Correlation between cervical infection and preterm labor.

Aim To investigate a correlation between cervical canal infection and imminent preterm labor and to identify most frequent pathogens. Methods A prospective study was conducted in obstetrics/gynecology departments of Health Center and the University Clinical Center Tuzla, and General Hospital Tesanj (Bosnia and Herzegovina, B&H) between October 2013 and May 2014. An examined group included 50 healthy pregnant women with singleton pregnancy of the gestation age between the 28th and 37th week, with cervical changes that are related to imminent preterm labor. Changes were detected by ultrasound biometry of cervix and modified Bishop score. A control group included 30 healthy pregnant women with singleton pregnancy of the gestation age between the 28th and 37th week of pregnancy without signs of imminent preterm labor. Cervical mucus was microbiologically analyzed for identification of pathogens. Results The infection in cervical canal was proven in 35 (70%) examinees and four (13%) patients from the control group (p=0.015). In seven (20%) cases each Ureaplasma and Mycoplasma were detected followed by E. coli in five (14%) cases (p=0.001). Conclusion Cervical canal infection is associated with changes on cervix and premature rupture of fetal membranes, i.e. preterm labor and imminent preterm labor. Screening for infection before pregnancy should be the main task of family doctors as well as gynecologists.

IGFBP-1 marker of cervical ripening and predictor of preterm birth.

Aim To establish a correlation between positive values of IGFBP-1(>10 mg/L, Actim Partus Test, APT) and premature cervical ripening in imminent preterm labor. Methods A prospective study was conducted in primary health care centers in Tuzla, Gynecology and Obstetrics Clinic of the University Clinical Centre in Tuzla and General Hospital Tesanj. The study included 50 women (singleton pregnancy, 28-37 week) with imminent preterm labor diagnosed by cervical biometry and modified Bishop score) (examinees) and 30 healthy pregnant women (control group). The presence of IGFBP-1 was tested in cervical secretion several times in weeks 28-37 until a positive test was shown. Results IGFBP-1 was positive in 43 (86%) examinees and in six (20%) patients from the control group (p=0.001). In 31 (62%) examinees APT was positive in weeks 28-30, and in nine (18%) in weeks 31- 33, while three (6%) examinees had positive test in 34-37 week; in the control group, three (10%) were tested positive in weeks 31-33 and three (10%) in weeks 34-37. At first testing (28-30 weeks) APT was statistically significantly more frequently positive in the examined group (p<0.05). Later, tests did not find statistically significant difference in the frequency of positivity between the control and examined group (p=0.08). Conclusion Elevated values of IGFBP -1 in cervical secretion were highly correlated with preterm labor. Screening for IGFBP could help in preventing preterm labor and its complications.