Cervical Lactobacillus and leukocyte infiltration in preterm premature rupture of membranes.
OBJECTIVE
To evaluate the possible association between microorganisms present in the cervical secretions and amniotic fluid of pregnant women with preterm premature rupture of membranes (PPROM), and histologic chorioamnionitis.


METHODS
Thirty-seven pregnant women with PPROM and 21 healthy pregnant women were studied. Secretions from the cervical canal and amniotic fluid were collected to isolate microorganisms present in the genital tract. Cervical smears were Gram stained and evaluated microscopically. At delivery, chorioamniotic membranes were collected for histopathologic analysis.


RESULTS
Microscopic examination of the cervical secretion smears obtained from the PPROM group showed a low rate of Lactobacillus species, large numbers of leukocytes, and a wide diversity of microorganisms compared with the control group. The PPROM group presented an 80% rate of chorioamnionitis. Staphylococcus aureus isolation in cervical secretion was associated with intense inflammatory infiltrate in the membranes and might play a role in the pathogenesis of PPROM.


CONCLUSIONS
The low colonization of cervical flora by Lactobacillus species associated with an intense leukocyte infiltrate detected in Gram-stained cervical smears can be considered a rapid method of detecting chorioamnionitis in pregnant women with PPROM.
Silva
M G
MG
Department of Pathology, Botucatu Medical School, Botucatu, UNESP, São Paulo, Brazil. mar_guimaraes@bol.com.br
Peraçoli
J C
JC
Sadatsune
T
T
Abreu
E S
ES
Peraçoli
M T S
MT
D000653:Amniotic Fluid / Q000382:microbiology*; D001424:Bacterial Infections / Q000175:diagnosis*; D016022:Case-Control Studies; D002584:Cervix Uteri / Q000382:microbiology*; D002821:Chorioamnionitis / Q000175:diagnosis*; D005260:Female; D005322:Premature Rupture of Fetal Membranes / Q000382:microbiology*; D006801:Humans; D007778:Lactobacillus / Q000302:isolation & purification; D007958:Leukocyte Count; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000175:diagnosis* / Q000382:microbiology; D013194:Staining and Labeling