TY - JOUR
T1 - Patients with an asymptomatic short cervix (≤15 mm) have a high rate of subclinical intraamniotic inflammation
T2 - implications for patient counseling
AU - Vaisbuch, Edi
AU - Hassan, Sonia S.
AU - Mazaki-Tovi, Shali
AU - Nhan-Chang, Chia Ling
AU - Kusanovic, Juan Pedro
AU - Chaiworapongsa, Tinnakorn
AU - Dong, Zhong
AU - Yeo, Lami
AU - Mittal, Pooja
AU - Yoon, Bo Hyun
AU - Romero, Roberto
PY - 2010/5
Y1 - 2010/5
N2 - Objective: 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 (≤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%.
AB - Objective: 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 (≤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%.
KW - cervical length
KW - intraamniotic inflammation
KW - matrix metalloproteinase-8
KW - MMP-8
KW - pregnancy
KW - prematurity
KW - preterm delivery
UR - http://www.scopus.com/inward/record.url?scp=77951950482&partnerID=8YFLogxK
U2 - 10.1016/j.ajog.2010.02.007
DO - 10.1016/j.ajog.2010.02.007
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C2 - 20452483
AN - SCOPUS:77951950482
SN - 0002-9378
VL - 202
SP - 433.e1-433.e8
JO - American Journal of Obstetrics and Gynecology
JF - American Journal of Obstetrics and Gynecology
IS - 5
ER -