J Korean Med Sci.  2007 Aug;22(4):713-717. 10.3346/jkms.2007.22.4.713.

Cervical Length and the Risk of Microbial Invasion of the Amniotic Cavity in Women with Preterm Premature Rupture of Membranes

• Hong JS
• Park KH
• Noh JH
• Suh YH

• KMID: 1127092
• DOI: http://doi.org/10.3346/jkms.2007.22.4.713

Abstract

The aims of this study were to determine whether sonographically measured cervical length is of value in the identification of microbial invasion of the amniotic cavity in women with preterm premature rupture of membranes (PPROM) and to compare its performance with maternal blood C-reactive protein (CRP), white blood cell count (WBC), and amniotic fluid (AF) WBC. This prospective observational study enrolled 50 singleton pregnancies with PPROM. Transvaginal ultrasound for measurement of cervical length was performed and maternal blood was collected for the determination of CRP and WBC at the time of amniocentesis. AF obtained by amniocentesis was cultured and WBC determined. The prevalence of a positive amniotic fluid culture was 26% (13/50). Patients with positive amniotic fluid cultures had a significantly shorter median cervical length and higher median CRP, WBC, and AF WBC than did those with negative cultures. Multiple logistic regression indicated that only cervical length had a significant relationship with the log odds of a positive AF culture. Transvaginal sonographic measurement of cervical length is valuable in the identification of microbial invasion of amniotic cavity in women with PPROM. Cervical length performs better than AF WBC, maternal blood CRP, and WBC in the identification of a positive amniotic fluid culture.

Keyword

Cervical Length; Microbial Invasion of the Amniotic Cavity; Preterm Premature Rupture of Membranes

MeSH Terms

Adult
Amniocentesis/methods
Amniotic Fluid/*microbiology
Bacterial Infections/*complications
C-Reactive Protein/metabolism
Cervix Uteri/*ultrasonography
Female
Fetal Membranes, Premature Rupture/etiology/*ultrasonography
Gestational Age
Humans
Leukocyte Count
Logistic Models
Maternal Age
Pregnancy
Pregnancy Complications, Infectious/blood/etiology/ultrasonography
Prospective Studies
Risk Factors
Ultrasonography/methods

Figure

• 

  Fig. 1 Receiver operating characteristic curve analysis showed that the curve constructed for cervical length was above the 45-degree angle, indicating a significant relationship with the presence of a positive amniotic fluid culture. Number next to solid dot represents cervical length (mm) (area under curve 0.696, SE 0.078, p=0.013).

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