Cervix Of Pregnant Women Research Articles

Characteristics of cervicovaginal microflora at different cervical maturity during late pregnancy: A nested case-control study.

The mechanism of cervical ripening in late pregnancy is still unclear. The vaginal microbiome has been reported to correlate with the preterm birth and short cervix in pregnant women. However, the associations between the cervical maturity and the vaginal microbiome are still poorly understood. We aim to analyze the cervicovaginal microflora in women with ripe cervix and in those who are unripe when delivering at term. Cervicovaginal swabs were collected between 40 and 41 weeks of gestation from the following 2 different groups of patients: ripe group (n = 25) and unripe group (n = 25). Samples were tested using 16S ribosomal RNA gene high-throughput sequencing and analyzed by bioinformatics platform. This study highlights the relationship between cervical maturity during late pregnancy and the composition of the cervicovaginal microflora. Both α- and β-diversity analyses demonstrated significant differences between women with a ripe cervix and those with an unripe cervix. Notably, the Lactobacillus profile was found to be closely linked to cervical maturity. There was a significant difference in the vaginal community state type, with CST IV being more prevalent in women with an unripe cervix. Furthermore, the association between CST IV and the unripe cervix group, as indicated by the odds ratio of 8.6, underscores its relevance in evaluating cervical maturity, when compared to other Lactobacillus-dominant community state types. Additionally, several bacterial taxa, particularly Lactobacillus, exhibited differential relative abundances between the two groups. This study provided significant evidence regarding the relationship between the vaginal microbiome and cervical maturity, highlighting the differential diversity, community state types, and specific bacterial taxa, such as Lactobacillus, that are associated with cervical maturation status. These findings contributed to our understanding of the dynamics of the cervicovaginal microflora during late pregnancy and its implications for cervical health.

Combined method of preparing the cervix uteri for labor in pregnant women with a lack of birth preparedness and a tendency to post-term pregnancy

Objective. Development of an effective method for preparing the cervix in pregnant women with a tendency to overmaturity against the background of a lack of biological readiness for childbirth, as well as reducing the time for preparing the soft birth canal for childbirth in order to conduct subsequent labor excitation.
 Material and methods. The patients were divided into 3 groups depending on the method of preparing the cervix for childbirth: in the 1st group (n = 50) only laminaria was used; in group 2 (n = 50), a Foley catheter was used in combination with mifepristone; in group 3 (n = 50), only mifepristone was used. Inclusion criteria: gestational period 41 weeks 41 weeks and 4 days inclusive, immature cervix (baseline score on the Bishop scale 0-2 points), singleton pregnancy, cephalic presentation, whole fetal bladder, vaginal cleanliness I-II, satisfactory fetal condition (normal type of curve according to CTG and the absence of fetal hemodynamic disorders according to Doppler data). Statistical processing of the obtained data was carried out using the STATISTICA 10.0 program.
 Research results. The patients of the three groups were comparable in age, gestational age, and did not differ in the parity of childbirth and body mass index. With the combined preparation of the cervix for childbirth with mifepristone and a Foley catheter, the dynamics of the assessment of the cervix on the Bishop scale is higher and achieved faster than when preparing for childbirth only with laminaria or only antigestagens. When combining mifepristone with a catheter Foley, it is possible to reduce the time interval from the onset of pre-induction to the development of labor in comparison with pre-induction of labor only with mifepristone or only with the help of laminaria, as well as reduce the frequency of caesarean section due to the lack of effect from induction of labor compared with pre-induction of labor only with mifepristone or only with the help of laminaria. The undoubted advantage of this combined method of preparing the cervix for childbirth is its effectiveness, low risk of uterine hyperstimulation, fetal distress syndrome, as well as the absence of a high risk of developing infectious complications.
 Conclusion. The combined method of preparing the body for childbirth with a tendency to post-term pregnancy is effective, safe and allows you to reduce the preparation time of the soft birth canal for childbirth against the background of a lack of biological readiness for childbirth with a tendency to post-term pregnancy.

