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

Edi 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*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

83 Scopus citations

Abstract

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%.

Original languageEnglish
Pages (from-to)433.e1-433.e8
JournalAmerican Journal of Obstetrics and Gynecology
Volume202
Issue number5
DOIs
StatePublished - May 2010
Externally publishedYes

Keywords

  • cervical length
  • intraamniotic inflammation
  • matrix metalloproteinase-8
  • MMP-8
  • pregnancy
  • prematurity
  • preterm delivery

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