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Patients with an asymptomatic short cervix (<or=15 mm) have a high rate of subclinical intraamniotic inflammation: implications for patient counseling.

AbstractOBJECTIVE:
The objective of the study was to determine the frequency and clinical significance of intraamniotic inflammation in asymptomatic women with a sonographic short cervix (SCX) in the midtrimester.
STUDY DESIGN:
This cohort study included 47 asymptomatic women (14-24 weeks) with an SCX (<or=15 mm) who underwent amniocentesis. Women with multiple gestation, cerclage, or cervical dilatation greater than 2 cm were excluded. Intraamniotic inflammation was defined as an elevated amniotic fluid (AF) matrix metalloproteinase-8 concentration (>23 ng/mL).
RESULTS:
(1) intraamniotic infection was found in 4.3% of patients; (2) among patients with a negative AF culture, the prevalence of intraamniotic inflammation was 22.2%; and (3) patients with a negative AF culture, but with intraamniotic inflammation, had a higher rate of delivery within 7 days (40% vs 5.7%; P=.016) and a shorter median diagnosis-to-delivery interval than those without intraamniotic inflammation (18 vs 42 days; P=.01).
CONCLUSION:
Twenty-two percent of patients with a midtrimester SCX have intraamniotic inflammation. The risk of preterm delivery within 7 days for these patients is 40%.
AuthorsEdi Vaisbuch, Sonia S Hassan, Shali Mazaki-Tovi, Chia-Ling Nhan-Chang, Juan Pedro Kusanovic, Tinnakorn Chaiworapongsa, Zhong Dong, Lami Yeo, Pooja Mittal, Bo Hyun Yoon, Roberto Romero
JournalAmerican journal of obstetrics and gynecology (Am J Obstet Gynecol) Vol. 202 Issue 5 Pg. 433.e1-8 (May 2010) ISSN: 1097-6868 [Electronic] United States
PMID20452483 (Publication Type: Journal Article, Research Support, N.I.H., Intramural)
Chemical References
  • Matrix Metalloproteinase 8
Topics
  • Adult
  • Cervix Uteri (anatomy & histology, diagnostic imaging)
  • Chorioamnionitis (epidemiology)
  • Counseling
  • Female
  • Humans
  • Logistic Models
  • Matrix Metalloproteinase 8 (blood)
  • Obstetric Labor, Premature (epidemiology)
  • Pregnancy
  • Pregnancy Trimester, Second
  • Retrospective Studies
  • Ultrasonography
  • Young Adult

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