Modern sonographic markers for the prognosis of preterm birth in women with different somatotypes

BACKGROUND:Preterm birth is one of the causes of perinatal morbidity and mortality. Premature infants have an increased risk of death and the development of neurological and other disorders.
 AIM:The aim of this study was to evaluate the modern sonographic parameters of the cervix in pregnant women with different somatotypes and to develop a mathematical model for predicting preterm birth.
 MATERIALS AND METHODS:The study included 390 women, among whom 110 were classified with macrosomatic, 173 with mesosomatic, and 107 with microsomatic types. Somatotype was determined in women in early stages of pregnancy (before 9-10 weeks of gestation) using the R.N. Dorokhov anthropometric test method. The utero-cervical angle was measured, shear wave elastography was performed, and the average shear wave speed in the area of the internal cervical os was determined. All measurements were performed on a Philips EPIQ 5 ultrasound machine.
 RESULTS:Preterm birth was more often identified in women with macro- and microsomatic types in comparison with women with mesosomatic type (p 0.05). In pregnant women with subsequent preterm birth at 22-23 weeks, the average SWS in the area of the internal cervical os was reduced (p 0.05) and the utero-cervical angle was higher in comparison with those women who did not have preterm birth (p 0.05). Using multiple regression analysis, we obtained the regression equation (formula), which predicts the development of preterm birth in women with different somatotypes.
 CONCLUSIONS:Such parameters as the average shear wave speed in the area of the internal cervical os and the utero-cervical angle may be regarded as markers of preterm birth. The mathematical formula obtained allows for predicting the development of preterm birth in women with different somatotypes and for timely prevention of pathology.

Кольпоскопічно-цитологічні паралелі у вагітних з безплідністю різного ґенезу в анамнезі

The state of the cervix was studied in pregnant women with a history of infertility of various genesis by colposcopic and cytological research methods. The data obtained indicate an increased level of precancerous pathology of the cervix in pregnant women with a history of tubo-peritoneal and concomitant infertility, compared with pregnant women who had endocrine infertility. Purpose — to determine the relationship between the nature and severity of colpocoscopic and cytological changes in the cervix in pregnant women who had a history of infertility. Materials and methods. 101 women were examined: 14 pregnant women with a history of endocrine infertility, group 1; 27 pregnant women with a history of tuboperitoneal infertility — group 2; 40 pregnant women, had combined infertility — group 3, 20 healthy pregnant women with no history of infertility — group 4. Methods for assessing the state of the cervix in pregnant women — video colposcopic and cytological (on glass). Results. Normal cytological changes (NILM) were found: in group 1–8 (57.2%), in group 2 — in 15 (55.6%), in group 3 — in 23 (57.5%), in group 4, 14 (70.0%) pregnant women. Benign cytological and ASCUS signs were: in group 1 — in 5 (35.7%), in group 2 — in 6 (22.2%), in group 3 — in 10 (25.0%), in group 4 — in 5 (25%) patients. Precancer (LSIL+HSIL): in group 1 — in 1 (7.1%), in group 2 — in 6 (22.2%), in group III — in 9 (22.5%) women, and in group 4, no precancers were found cytologically. Normal colposcopic signs (stratified squamous epithelium) were found: in group 3 — in 11 (27.5%), in group 2 — in 8 (29.6%), and in group 1 — in 7 (50.0%) pregnant women. And benign colposcopic changes (ectopia, open glands, Nabotovi cysts, deciduosis): in group 3 — in 19 (47.5%), in group 2 — in 16 (59.3%), in group 1 — in 6 (42.9%), in group 4 — in 5 (35.7%) patients. Our data indicate that precancers during colposcopy occurred: in group 3 — in 9 (22.5%), in group 2 — in 3 (11.1%), in group 1 — in 1 (7.1%), in group 4 — in 1 (5.0%) women. No colposcopic signs of invasive growth were found in any of the groups. Conclusions. The study revealed an increased level of precancerous pathology of the cervix in pregnant women with a history of tubo-peritoneal and concomitant infertility. A fairly high percentage of precancerous conditions of the cervix in group 2 — in 6 (22.2%) and in group 3 — in 9 (22.5%) women indicates that in the presence of Human papillomavirus (HPV) and other genital infections and with increasing age, the probability self-elimination of the papilloma virus is reduced. After long-term infertility treatment, all pregnant women must undergo a colposcopic examination at the first visit to the antenatal clinic, in addition to taking a cytological smear. If LSIL and HSIL are found in this category of women, colposcopic and cytological control once every 3 months during pregnancy with mandatory HPV PCR HCR. The research was carried out in accordance with the principles of the Helsinki declaration. The study protocol was approved by the Local ethics committee of all participating institution. The informed consent of the patient was obtained for conducting the studies. No conflict of interest was declared by the author. Key words: pathology of the cervix, pregnancy after infertility, video colposcopy, cytology.

