Risk of Impending Preterm Delivery Associated with the Presence of Amniotic Fluid Sludge in Women in Preterm Labor with Intact Membranes

Abstract

Objective: To determine the association of amniotic fluid sludge with impending preterm delivery in women in preterm labor with intact membranes. Methods: This was a retrospective cohort study in women at 22–34 weeks’ gestation in preterm labor with intact fetal membranes between February 2008 and May 2009. 16 women with amniotic sludge were identified. Each case of amniotic sludge was matched with 3 randomly selected controls. The primary outcome was delivery within 48 h of examination. Results: Mean cervical length was shorter in women with sludge than women without sludge (20.5 ± 9.0 vs. 27.9 ± 6.9 mm, p = 0.0016). There was a significant difference in the mean ultrasound-to-delivery interval in women with and without sludge (21.7 vs. 49.4 days, p = 0.006). Logistic regression analyses demonstrated that amniotic fluid sludge is a strong independent predictor of impending preterm delivery within 48 h (OR 11.2, 95% CI 1.2–125.9), 7 days (OR 3.8, 95% CI 1.2–17.3) and 14 days (OR 7.5, 95% CI 1.8–30.4). Conclusions: Amniotic fluid sludge on ultrasound scan is associated with impending preterm delivery in women in preterm labor with intact membranes.

The Independent Association of a Short Cervix, Positive Fetal Fibronectin, Amniotic Fluid Sludge, and Cervical Funneling with Spontaneous Preterm Birth in Twin Pregnancies

“…12 In several studies on AF sludge in singleton pregnancies, preterm delivery rates were significantly increased in patients in which sludge was present. 13,22,23 In 2014, Boyer et al examined the significance of AF sludge in twin pregnancies. 17 Their study demonstrated that in twin pregnancies with a short cervix (defined as CL 25 mm at 16-26 weeks), the presence of AF sludge increased the risk for preterm delivery, chorioamnionitis, neonatal morbidity, and neonatal mortality.…”

Maternal Supplementation of Low Dose Fluoride Alleviates Adverse Perinatal Outcomes Following Exposure to Intrauterine Inflammation

“…Biofilms are also important in PTB, as they can be present in amniotic fluid sludge, which is the presence of minute particles aggregated in amniotic fluid near the cervix. In human studies, the presence of amniotic fluid sludge has been identified as an independent predictor of imminent preterm delivery 47,48 .…”

Presence of amniotic fluid sludge and pregnancy outcomes: A systematic review

“…[17][18][19][20][21][22][23] Seventeen studies were included in the present systematic review with a total number of 2432 women (Table 1). [11][12][13][14][24][25][26][27][28][29][30][31][32][33][34][35][36] Among them, 699 women (27.3%) had ultrasonographic evidence of AFS. Six studies investigated the presence of AFS in high-risk populations.…”