The increased concentration of sP-selectin and decreased sL-selectin, as well as the lack of change in endothelial cell-associated soluble adhesion molecules suggest that pregnancy is associated with platelet and leukocyte activation, but not endothelial cell activation. In contrast, pre-eclampsia appears to be characterized by activation of platelets, leukocytes and endothelial cells.

Results: Mean gestational age at birth was 33.0 ± 1.4 weeks (range 30.3-35) and mean birth weight was 2003 ± 335 gm (range 1262-2880). Fourteen of them were given dexamethasone. The mean velocity of pulmonary artery was 67 cm/sec. The mean acceleration/ejection time ratio of right and left pulmonary arteries were 0.16 ± 0.05 and 0.15 ± 0.05 respectively. After birth, 7 of them needed mechanical ventilation, and 3 needed surfactants. However, we found no significant correlation between prenatal pulmonary blood flow findings and postnatal pulmonary functions. Conclusion: Doppler blood flow of the pulmonary artery in preterm births has no relationship with the postnatal pulmonary functions. P08.09Risk factors for the development of histologic chorioamnionitis after preterm premature rupture of membranes: sonographic cervical length, intra-amniotic infection at presentation and prolonged latency K. Park, S. Kim, H. Jung, J. S. HongDepartment of Obstetrics and Gynecology, Seoul National University Bundang Hospital, Seongnam, South Korea Aims: To determine whether decreased cervical length, intraamniotic infection at presentation and prolonged latency are associated with an increased risk of the development of histologic chorioamnionitis after preterm premature rupture of membranes (PPROM). Methods: Transvaginal ultrasonographic assessment of cervical length was performed and antibiotic therapy was initiated immediately after amniocentesis in 81 consecutive women with PPROM at 23.4 to 35.0 weeks of gestation. Amniotic fluid obtained by amniocentesis was cultured for aerobic and anaerobic bacteria and for Mycoplasmas, and WBC count was determined. PPROM was defined as gross rupture and histologic chorioamnionitis was diagnosed in the presence of neutrophil infiltration into any tissues samples (amnion, chorion-decidua, umbilical cord, or chorionic plate). Results: The prevalence of acute histologic chorioamnionitis in patients after PPROM was 41% (33/81) and that of positive amniotic fluid cultures was 22% (18/81). Logistic regression indicated that decreased cervical length, a positive amniotic fluid culture, and gestational age at amniocentesis, but not prolonged latency, bear a significant relationship with the development of histologic chorioamnionitis after PPROM. Similarly, in terms of the development of the funisitis as the outcome variable, logistic regression demonstrated that only gestational age at amniocentesis was significantly and independently associated with an increased risk of development of funisitis after PPROM. Conclusions: We demonstrated the shorter the cervix in patients with PPROM, the greater the risk of ascending transcervical infection after PPROM documented by the increasing odds ratios of placental inflammation. Methods: 60 women admitted in labour who are nulliparous, gestational age from 37 to 40 weeks, singleton pregnancy, cephalic presentation and delivered vaginally will be randomized into three groups for management of the third stage; 20 women will be managed with full packag...

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Objective: To evaluate cervical length and gestational age as predictors of intra-amniotic inflammation in patients admitted because of preterm labor and intact membranes. Methods: 93 pregnant women with preterm labor and intact membranes were included in our study. Transvaginal cervical length was measured on admission and transabdominal amniocentesis was performed within the first 48 hours at admission. Positive amniotic fluid cultures defined intra-amniotic infection. High levels of IL6 defined intra-amniotic inflammation. To determine the best cut off point of IL6, a ROC curve was constructed. Logistic regression was used to investigate associations of different explanatory variables with inflammatory status. Results: Intra-amniotic infection and inflammation rates were 14% and 28%, respectively. ROC curve analysis showed that best cut off value for IL6 was 13.4 ng/mL which was comparable to the cut off of 11.3 ng/mL reported previously by other authors. Cervical length < 15 mm and gestational age at admission < 28 weeks were independently associated with intra-amniotic inflammation. A strategy considering these two non-invasive parameters could detect 84% of women with intra-amniotic inflammation. Conclusion: Cervical length and gestational age at admission can be used as a non-invasive method to assess the risk of intra-amniotic inflammation in preterm labor and intact membranes. Aims: To determine whether sonographic cervical length is valuable in terms of predicting intra-amniotic inflammation in women with preterm labor and intact membranes, and to compare performance with maternal blood C-reactive protein (CRP), white blood cell (WBC), amniotic fluid (AF) culture, and WBC. Methods: Transvaginal ultrasonographic assessment of cervical length was performed and maternal blood was collected for the determination of CRP and WBC immediately after amniocentesis in 133 consecutive women with preterm labor at 22.1 to 35.0 weeks of gestation. AF obtained by amniocentesis was cultured for aerobic and anaerobic bacteria and for Mycoplasmas, and WBC count was determined. Intra-amniotic inflammation was defined as an elevated amniotic fluid interleukin-6 concentration (> 2.6 ng/mL). Univariate and multivariate analyses were used for statistical analyses. OP25.08: TableResults: The prevalence of a positive amniotic fluid culture was 8% (11/133) and that of intra-amniotic inflammation was 20% (26/133). Women with intra-amniotic inflammation had a significantly higher mean maternal blood CRP and WBC, higher rate of a positive AF culture, higher mean AF WBC count, and lower mean gestational age at amniocentesis than did those without intra-amniotic inflammation. However, the mean cervical length was not significantly different between women with and without intra-amniotic inflammation (p = 0.069). Multivariate analysis demonstrated that maternal blood CRP and AF WBC count, but not cervical length, were significantly and independently associated with intra-amniotic inflammation. Conclusions: AF WBC and maternal blood CRP...

Electronic poster abstracts P16: PRETERM LABOUR P16.01The association between mid-trimester cervical length and the risk of histologic chorioamnionitis and funisitis J. Joo, K. Park, B. Han, E. Jung, S.M. Lee, A. Ryu, K. Oh Obstetrics and Gynecology, Seoul National University Bundang Hospital, Seongnam-si, Republic of Korea Objectives: To determine whether sonographic short cervix at mid-trimester is associated with an increased risk of the development of histologic chorioamnionitis and funisitis in asymptomatic women who subsequently had spontaneous preterm delivery (<37.0 weeks). Methods: This is a retrospective cohort study of 135 consecutive women with spontaneous preterm delivery before 37 weeks who underwent routine cervical length assessment between 19 and 25 weeks of gestation. Two groups of women were identified and compared: those with a mid-trimester sonographically short cervix and those without evidence of cervical shortening. Women with multiple gestation, cerclage, and indicated preterm delivery without labour were excluded. The placentas were examined histologically after delivery. The data were analyzed at cutoff cervical lengths of 25, 20, and 15 mm to define a short cervix. Results: A short mid-trimester cervical length (<2.5 cm) was found in 9.6% (13/135) of women with spontaneous preterm delivery. Maternal demographic characteristics were not significantly different between the two groups. Women with mid-trimester cervical shortening had significantly higher rates of both histologic chorioamnionits and funisitis, as compared to women without mid-trimester cervical shortening. In multivariable linear regression, both a short cervix and histologic chorioamnionitis were significantly associated with gestational age at birth. Conclusions:In asymptomatic women at mid-trimester who subsequently delivered prematurely, a short cervix is associated with an increased risk of subsequent histologic chorioamnionitis and funisitis. Both a short cervix and histologic chorioamnionitis were independently associated with gestational age at birth. These data suggest that earlier gestational age at birth associated with a short mid-trimester cervix is not merely due to intra-uterine infection.