Appropriate fixative for MEM-G/9 staining of cultured human HLA-G-positive JEG-3 trophoblast tumor cells

ABSTRACT Human leukocyte antigen (HLA-G) participates in immunosuppression and is useful for prenatal diagnostics. Isolation of fetal cells positive for HLA-G by HLA-G antibody conjugated nanoparticles from the cervix of pregnant women is the basis for non-invasive prenatal testing. Endocervical specimens are fixed in transport medium before isolation using antibody conjugated nanoparticles. Staining of HLA-G using MEM-G/9 antibody, however, is restricted to unfixed cells. We investigated the effect of several fixatives on the interaction of HLA-G with MEM-G/9 in the HLA-G-positive cell line, JEG-3. We investigated absolute methanol, 1:1 acetate buffer:methanol, Pap solution and paraformaldehyde. The effects of these fixatives were evaluated using immunofluorescence. We found no MEM-G/9 surface staining of methanol fixed cells. Approximately 40% of JEG-3 cells fixed with paraformaldehyde failed to stain. Nearly all cells were stained with MEM-G/9 following fixation with acetate buffer:methanol or Pap solution. Our findings indicate the importance of using an appropriate fixative for preserving HLA-G cell surface antigen for studies using the MEM-G/9 antibody.

Colposcopic assessment of the normal cervix in pregnant women

Background. Colposcopy in a pregnant woman is carried out to rule out the presence of invasive cervical cancer and to determine the need for targeted biopsy. Indications for colposcopy include pathological cytological smear, abnormal appearance of cervix, or bleeding of unknown origin.
 Objective. To describe the features of colposcopic examination in pregnant women.
 Materials and methods. Analysis of own experience and literature sources on this topic.
 Results and discussion. Literature data indicate the reliability and safety of colposcopic examination of pregnant women. It should be noted that the examination of pregnant women requires a higher qualification from the colposcopist than the examination of non-pregnant women, although the assessment is based on the same principles. Simple colposcopy allows to assess the vascular pattern and color of the epithelium. For a more thorough assessment acetic acid and aqueous Lugol solution probes are carried out. The tasks of colposcopy are to identify the causes of deviations from the norm of cytological examination, to determine the location and boundaries of the pathological area, to choose the location of the targeted biopsy, to carry out medical manipulations within healthy tissues, and to monitor treatment results. To improve the planning of the necessary treatment options for excisions, a Nomenclature of colposcopic terms for cervix was created. Features of the cervix in pregnant women include the increased cervix vascularization, edema and hypertrophy of the papillae of the cervical canal, increased secretory activity of the cervical canal, eversion of the cervical mucosa, dehiscence of the cervical canal, increased metaplasia, deciduosis, prolapse of the vaginal walls. These physiological changes may cause overdiagnosis of pathological conditions. Thus, hypervascularization can mimic atypical vessels, and deciduosis – malignant tumors. Conversely, hypervascularization and bleeding, increased mucus production and prolapse of the vaginal walls can mask the manifestations of the disease, being the causes of underdiagnosis. The progression of eversion during pregnancy allows to visualize the lesion, which was previously localized in the cervical canal, better and better. Deciduosis in pregnant women is divided into decidual ectopia and decidual polyps of the cervical canal. The tumor-like form of deciduosis visually and colposcopically mimics exophytic tumors. The ulcer form is characterized by dense whitening when applying acetic acid, but is not stained with Lugol solution. Manifestations of the papillary form become the most pronounced after the acetic acid test. The vesicular form is the most common and most easily diagnosed by colposcopists. Decidual polyps become densely whitened during the acetic acid test, but unlike cervical cancer, blood vessels do not disappear. These polyps are not stained with iodine. Decidual polyps are usually localized in the areas of the original epithelium; they are multifocal and small in size. Instead, malignant tumors are localized within the atypical zone of transformation; they are single and have a bumpy uneven surface. Polymorphism and variety of lesions, young age, pregnancy, normal results of cytological examination are more typical for deciduosis. If the colposcopist is unsure of the benign nature of the process, a targeted biopsy should always be performed.
 Conclusions. 1. The purpose of colposcopy in a pregnant woman is to rule out the presence of invasive cervical cancer and to determine the need for targeted biopsy. 2. Indications for colposcopy include pathological cytological smear, abnormal cervix appearance, or bleeding of unknown origin. 3. Physiological changes during pregnancy can be the cause of hyper- and hypodiagnosis of pathological conditions. 4. If the colposcopist is unsure of the benign nature of the process, a targeted biopsy should always be performed.

