title: Patients with an asymptomatic short cervix (<or=15 mm) have a high rate of subclinical intraamniotic inflammation: implications for patient counseling.
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.
  
  
  METHODS
  This cohort study included 47 asymptomatic women (14-24 weeks) with an SCX (<or=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).
  
  
  CONCLUSIONS
  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%.
authors.affiliation: Perinatology Research Branch, National Institute of Child Health and Human Development, National Institutes of Health, Department of Health and Human Services, Bethesda, MD, USA.
authors.forename: Edi
authors.initials: E
authors.lastname: Vaisbuch
authors.forename: Sonia S
authors.initials: SS
authors.lastname: Hassan
authors.forename: Shali
authors.initials: S
authors.lastname: Mazaki-Tovi
authors.forename: Chia-Ling
authors.initials: CL
authors.lastname: Nhan-Chang
authors.forename: Juan Pedro
authors.initials: JP
authors.lastname: Kusanovic
authors.forename: Tinnakorn
authors.initials: T
authors.lastname: Chaiworapongsa
authors.forename: Zhong
authors.initials: Z
authors.lastname: Dong
authors.forename: Lami
authors.initials: L
authors.lastname: Yeo
authors.forename: Pooja
authors.initials: P
authors.lastname: Mittal
authors.forename: Bo Hyun
authors.initials: BH
authors.lastname: Yoon
authors.forename: Roberto
authors.initials: R
authors.lastname: Romero
mesh_terms: D000328:Adult; D002584:Cervix Uteri / Q000033:anatomy & histology* / Q000000981:diagnostic imaging; D002821:Chorioamnionitis / Q000453:epidemiology; D003376:Counseling; D005260:Female; D006801:Humans; D016015:Logistic Models; D020784:Matrix Metalloproteinase 8 / Q000097:blood; D007752:Obstetric Labor, Premature / Q000453:epidemiology*; D011247:Pregnancy; D011262:Pregnancy Trimester, Second; D012189:Retrospective Studies; D014463:Ultrasonography; D055815:Young Adult
chemical_list: D020784:Matrix Metalloproteinase 8
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