SUBCHORIONIC INTERVILLOSITIS - RELATIONSHIP TO PREMATURE RUPTURE OF MEMBRANES AND CERVICITIS

Study Objective: The inflammatory response engendered by cervicovagina l infections is believed to be an important, preventable, antecedent o f premature rupture of the membranes. The objective of this study was to test the hypothesis that early histologic evidence of placental inf lammation, subchorionic intervillositis, is a more common finding in p lacentas obtained from women who have cervicitis during gestation than in placentas obtained from other women. Design, Main Outcome Measure, and Participants/ Setting: Standard gross and histologic techniques w ere used to examine the placentas of 105 poor, black women in relation to three clinical signs of cervicitis: hypertrophic ectopia, friabili ty, and inflammatory discharge. Results: We found subchorionic intervi llositis in 28 (26.7%) of the placentas. Subchorionic intervillositis was significantly associated with both premature rupture of the membra nes and neonatal morbidity. Cervicitis was diagnosed in 63.5% of the s ubjects who were examined. Contrary to the study hypothesis, subchorio nic intervillositis was a less common finding in the placentas of stud y subjects who had cervicitis (6.1% vs. 47.4%; chi(2) = 12.3 p < 0.001 ). Conclusions: We speculate that prompt antibiotic treatment of clini cally evident cervicitis eradicated potentially pathogenic microflora and prevented the ascent of the local inflammatory response up the bir th canal.