Subchorionic intervillositis: Relationship to premature rupture of membranes and cervicitis

Study Objective: The inflammatory response engendered by cervicovaginal infections is believed to be an important, preventable, antecedent of premature rupture of the membranes. The objective of this study was to test the hypothesis that early histologic evidence of placental inflammation, subchorionic intervillositis, is a more common finding in placentas obtained from women who have cervicitis during gestation than in placentas obtained from other women.

Design, Main Outcome Measure, and Participants/Setting: Standard gross and histologic techniques were used to examine the placentas of 105 poor, black women in relation to three clinical signs of cervicitis: hypertrophic ectopia, friability, and inflammatory discharge.

Results: We found subchorionic intervillositis in 28 (26.7%) of the placentas. Subchorionic intervillositis was significantly associated with both premature rupture of the membranes and neonatal morbidity. Cervicitis was diagnosed in 63.5% of the subjects who were examined. Contrary to the study hypothesis, subchorionic intervillositis was a less common finding in the placentas of study subjects who had cervicitis (6.1% vs. 47.4%; χ² = 12.3 p < 0.001).

Conclusions: We speculate that prompt antibiotic treatment of clinically evident cervicitis eradicated potentially pathogenic microflora and prevented the ascent of the local inflammatory response up the birth canal.