jyh Kae Nien; Tinnakorn Chaiworapongsa; Luis Medina; Yeon Mee Kim; Bo Hyun Yoon; Mario Carstens; Jimmy Espinoza; Jay D Iams; Rogelio Gonzalez |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: American journal of obstetrics and gynecology Volume: 192 ISSN: 0002-9378 ISO Abbreviation: Am. J. Obstet. Gynecol. Publication Date: 2005 Mar |
Date Detail:
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Created Date: 2005-03-04 Completed Date: 2005-04-01 Revised Date: 2006-05-16 |
Medline Journal Info:
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Nlm Unique ID: 0370476 Medline TA: Am J Obstet Gynecol Country: United States |
Other Details:
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Languages: eng Pagination: 678-89 Citation Subset: AIM; IM |
Affiliation:
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Center for Perinatal Diagnosis and Research (CEDIP), Sótero del Río Hospital, P Universidad Católica de Chile, Puente Alto, Chile. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Amniocentesis Amniotic Fluid / microbiology Bacterial Infections / etiology* Cervix Uteri / anatomy & histology, ultrasonography* Female Humans Obstetric Labor, Premature / etiology* Pregnancy Pregnancy Complications, Infectious / etiology* Risk Factors Uterine Diseases / etiology* |
| Comments/Corrections | |
Comment In:
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Am J Obstet Gynecol. 2006 Mar;194(3):901-2; author reply 902-3
[PMID:
16522435
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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