Assessment of the cervix in pregnant women with a history of cervical insufficiency during the first trimester using elastography.

To investigate changes in first trimester cervical elastography, cervical length and endocervical canal width in pregnant women with a history of cervical insufficiency, and further discuss the possibility of using these markers as predictors of cervical insufficiency in early pregnancy. This was an observational ultrasound study of first trimester cervical changes in singleton pregnancies between January 2016 and June 2018. Cervical elastography, cervical length and endocervical canal width were measured during the first trimester. Strain elastography was used to estimate the softness of anterior and posterior cervical lips and was expressed as percentages (strain rate). Of the 339 pregnant women enrolled, 24 had a history of cervical insufficiency. The anterior cervical lip was significantly softer in the cervical insufficiency group (strain rate: 0.19% ± 0.05% vs 0.11% ± 0.04%; P < .001). Cervical length was significantly shorter in the cervical insufficiency group (36.3 ± 4.8 mm vs 38.3 ± 3.8 mm; P = .014). Endocervical canal width was significantly wider in the cervical insufficiency group (5.7 ± 1.1 mm vs 5.2 ± 0.7 mm; P = .001). Receiver operating characteristic curve analyses revealed that the optimal cut-off values of anterior cervical lip, cervical length and endocervical canal width to confirm the diagnosis of cervical insufficiency were 0.15%, 35.5 mm and 5.75 mm, respectively. In multivariate logistic regression analysis, significant differences were still observed in anterior cervical strain rate (adjusted odds ratio [OR] 53.78, 95% [confidence interval [CI] 11-270; P < .001) and endocervical canal width (adjusted OR, 5.41, 95% CI,1.2-24.7; P = .029). First trimester cervical elastography is a valuable tool in the assessment of women with a history of cervical insufficiency. The anterior cervical lip was significantly softer in women with a history of cervical insufficiency, and the sensitivity and specificity of anterior cervical lip strain were better than that of cervical length and endocervical canal width.

Prediction of Preterm Delivery by Ultrasound Measurement of Cervical Length and Funneling Changes of the Cervix in Pregnant Women with Preterm Labor at 28-34 weeks of Gestation.

