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PLoS One. 2017 Mar 30;12(3):e0174657. doi: 10.1371/journal.pone.0174657. eCollection 2017.

Frequency and clinical significance of short cervix in patients with preterm premature rupture of membranes.

Lee SM1,2, Park KH1,3, Jung EY1,3, Jang JA1,3, Yoo HN1,3.

Author information

1
Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Korea.
2
Department of Obstetrics and Gynecology, Seoul National University Hospital, Seoul, Korea.
3
Department of Obstetrics and Gynecology, Seoul National University Bundang Hospital, Seongnam, Korea.

Abstract

OBJECTIVE:

Cervical length measurement has been uggested as a useful tool for predicting intra-amniotic infection/inflammation in preterm labor, but little information is available in the setting of preterm premature rupture of membranes (pPROM). We aimed to determine whether a short cervical length is independently associated with an increased risk of intra-amniotic infection or inflammation and impending preterm delivery in women with pPROM.

METHODS:

This was a retrospective cohort study involving 171 consecutive singleton pregnant women with pPROM (21+0-33+6 weeks' gestation), who underwent amniocentesis. Amniotic fluid (AF) was cultured, and assayed for interleukin (IL)-6 and IL-8. Cervical length was measured at the time of amniocentesis by transvaginal ultrasonography with an aseptic technique. Short cervical length was defined as a cervical length of ≤15 mm. Intra-amniotic infection was defined as a positive AF culture for microorganisms and intra-amniotic inflammation was defined as elevated AF concentrations of IL-6 or IL-8 (IL-6 ≥1.5 ng/mL and/or IL-8 ≥1.3 ng/mL).

RESULTS:

Fifty (29.2%) women had a sonographic cervical length of ≤15mm. On univariate analysis, short cervical length was associated with an increased risk for intra-amniotic infection and/or inflammation; no other parameters studied showed a significant association. Multivariable analyses indicated that short cervical length was significantly associated with a higher risk of impending preterm delivery (within 2 days of measurement, within 7 days of measurement, and before 34 weeks), and remained significant after adjustment for potential confounders.

CONCLUSION:

In women with pPROM, short cervical length is associated with an increased risk for intra-amniotic infection/inflammation and associated with impending preterm delivery, independent of the presence of intra-amniotic infection/inflammation.

PMID:
28358839
PMCID:
PMC5373606
DOI:
10.1371/journal.pone.0174657
[Indexed for MEDLINE]
Free PMC Article

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