Abstract
Background
Histopathology shows that 49.8% of women with preterm labor between 23–32 weeks of gestation had histological chorioamnionitis (HCA), but there is poor correlation between HCA and clinical diagnosis of chorioamnionitis. Cervical swab culture is used as a standard tool for evidence of infection.
Objectives
To determine the relationship between cervical swab culture and placental histological evidence of amniotic fluid infection in preterm labor.
Methods
Retrospective observational review of cervical swab culture and placental pathology of women presenting to labor rooms of King Chulalongkorn Memorial Hospital.
Results
We identified 104 patients with preterm labor and intact membranes from January 2012 to May 2013. Amniotic fluid infection detected by placental pathology was present in 10 patients, while a positive cervical culture was present in 12. There was only one patient that showed a positive result for both cervical swab culture and HCA. In patients with HCA, acute chorioamnionitis was present in 7 of 10 cases. Fetal inflammatory response was noted in only one case. There was no significant correlation between cervical swab culture and evidence of amniotic fluid infection in placental pathology (P = 0.87, odds ratio 0.84, 95% confidence interval 0.1 to 7.27).
Conclusions
There was no significant relationship between evidence of amniotic fluid infection in placental pathology and cervical swab culture or clinical signs of chorioamnionitis in preterm labor with intact membrane. However, because of some limitations in this study, the role of cervical swab culture in preterm labor remains inconclusive and more study is needed for clarification.