The present study aims at predicting preterm delivery by ultrasound measurement of cervical length and the funneling changes of the cervix in preterm labor pregnant women at 28-34 weeks of gestation. The present study is an observational-analytical study with a prospective cohort design. The statistical population of this study includes 70 preterm labor pregnant women who were referred to Tehran hospitals from March 2018 to March 2020. The case group includes 35 women who had short cervical length as well as the funneling changes of the cervix. The control group includes 35 patients whose cervical length was normal and lacked the funneling changes of the cervix. The samples were analyzed after being collected. The mean age of mothers was 29.22 years in the short cervical length group (SD=4.64) and 28.45 years in the normal cervical length group (SD=4.59). The mean length of cervical length was 17.34 mm in the short cervical length group (SD=5.64) and 38.74 mm in the normal cervical length group (SD=4.53). In the case group, the delivery occurred two or seven days after the first visit; as for the proper cervical length group without funneling changes, the delivery occurred 14 days after the first delivery. Thus, the difference is statistically significant (P=0.00). In terms of the preterm delivery before week 34, there was also a significant difference between the short and normal cervical length group, as well as the groups with the funnel-shaped and non-funnel-shaped cervix (P=0.00). However, in terms of post-term delivery before week 37, there was no significant difference between short and normal cervical length groups as well as funneled and non-funneled groups (P=0.78). In terms of term labor, there was a significant difference between short and normal cervical length groups, as well as funneled and non-funneled groups (P=0.00). In investigating the cut-off point with good sensitivity, it was indicated that the cervical length and cervical funneling in pregnant women at risk predict preterm labor before week 34. With the measurement of cervical length and diagnosis of cervical funneling by applying ultrasound, preterm delivery before week 34 can be predicted. Therefore, neonatal mortality and morbidity rates can be reduced in this way.

Performance of multimodal hyperspectroscopy for scanning of cervix in pregnant women: a preliminary study

Performance of multimodal hyperspectroscopy for scanning of cervix in pregnant women: a preliminary study

EP02.41: Interobserver reproducibility of elastographic measurements of cervix in pregnant women: according to cervical length

EP02.41: Interobserver reproducibility of elastographic measurements of cervix in pregnant women: according to cervical length

In Vivo Measurement of Cervical Elasticity on Pregnant Women by Torsional Wave Technique: A Preliminary Study.

A torsional wave (TW) sensor prototype was employed to quantify stiffness of the cervix in pregnant women. A cross-sectional study in a total of 18 women between 16 weeks and 35 weeks + 5 days of gestation was performed. The potential of TW technique to assess cervical ripening was evaluated by the measurement of stiffness related to gestational age and cervical length. Statistically significant correlations were found between cervical stiffness and gestational age (, , using 1 kHz waves and , , using 1.5 kHz waves). A uniform decrease in stiffness of the cervical tissue was confirmed to happen during the complete gestation. There was no significant correlation between stiffness and cervical length. A stronger association between gestational age and cervical stiffness was found compared to gestational age and cervical length correlation. As a conclusion, TW technique is a feasible approach to objectively quantify the decrease of cervical stiffness related to gestational age. Further research is required to evaluate the application of TW technique in obstetric evaluations, such as prediction of preterm delivery and labor induction failure.

Contributions to the dynamics of cervix remodeling prior to term and preterm birth.

Major clinical challenges for obstetricians and neonatologists result from early cervix remodeling and preterm birth. Complications related to cervix remodeling or delivery account for significant morbidity in newborns and peripartum mothers. Understanding morphology and structure of the cervix in pregnant women is limited mostly to the period soon before and after birth. However, evidence in rodent models supports a working hypothesis that a convergence of factors promotes a physiological inflammatory process that degrades the extracellular collagen matrix and enhances biomechanical distensibility of the cervix well before the uterus develops the contractile capabilities for labor. Contributing factors to this remodeling process include innervation, mechanical stretch, hypoxia, and proinflammatory mediators. Importantly, the softening and shift to ripening occurs while progesterone is near peak concentrations in circulation across species. Since progesterone is required to maintain pregnancy, the premise of this review is that loss of responsiveness to progesterone constitutes a common final mechanism for remodeling the mammalian cervix in preparation for birth at term. Various inputs are suggested to promote signaling between stromal cells and resident macrophages to drive proinflammatory processes that advance the soft cervix into ripening. With infection, pathophysiological processes may prematurely drive components of this remodeling mechanism and lead to preterm birth. Identification of critical molecules and pathways from studies in various rodent models hold promise for novel endpoints to assess risk and provide innovative approaches to treat preterm birth or promote the progress of ripening at term.

