Medical news
of the North Caucasus
Scientific journal
Mass media registration certificate dated December 7, 2006.
Series ПИ #ФС 77-26521.
Federal service for surveillance over non-violation of the legislation in the sphere of mass communications and protection of cultural heritage.
ISSN 2073-8137

Site search

Correspondence address
310 Mira Street, Stavropol, Russia, 355017

+7 8652 352524; +7 8652 353229.

+7 8652 352524.


Intrauterine infection verification by gray-scale echography for patients with preterm labor

[Obstetrios and gynecology]
Natalya Vladimirovna Krivonosova; Grigory Artemovich Penzhoyan; Olga Ivanovna Sikalchuk; Milena Aleksandrovna Penzhoyan; Victoria Valerievna Makukhina;

The informative value of the ultrasound assessment of the thymus in the diagnosis of intrauterine infection (IUI) was studied to increase the accuracy of the prediction of premature birth (PB). A retrospective study of 134 patients with menacing PR at 22–35 weeks of gestation was carried out. Clinical, laboratory, ultrasound signs of IUI were evaluated. The thymic-thoracic ratio (TTR) was used to evaluate the thymus. The information content of the signs for the PB forecast was estimated by the method of binary logistic regression with the construction of ROC-curves. The combination of TTR and premature rupture of the membranes (ROM) had the maximum diagnostic value for predicting PB (AUC=0.894±0.032; sensitivity (S)=82.1 %; specificity (Sp)=96.8 %; prognostic value of a positive test (VPT)=91.4 %; prognostic value of the negative test (VNT)=92.9 %). The combination of TTR, cervical length and echopositive sludge in amniotic fluid predicts PB in patients with IUI with S=84.6 %, Sp=89.5 %, VPT=82.1 %, VNT=93.4 %, AUC=0.860±0,034.


1. Celik E., To M., Gajewska K., Smith G. C. S., Nicolaides K. H. Cervical length and obstetric history predict spontaneous preterm birth: development and validation of a model to provide individualized risk assessment. Ultrasound. Obstet. Gynecol. 2008;31:549-554. https://doi.org/10.1002/uog.5333
2. Marlow N., Wolke D., Bracewell M. A., Samara M. Neurologic and developmental disability at six years of age after extremely preterm birth. N. Engl. J. Med. 2005;352:9-19. https://doi.org/10.1056/NEJMoa041367
3. Mingaleva N. V. Ways of optimization of gynecological healthcare on Regional level. Krasnodar:«MD-prodaction», 2008. (In Russ.).
4. Novikova V. A., Penzhoyan G. A., Rybalka E. V., Autleva S. R., Vasina I. B., Filina K. V. Unsolved problems of preterm birth in premature rupture of fetal membranes. Rossysky vestnik akushera-ginekologa. – Russian Bulletin of Obstetrician- Gynecologist. 2012;12(4);25-31. (In Russ.).
5. Novikova V. A., Penzhoyan G. A., Rybalka E. V., Autleva S. R., Sikalchuk O. I., Aseyeva E. V. Role of infection in premature rupture of the membranes. Rossysky vestnik akushera-ginekologa. – Russian Bulletin of Obstetrician- Gynecologist. 2012;12(6);35-39. (In Russ.).
6. Kopylov A. V., Ryzhkov V. V. Medicolegal aspects of perinatal losses from pre-natal infections. Sudebno-medicinskaja jekspertiza. – Forensic medical examination. 2016;59(6):18-21. (In Russ.). https://doi.org/10.17116/sudmed201659618-21
7. Ryzhkov V. V., Kopylov A. V., Koltunov E. N., Kulakova E. V., Kontlokova O. R. Intrauterine infections: Perinatal aspects. Rossysky vestnik akushera-ginekologa. – Russian Bulletin of Obstetrician-Gynecologist. 2017;17(4):33-36. (In Russ.). https://doi.org/10.17116/rosakush201717433-36
8. Sciaky-Tamir Y., Hershkovitz R., Mazor M., Shelef I., Erez O. The use of imaging technology in the assessment of the fetal inflammatory response syndrome–imaging of the fetal thymus. Prenatal Diagnosis. 2015;35:413-419. https://doi.org/10.1002/pd.4560
9. Sidorova I. S., Makarov I. O. Matvienko N. A. Intrauterine infection: diagnostic, prophylactic and treatment. M: MEDpress-inform. 2008. (In Russ.).
10. Yinon Y., Zalel Y., Weisz B., Mazaki-Tovi S., Sivan E. [et al.]. Fetal thymus size as a predictor of chorioamnionitis in women with preterm premature rupture of membranes. Ultrasound Obstet. Gynecol. 2007;29:639-643. https://doi.org/10.1002/uog.4022
11. Sukhikh G. T., Serov V. N., Adamian L. V., Phillipov O. S., Baev O. R. [et al.]. Preterm labor. Clinical recommendations (protocol). M.: 2013. (In Russ.).
12. Cohen J. A coefficient of agreement for nominal scales. Educ. Psychol. Meas. 1960;20:37-46. 13. McHugh M. Interrater reliability: the kappa statistic. Biochemia Medica. 2012;22(3):276-282.
14. El-Haieg D. O., Zidan A. A., El-Nemr M. M. The relationship between sonographic fetal thymus size and the components of the systemic fetal inflammatory response syndrome in women with preterm prelabour rupture of membranes. BJOG. 2008;115(7):836-841. https://doi.org/10.1111/j.1471-0528.2008.01715.x
15. Tskitishvili E., Tomimatsu T., Kanagawa T., Sawada K., Kinugasa Y. [et al.]. Amniotic fluid ‘sludge’ detected in patients with subchorionic hematoma: a report of two cases. Ultrasound Obstet. Gynecol. 2009;33:484-486. https://doi.org/10.1002/uog.6348
16. Kusanovic J. P., Romero R., Martinovic C., Silva K., Erez O. [et al.]. Transabdominal collection of amniotic fluid «sludge» and identification of Candida albicans intra-amniotic infection. J. Matern. Fetal. Neonatal. Med. 2017;3:1-6. https://doi.org/10.1080/14767058.2017.1315095
17. Himaya E., Desgagnes J., Tetu A., Gekas J., Giguere Y., Bujold E. Mid-trimester amniotic sludge and preterm delivery in asymptomatic women. Ultrasound Obstet. Gynecol. 2010;36:88.
18. Kenneth Lim, Kimberly Butt, Joan M. Crane. SOGC CLINICAL PRACTICE GUIDELINE Ultrasonographic Cervical Length Assessment in Predicting Preterm Birth in Singleton Pregnancies. JOG. 2011;257:486-499.
19. Begum J., Behera A. K. Cervical length by ultrasound as a predictor of preterm labour. Int. J. Reprod. Contracept. Obstet. Gynecol. 2014;3(3):646-652. https://doi.org/10.5455/2320-1770.ijrcog20140950

Keywords: intrauterine infection, ultrasound examination, preterm labor, thymus, cervical length, sludge

Stavropol State Medical Academy
Pyatigorsk State Research Institute of Balneotherapeutics
Pyatigorsk State Pharmaceutical Academy