title: Cervical length and the risk of microbial invasion of the amniotic cavity in women with preterm premature rupture of membranes.
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.
authors.affiliation: Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: Joon Seok
authors.initials: JS
authors.lastname: Hong
authors.forename: Kyo Hoon
authors.initials: KH
authors.lastname: Park
authors.forename: Jae Hong
authors.initials: JH
authors.lastname: Noh
authors.forename: Young Hoon
authors.initials: YH
authors.lastname: Suh
mesh_terms: D000328:Adult; D000649:Amniocentesis / Q000379:methods; D000653:Amniotic Fluid / Q000382:microbiology*; D001424:Bacterial Infections / Q000150:complications*; D002097:C-Reactive Protein / Q000378:metabolism; D002584:Cervix Uteri / Q000000981:diagnostic imaging*; D005260:Female; D005322:Premature Rupture of Fetal Membranes / Q000000981:diagnostic imaging* / Q000209:etiology; D005865:Gestational Age; D006801:Humans; D007958:Leukocyte Count; D016015:Logistic Models; D008423:Maternal Age; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000097:blood / Q000000981:diagnostic imaging / Q000209:etiology; D011446:Prospective Studies; D012307:Risk Factors; D014463:Ultrasonography / Q000379:methods
chemical_list: D002097:C-Reactive Protein