Assessment of the Cervix in Pregnant Women Using Shear Wave Elastography: A Feasibility Study

The quantitative assessment of the cervix is crucial for the estimation of pre-term delivery risk and the prediction of the success of labor induction. We conducted a cross-sectional study using shear wave elastography based on the supersonic shear imaging technique. The shear wave speed (SWS) of the lower anterior part of the cervix was quantified over an 8-mm region of interest in 157 pregnant women. Cervical SWS is slightly but significantly reduced in patients diagnosed with pre-term labor and in patients who actually delivered pre-term.

Transcervical Foley’s catheter versus Cook balloon for cervical ripening in stillbirth with a scarred uterus: a randomized controlled trial

Objective: To compare the efficacy and safety of the use of transcervical Foley’s catheter versus Cook cervical ripening balloon in pregnant women with stillbirth, unfavorable cervix and scarred uterus.Design: Randomized controlled study.Setting: El Minia University Hospital, El Minia, Egypt.Patients and methods: Two-hundred pregnant women with stillbirth, unfavorable cervix and scarred uterus were recruited into this study. They were randomized into two groups. In group I (n = 100), cervical ripening was done using Foley’s catheter. In group II (n = 100), cervical ripening was done using Cook cervical ripening balloon.Main outcome measures: Balloon insertion to delivery interval, successful ripening rate, cesarean delivery rate, maternal adverse events and maternal satisfaction.Results: Time from balloon insertion to expulsion and from balloon insertion to delivery was significantly shorter in Foley’s catheter group. However, the difference between the two groups regarding time from balloon insertion to active labor, time from balloon expulsion to delivery, cervical ripening, cesarean section, instrumental delivery, pain score, need for analgesia, hospital stay and maternal satisfaction was not statistically significant.Conclusions: Foley’s catheter and Cook cervical ripening balloon are comparable regarding efficacy and safety profile when used to ripen the cervix in pregnant women with stillbirth, unfavorable cervix and scarred uterus. However, Foley’s catheter has a shorter induction to delivery interval and is relatively cheaper device.

Early indicators of cervical insufficiency assessed using magnetic resonance imaging of the cervix during pregnancy

Objective: To establish the main characteristics of the cervix in pregnant women with cervical insufficiency, by means of magnetic resonance imaging (MRI).Methods: A prospective observational case-control study was conducted among 59 pregnant women with cervical insufficiency and 10 normal pregnant women, between their 10th and 28th weeks. The parameters analyzed in the MRI examinations were: precise identification of the cervix; presence of hyposignal at the internal orifice of the cervix; loss of definition of the periendocervical stromal zone (PESZ); presence of hyposignal content inside the amniotic sac (sludge sign) and anatomical and functional biometry of the cervix.Results: Peripheral hyposignal was found in 41 (85.4%) and loss of definition of the PESZ was observed in 36 pregnant women (73.5%) with cervical insufficiency. Sludge was observed in 46 pregnant women with cervical insufficiency, and this was seen on MRI in 27 cases (58.7%). The mean anatomical and functional lengths of the cervix on MRI in the pregnant women with cervical insufficiency were 3.5 ± 0.8 cm (0.8–4.9 cm) and 28.7 ± 6.3 mm (9–41 mm). None of the normal pregnant women presented hyposignal loss of the PESZ and the sludge sign.Conclusion: MRI may be useful for evaluating the cervix and for early identification of signs of cervical insufficiency during pregnancy.

