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150: The relationship between placental lesions of inflammation and spontaneous preterm birth in twin gestations with cervical shortening in the second trimester

      Objective

      To determine whether inflammatory lesions of the placenta are associated with an increased risk of preterm birth in twin gestations with ultrasonographic findings of cervical shortening in the second trimester.

      Study Design

      Retrospective review of those twin gestations from January 2004 through January 2008 with ultrasonographic assessment of cervical length between 16 and 24 weeks gestation and subsequent pathological examination of the placenta. A cervical length of 2.5cm (10%ile) was used to define a short cervix.

      Results

      62 twin gestations were identified with cervical shortening. Of these, 42 (67.7%) patients delivered prior to 37 weeks gestation. Of the 20 patients who delivered at term (37 weeks of gestation), placental examination failed to demonstrate any acute (acute chorioamnionitis or funisitis) or chronic (chronic deciduitis or villitis) lesions of inflammation. Acute inflammatory lesions of the placenta were significantly associated with an increased risk of spontaneous preterm birth (23.8% vs. 0%, p=0.023). There was no significant difference in the frequency of chronic inflammatory lesions of the placenta between the groups.

      Conclusion

      Tabled 1Relationship between placental lesions of inflammation and preterm birth in twins with cervical shortening (n=62)
      Placental LesionsBirth < 37 weeksBirth ≥ 37 weeksp value
      Acute Inflamm.10 (23.8%)0 (0%)0.0230
      Chronic Inflamm.4 (9.5%)0 (0%)0.2952