TY - JOUR
T1 - Sonographic myometrial thickness predicts the latency interval of women with preterm premature rupture of the membranes and oligohydramnios
AU - Buhimschi, Catalin S.
AU - Buhimschi, Irina A.
AU - Norwitz, Errol R.
AU - Sfakianaki, Anna K.
AU - Hamar, Benjamin
AU - Copel, Joshua A.
AU - Saade, George R.
AU - Weiner, Carl P.
PY - 2005/9
Y1 - 2005/9
N2 - Objective: Term labor is associated with global thinning of the myometrium. We hypothesized that a thickened myometrium at the time of preterm premature rupture of membranes (PPROM) predicts less myometrial wall stress and, consequently, a longer latency interval. Study design: Myometrial thickness was measured prospectively in 76 pregnant women enrolled in the following groups: PPROM (n = 28, mean [range], gestational age [GA]: 29.5 weeks [w] [21.0 w-33.0 w]), preterm nonlabor control group (P-CTR), (n = 21, GA: 27.5 w [23.0 w-32.0 w]) and term nonlabor control (T-CTR) (n = 27, GA: 38.6 w [37.0 w-41.6 w]). All PPROM women had oligohydramnios (AFI: 1.4 cm [0.0 cm-5.1 cm]). MT was measured ultrasonographically at the midanterior, fundal, posterior, and lower uterine segment wall in cases and controls with an intraoperator variability <10%. Results: Women in the PPROM group displayed uniform thickness of the uterine body (mean ± SEM, anterior: 10.6 ± 0.6 mm, fundal: 10.7 ± 0.7 mm, posterior: 8.9 ± 0.5 mm, P = .078). At midanterior site the myometrium of the PPROM group was thicker compared to both P-CTR (P < .001) and T-CTR (P = .025) groups. This difference was preserved at the fundus (PPROM vs P-CTR, P < .001; PPROM vs T-CTR, P = .015). There was a positive correlation between fundal MT and latency period (r = 0.43, P = 0.02) that persisted after adjusting for GA (P = .04). A fundal MT less than 12.1 mm was 93.7% sensitive and 63.6% specific for the identification of women whose latency period was less than 120 hours. Conclusion: Significant thickening of the anterior and fundal walls of the uterus follows PPROM. A thick myometrium in nonlaboring patients with PPROM is associated with longer latency interval. Sonographic evaluation of MT may represent an alternative clinical tool for the prediction of a short latency interval in women with PPROM.
AB - Objective: Term labor is associated with global thinning of the myometrium. We hypothesized that a thickened myometrium at the time of preterm premature rupture of membranes (PPROM) predicts less myometrial wall stress and, consequently, a longer latency interval. Study design: Myometrial thickness was measured prospectively in 76 pregnant women enrolled in the following groups: PPROM (n = 28, mean [range], gestational age [GA]: 29.5 weeks [w] [21.0 w-33.0 w]), preterm nonlabor control group (P-CTR), (n = 21, GA: 27.5 w [23.0 w-32.0 w]) and term nonlabor control (T-CTR) (n = 27, GA: 38.6 w [37.0 w-41.6 w]). All PPROM women had oligohydramnios (AFI: 1.4 cm [0.0 cm-5.1 cm]). MT was measured ultrasonographically at the midanterior, fundal, posterior, and lower uterine segment wall in cases and controls with an intraoperator variability <10%. Results: Women in the PPROM group displayed uniform thickness of the uterine body (mean ± SEM, anterior: 10.6 ± 0.6 mm, fundal: 10.7 ± 0.7 mm, posterior: 8.9 ± 0.5 mm, P = .078). At midanterior site the myometrium of the PPROM group was thicker compared to both P-CTR (P < .001) and T-CTR (P = .025) groups. This difference was preserved at the fundus (PPROM vs P-CTR, P < .001; PPROM vs T-CTR, P = .015). There was a positive correlation between fundal MT and latency period (r = 0.43, P = 0.02) that persisted after adjusting for GA (P = .04). A fundal MT less than 12.1 mm was 93.7% sensitive and 63.6% specific for the identification of women whose latency period was less than 120 hours. Conclusion: Significant thickening of the anterior and fundal walls of the uterus follows PPROM. A thick myometrium in nonlaboring patients with PPROM is associated with longer latency interval. Sonographic evaluation of MT may represent an alternative clinical tool for the prediction of a short latency interval in women with PPROM.
KW - Myometrium
KW - Oligohydramnios
KW - PPROM
KW - Ultrasound preterm birth
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U2 - 10.1016/j.ajog.2005.01.053
DO - 10.1016/j.ajog.2005.01.053
M3 - Article
C2 - 16150272
AN - SCOPUS:24344504108
SN - 0002-9378
VL - 193
SP - 762
EP - 770
JO - American journal of obstetrics and gynecology
JF - American journal of obstetrics and gynecology
IS - 3
ER -