SONOGRAPHIC SHORT CERVIX - CLINICAL MANIFESTATION OF SUBCLINICAL INTRA-AMNIOTIC INFECTION: A COMPREHENSIVE REVIEW

DAVID DAVARASHVILI; SALOME GOGIASHVILI; GIORGI MGELADZE

doi:10.52340/jecm.2025.06.13

SONOGRAPHIC SHORT CERVIX - CLINICAL MANIFESTATION OF SUBCLINICAL INTRA-AMNIOTIC INFECTION: A COMPREHENSIVE REVIEW

Authors

DAVID DAVARASHVILI David Davarashvili Clinic
SALOME GOGIASHVILI David Davarashvili Clinic
GIORGI MGELADZE Clinic on Lars

DOI:

https://doi.org/10.52340/jecm.2025.06.13

Keywords:

short cervix, intra-amniotic infection, inflammation, preterm birth, chorioamnionitis

Abstract

A sonographic short cervix in the mid-trimester is a powerful predictor of spontaneous preterm delivery and may represent the only clinical manifestation of subclinical intra-amniotic infection or inflammation. This review examines the relationship between cervical shortening and intra-amniotic pathology, diagnostic approaches, treatment strategies, and long-term outcomes. Evidence demonstrates that 9-10% of asymptomatic women with sonographic short cervix (<25 mm) have microbial invasion of the amniotic cavity (MIAC), while sterile intra-amniotic inflammation occurs in an additional 10-22% of cases. Biomarkers including interleukin-6 (IL-6) and matrix metalloproteinase-8 (MMP-8) show promise for rapid diagnosis. Targeted antibiotic therapy with ceftriaxone, clarithromycin, and metronidazole has demonstrated success in eradicating intra-amniotic infection in selected cases, potentially allowing term delivery. However, the association with adverse neurodevelopmental outcomes, including cerebral palsy, underscores the importance of early recognition and intervention.

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