Perinatology Research Branch, National Institute of Child Health and Human Development, National Institutes of Health, Department of Health and Human Services, Bethesda, MD, USA.
Am J Obstet Gynecol. 2010 May;202(5):433.e1-8. doi: 10.1016/j.ajog.2010.02.007.
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.
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).
(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).
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%.
本研究旨在确定在中期妊娠时超声检查显示宫颈管短（SCX）但无症状的女性中，羊膜腔内炎症的发生频率及其临床意义。
本队列研究纳入了 47 名（14-24 周）无症状且 SCX（<或=15mm）的女性患者，对其进行了羊膜腔穿刺术。排除多胎妊娠、宫颈环扎术或宫颈扩张大于 2cm 的患者。羊膜腔内炎症定义为羊水基质金属蛋白酶-8 浓度升高（>23ng/mL）。
（1）4.3%的患者存在羊膜腔内感染；（2）在 AF 培养阴性的患者中，羊膜腔内炎症的发生率为 22.2%；（3）AF 培养阴性但存在羊膜腔内炎症的患者在 7 天内分娩的发生率（40% vs. 5.7%；P=.016）以及从诊断到分娩的中位时间（18 天 vs. 42 天；P=.01）均高于无羊膜腔内炎症的患者。
22%的中期妊娠 SCX 患者存在羊膜腔内炎症。这些患者在 7 天内早产的风险为 40%。
