<abstract xmlns="http://www.w3.org/1999/xhtml"><sec id="j_1905-7415.0906.453_s_001_w2aab3b7b9b1b6b1aab1c16b1Aa"><h3>Background</h3><p>Histopathology shows that 49.8% of women with preterm labor between 23–32 weeks of gestation had histological chorioamnionitis (HCA), but there is poor correlation between HCA and clinical diagnosis of chorioamnionitis. Cervical swab culture is used as a standard tool for evidence of infection.</p></sec><sec id="j_1905-7415.0906.453_s_002_w2aab3b7b9b1b6b1aab1c16b2Aa"><h3>Objectives</h3><p>To determine the relationship between cervical swab culture and placental histological evidence of amniotic fluid infection in preterm labor.</p></sec><sec id="j_1905-7415.0906.453_s_003_w2aab3b7b9b1b6b1aab1c16b3Aa"><h3>Methods</h3><p>Retrospective observational review of cervical swab culture and placental pathology of women presenting to labor rooms of King Chulalongkorn Memorial Hospital.</p></sec><sec id="j_1905-7415.0906.453_s_004_w2aab3b7b9b1b6b1aab1c16b4Aa"><h3>Results</h3><p>We identified 104 patients with preterm labor and intact membranes from January 2012 to May 2013. Amniotic fluid infection detected by placental pathology was present in 10 patients, while a positive cervical culture was present in 12. There was only one patient that showed a positive result for both cervical swab culture and HCA. In patients with HCA, acute chorioamnionitis was present in 7 of 10 cases. Fetal inflammatory response was noted in only one case. There was no significant correlation between cervical swab culture and evidence of amniotic fluid infection in placental pathology <italic>(P =</italic> 0.87, odds ratio 0.84, 95% confidence interval 0.1 to 7.27).</p></sec><sec id="j_1905-7415.0906.453_s_005_w2aab3b7b9b1b6b1aab1c16b5Aa"><h3>Conclusions</h3><p>There was no significant relationship between evidence of amniotic fluid infection in placental pathology and cervical swab culture or clinical signs of chorioamnionitis in preterm labor with intact membrane. However, because of some limitations in this study, the role of cervical swab culture in preterm labor remains inconclusive and more study is needed for clarification.</p></sec></abstract>

BackgroundHistopathology shows that 49.8% of women with preterm labor between 23–32 weeks of gestation had histological chorioamnionitis (HCA), but there is poor correlation between HCA and clinical diagnosis of chorioamnionitis. Cervical swab culture is used as a standard tool for evidence of infection.ObjectivesTo determine the relationship between cervical swab culture and placental histological evidence of amniotic fluid infection in preterm labor.MethodsRetrospective observational review of cervical swab culture and placental pathology of women presenting to labor rooms of King Chulalongkorn Memorial Hospital.ResultsWe identified 104 patients with preterm labor and intact membranes from January 2012 to May 2013. Amniotic fluid infection detected by placental pathology was present in 10 patients, while a positive cervical culture was present in 12. There was only one patient that showed a positive result for both cervical swab culture and HCA. In patients with HCA, acute chorioamnionitis was present in 7 of 10 cases. Fetal inflammatory response was noted in only one case. There was no significant correlation between cervical swab culture and evidence of amniotic fluid infection in placental pathology (P = 0.87, odds ratio 0.84, 95% confidence interval 0.1 to 7.27).ConclusionsThere was no significant relationship between evidence of amniotic fluid infection in placental pathology and cervical swab culture or clinical signs of chorioamnionitis in preterm labor with intact membrane. However, because of some limitations in this study, the role of cervical swab culture in preterm labor remains inconclusive and more study is needed for clarification.

Relationship between cervical swab culture and placental histological evidence of amniotic fluid infection in preterm labor

Asian Biomedicine

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

BackgroundHistopathology shows that 49.8% of women with preterm labor between 23–32 weeks of gestation had histological chorioamnionitis (HCA), but there is...

Microorganism	Cases	%
No. growth	92	89
Growth
Escherichia coli	4	4
There was one patient infected with both Klebsiella pneumonia and Acinetobacter baumannii Klebsiella pneumonia	4	4
Group B streptococcus	2	2
Enterobacter spp.	1	1
Micrococcus spp.	1	1
There was one patient infected with both Klebsiella pneumonia and Acinetobacter baumannii Acinetobacter baumannii	1	1
Yeasts	12	12

Variable	n	%
Age (y)	26.79 ±6.75
Gravidity
1	39	38
2	38	37
>2	27	26
BMI before pregnancy (kg/m²)	20.54 ±3.42
Risk factors of preterm labor
Having previous premature birth	13	13
Smoking cigarettes	0	0
Drinking alcohol	0	0
Using illicit drugs	1	1
BMI<18.5kg/m²	31	30
Problems with the uterus or cervix	4	4
Physical injury or trauma	0	0
Teenage pregnancy	21	20
Advanced maternal age	13	13
Gestational age at presentation (wk)
<28	2	2
28-33	23	22
34-36	79	76
Duration from preterm labor to delivery
within 48 h after admission	98	94
48 h to 1 wk	3	3
>1 wk	3	3
Gestational age at delivery (wk)
<28	2	2
28-33	21	20
34-36	80	77
>37	1	1
Clinical manifestation of chorioamnionitis	18	17

Clinical chorioamnionitis	N	%
None	86	83
Body temperature >38°C
Maternal heart rate >100/min	4	4
Fetal heart rate >160/min	4	4
Uterine tenderness	2	2
Foul smell amniotic fluid	1	1
White blood cell >20,000/μL	1	1

		HCA

		Yes	No	Total
Cervical swab culture	Growth	1	11	12
	No growth	9	83	92
Total		10	94	104

Relationship between cervical swab culture and placental histological evidence of amniotic fluid infection in preterm labor

Article Category: Brief communication (Original)

Publié en ligne: 31 janv. 2017

Pages: 797 - 801

DOI: https://doi.org/10.5372/1905-7415.0906.453

Mots clés
Cervical swab culture, histological chorioamnionitis, preterm labor

© 2015 Kamonlapat Wijuckhapan, Patou Tantbirojn, Vorapong Phupong

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

Cervical swab culture results

General maternal characteristics (n= 104)

Clinical manifestation of chorioamnionitis

Relationship between cervical swab culture and HCA

Relationship between cervical swab culture and placental histological evidence of amniotic fluid infection in preterm labor

Article Category: Brief communication (Original)

Publié en ligne: 31 janv. 2017

Pages: 797 - 801

DOI: https://doi.org/10.5372/1905-7415.0906.453

Mots clésCervical swab culture, histological chorioamnionitis, preterm labor

© 2015 Kamonlapat Wijuckhapan, Patou Tantbirojn, Vorapong Phupong

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

Cervical swab culture results

General maternal characteristics (n= 104)

Clinical manifestation of chorioamnionitis

Relationship between cervical swab culture and HCA

Mots clés
Cervical swab culture, histological chorioamnionitis, preterm labor