Sonographic myometrial thickness predicts the latency interval of women with preterm premature rupture of the membranes and oligohydramnios

Catalin S. Buhimschi, Irina A. Buhimschi, Errol R. Norwitz, Anna K. Sfakianaki, Benjamin Hamar, Joshua A. Copel, George Saade, Carl P. Weiner

Research output: Contribution to journalArticle

17 Citations (Scopus)

Abstract

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.

Original languageEnglish (US)
Pages (from-to)762-770
Number of pages9
JournalAmerican Journal of Obstetrics and Gynecology
Volume193
Issue number3
DOIs
StatePublished - Sep 2005

Fingerprint

Oligohydramnios
Myometrium
Gestational Age
Preterm Premature Rupture of the Membranes
Uterus
Pregnant Women

Keywords

  • Myometrium
  • Oligohydramnios
  • PPROM
  • Ultrasound preterm birth

ASJC Scopus subject areas

  • Medicine(all)
  • Obstetrics and Gynecology

Cite this

Sonographic myometrial thickness predicts the latency interval of women with preterm premature rupture of the membranes and oligohydramnios. / Buhimschi, Catalin S.; Buhimschi, Irina A.; Norwitz, Errol R.; Sfakianaki, Anna K.; Hamar, Benjamin; Copel, Joshua A.; Saade, George; Weiner, Carl P.

In: American Journal of Obstetrics and Gynecology, Vol. 193, No. 3, 09.2005, p. 762-770.

Research output: Contribution to journalArticle

Buhimschi, Catalin S. ; Buhimschi, Irina A. ; Norwitz, Errol R. ; Sfakianaki, Anna K. ; Hamar, Benjamin ; Copel, Joshua A. ; Saade, George ; Weiner, Carl P. / Sonographic myometrial thickness predicts the latency interval of women with preterm premature rupture of the membranes and oligohydramnios. In: American Journal of Obstetrics and Gynecology. 2005 ; Vol. 193, No. 3. pp. 762-770.
@article{6c91d0c156ef4d87976867402bcfe2fe,
title = "Sonographic myometrial thickness predicts the latency interval of women with preterm premature rupture of the membranes and oligohydramnios",
abstract = "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.",
keywords = "Myometrium, Oligohydramnios, PPROM, Ultrasound preterm birth",
author = "Buhimschi, {Catalin S.} and Buhimschi, {Irina A.} and Norwitz, {Errol R.} and Sfakianaki, {Anna K.} and Benjamin Hamar and Copel, {Joshua A.} and George Saade and Weiner, {Carl P.}",
year = "2005",
month = "9",
doi = "10.1016/j.ajog.2005.01.053",
language = "English (US)",
volume = "193",
pages = "762--770",
journal = "American Journal of Obstetrics and Gynecology",
issn = "0002-9378",
publisher = "Mosby Inc.",
number = "3",

}

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

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

UR - http://www.scopus.com/inward/record.url?scp=24344504108&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=24344504108&partnerID=8YFLogxK

U2 - 10.1016/j.ajog.2005.01.053

DO - 10.1016/j.ajog.2005.01.053

M3 - Article

C2 - 16150272

AN - SCOPUS:24344504108

VL - 193

SP - 762

EP - 770

JO - American Journal of Obstetrics and Gynecology

JF - American Journal of Obstetrics and Gynecology

SN - 0002-9378

IS - 3

ER -