J. Dowd et al., Is there an interaction between cervical length and cervical microbiology in the pathogenesis of preterm labour?, AUST NZ J O, 41(2), 2001, pp. 177-181
Citations number
14
Categorie Soggetti
Reproductive Medicine
Journal title
AUSTRALIAN & NEW ZEALAND JOURNAL OF OBSTETRICS & GYNAECOLOGY
Transvaginal ultrasound of the cervix is increasingly used to estimate cerv
ical length during pregnancy. Initially used to determine a possible need f
or cervical suture, the technique has been shown to be of value in the pred
iction of preterm delivery. In addition, bacterial vaginosis has been shown
to be associated with an increased risk of preterm delivery. We hypothesis
ed that shortening of the cervix and potential cervical pathogens, in parti
cular the presence of bacterial vaginosis, act synergistically in the patho
genesis of premature labour. Three hundred and sixteen women were recruited
for prospective longitudinal follow-up, with both transvaginal ultrasound
and cervical bacteriology performed at approximately 18 and 28 weeks gestat
ion. A strong correlation was found between a shortened cervix and preterm
delivery (p < 0.02 at 18 weeks; p < 0.001 at 28 weeks). Women with both a s
hort cervix and cervical pathogens had the highest risk of preterm delivery
(43%), although not significantly greater than a short cervix with normal
cervical flora (31% preterm delivery). In the presence of a normal cervical
length, preterm delivery rates in the presence of normal nora and potentia
l cervical pathogens were much lower (9% and 5% respectively).