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#374 Cervical excisional treatment increases the risk of intra-amniotic infection in subsequent pregnancy complicated by preterm prelabor rupture of membranes
  1. Ivan Praznovec1,
  2. Marian Kacerovsky1,
  3. Simona Baresova1,
  4. Klara Kolarova1,
  5. Jana Matulova1 and
  6. Bo Jacobsson2
  1. 1University Hospital Hradec Kralove, Hradec Kralove, Czech Republic
  2. 2University of Gothenburg, Gothenburg, Sweden


Introduction/Background Excisional treatment of cervical intraepithelial neoplasia or very early stages of cervical cancer increases the risk of preterm prelabor rupture of membranes (PPROM) in subsequent pregnancies. The subset of PPROM with a history of cervical excisional treatment could also be jeopardized by a higher risk intra-amniotic infection/inflammation. However, there is a paucity of relevant information on this field.

Methodology To assess the differences in the rates of intra-amniotic infection/inflammation and early-onset neonatal sepsis between singleton PPROM pregnancies without and with a history of cervical excisional treatment and to identify an association between these complications of PPROM and the excised cone length.

This retrospective cohort study included PPROM pregnancies in whom transabdominal amniocentesis was performed as part of standard clinical management to determine intra-amniotic environment. Women were divided into four subgroups according to microbial invasion of the amniotic cavity and/or intra-amniotic inflammation.

Results A history of cervical excisional treatment was found in 10% (76/765) of the women. Of these, 82% (62/76) had a history of only one treatment. Women with a history of one cervical excisional treatment had higher rates of presence of both microbial invasion of the amniotic cavity and intra-amniotic inflammation [with: 25% (19/76) vs. without: 12% (85/689), adj. OR: 2.5, adj. p = 0.004], microbial invasion of the amniotic cavity without inflammation [with: 25% (19/76) vs. without: 11% (74/689), adj. OR: 3.1, adj. p < 0.0001], and early-onset neonatal sepsis [with: 8% (11/76) vs. without: 3% (23/689), adj. OR: 2.9, adj. p = 0.02] than those without cervical excisional treatment.

Conclusion History of cervical excisional treatment increases risks of intra-amniotic infection, microbial invasion of the amniotic cavity without inflammation, and development of early-onset neonatal sepsis in a subsequent pregnancy complicated by PPROM

Disclosures University Hospital Hradec Kralove and Charles University, Faculty of Medicine in Hradec Kralove, Czech Republic.

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