Mast cells reside in myometrium and cervix, but are dispensable in mice for successful pregnancy and labor

Parturition is associated with myometrial and cervical inflammation. The causes and consequences of this inflammatory response are not clear. Mast cells (MCs) are important inducers of allergic and non-allergic inflammation, and their secreted products can induce myometrial contractions. Thus, mast cell activation has been hypothesized to have a role in initiating labor and/or driving labor-associated inflammation. We report that small numbers of MCs expressing chymase and tryptase are present in the myometrium and cervix of pregnant women. Labor did not lead to any change in mast cell abundance in these tissues, but was associated with reduced expression of the mast-cell regulator FcεR1A, indicative of a change in mast cell properties. This coincided with contraction-dependent myocyte production of interleukin-10 (IL-10), a known suppressor of FcεR1A expression. MCs were also found in the uterine horn and cervical region of pregnant C57BL/6 mice, increasing in number in the cervix, but not the myometrium, with labor. As expected, these cells were absent from mast-cell-deficient Kit(W-sh) mice. Nonetheless, pregnant Kit(W-sh) mice showed no defects in the timing of labor induction or in the upregulation of leukocyte markers during labor. Thus, MCs are present in the uterus and cervix of humans and mice, and our mouse studies suggest that they do not have a vital role in the induction of labor, or in the promotion of labor-associated inflammation.

Prediction and prevention of preterm birth after cervical conization

Prediction and prevention of preterm birth after cervical conization

A possible association between cervical erosion in pregnant women and congenital abnormalities in their children－a population-based case-control study

Objective to study the possible association between erosion of cervix in pregnant women (ECP) and structural birth defects, i.e. congenital abnormalities (CA) in their offspring. Study design: Comparison of cases with CA and all matched controls without any CA born to wo- men with prospectively and medical record ECP in the population-based large data set of the Hungarian Case-Control Surveillance of Congenital Abnormalities (HCCSCA). Results: HCC- SCA contained 22,843 cases and 38,151 matched controls, the informative offspring of 40 (0.18%) case mothers and the newborns of 25 control mothers (0.07%) with ECP were compared and the higher risk for total CA (adjusted OR with 95% CI: 2.7, 1.6-4.4) was found explained by the higher risk of 9 cases with hypospadias (OR with 95% CI: 4.5, 2.1-9.7) and 10 cases with car-diovascular CAs (OR with 95% CI: 3.4, 1.6-7.1), particularly with conotruncal CAs. Conclusions: An unexpected possible association of ECP with higher risk for hypospadias and conotrun-cal cardiovascular CAs was found and these findings are considered as signals that need confirmation or rejection

3622: The relationship between cervical length and ultrasound elastogram of the uterine cervix in pregnant women

3622: The relationship between cervical length and ultrasound elastogram of the uterine cervix in pregnant women

The Congruity Between Urine and Cervical Swab Cultures in Pregnant Women With Versus Without Amniotic Fluid Infection

We observed the congruity of bacteria found in urine and cervix of pregnant women with amniotic fluid infection (AFI) compared to healthy controls. Over three years, we prospectively analysed urine and cervical swabs cultures in 120 pregnant women in gestational week 16-20. The patient population was divided in two groups: group I patients had clinical symptoms of AFI. The rest of the patients were designated as healthy controls (group II). Congruity between findings in both groups was observed. In patients with bacterial growth, antibiotic treatment was initiated as recommended and once ended - culture probes were repeated. The rates of nonsignificant and significant bacteriuria were doubled in group I. Fifty-five percent (n = 33) of patients in group I had identical bacteria cultured both from the urine sample and cervical swab, in contrast to only 13.3 % in group II. Congruity was most pronounced for Klebsiella species and E. coli, the later being single most dominant isolate in regards to both cultures. After antimicrobial treatment, microbial eradication occurred in 15 patients (45.5 %). The observed incidences of abortions and preterm deliveries were significantly lower in patients with microbial eradication versus patients with microbial persistence. Patients with clinical symptoms of AFI have high risk for bacteriuria identical to bacterial culture from cervical swab. Antimicrobial treatment was effective only partially where indicated. Screening for eradication is recommended and consensus on the most appropriate therapy is needed.