A sonographic short cervix as the only clinical manifestation of intra-amniotic infection

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dc.contributor.authorHassan, S
dc.contributor.authorRomero, R
dc.contributor.authorHendler, I
dc.contributor.authorGomez, R
dc.contributor.authorKhalek, N
dc.contributor.authorEspinoza, J
dc.contributor.authorNien, JK
dc.contributor.authorBerry, SM
dc.contributor.authorBujold, E
dc.contributor.authorCamacho, N
dc.contributor.authorSorokin, Y
dc.date.accessioned2025-01-21T01:06:24Z
dc.date.available2025-01-21T01:06:24Z
dc.date.issued2006
dc.description.abstractObjective: A sonographically short cervix is a powerful predictor of spontaneous preterm delivery. However, the etiology and optimal management of a patient with a short cervix in the mid-trimester of pregnancy remain uncertain. Microbial invasion of the amniotic cavity (MIAC) and intra-amniotic inflammation are frequently present in patients with spontaneous preterm labor or acute cervical insufficiency. This study was conducted to determine the rate of MIAC and intra-amniotic inflammation in patients with a cervical length < 25 mm in the mid-trimester.
dc.description.abstractStudy design: A retrospective cohort study was conducted of patients referred to our high risk clinic because of a sonographic short cervix or a history of a previous preterm birth. Amniocenteses were performed for the evaluation of MIAC and for karyotype analysis in patients with a short cervix. Fluid was cultured for aerobic and anaerobic bacteria, as well as genital mycoplasmas. Patients with MIAC were treated with antibiotics selected by their physician.
dc.description.abstractResults: Of 152 patients with a short cervix at 14-24 weeks, 57 had amniotic fluid analysis. The prevalence of MIAC was 9% (5/57). Among these patients, the rate of preterm delivery (< 32 weeks) was 40% (2/5). Microorganisms isolated from amniotic fluid included Ureaplasma urealyticum (n = 4) and Fusobacterium nucleatum ( n = 1). Patients with a positive culture for Ureaplasma urealyticum received intravenous Azithromycin. Three patients with Ureaplasma urealyticum had a sterile amniotic fluid culture after treatment, and subsequently delivered at term. The patient with Fusobacterium nucleatum developed clinical chorioamnionitis and was induced.
dc.description.abstractConclusion: (1) Sub-clinical MIAC was detected in 9% of patients with a sonographically short cervix (< 25 mm); and ( 2) maternal parenteral treatment with antibiotics can eradicate MIAC caused by Ureaplasma urealyticum. This was associated with delivery at term in the three patients whose successful treatment was documented by microbiologic studies.
dc.fuente.origenWOS
dc.identifier.doi10.1515/JPM.2006.002
dc.identifier.issn0300-5577
dc.identifier.urihttps://doi.org/10.1515/JPM.2006.002
dc.identifier.urihttps://repositorio.uc.cl/handle/11534/96151
dc.identifier.wosidWOS:000235082100002
dc.issue.numero1
dc.language.isoen
dc.pagina.final19
dc.pagina.inicio13
dc.revistaJournal of perinatal medicine
dc.rightsacceso restringido
dc.subjectcervical insufficiency
dc.subjectcervical length
dc.subjectchorioamnionitis
dc.subjectintra-amniotic infection
dc.subjectmicrobial invasion of the amniotic cavity
dc.subjectpreterm delivery
dc.subjectshort cervix
dc.subjectultrasound
dc.subject.ods03 Good Health and Well-being
dc.subject.ods05 Gender Equality
dc.subject.odspa03 Salud y bienestar
dc.subject.odspa05 Igualdad de género
dc.titleA sonographic short cervix as the only clinical manifestation of intra-amniotic infection
dc.typeartículo
dc.volumen34
sipa.indexWOS
sipa.trazabilidadWOS;2025-01-12
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