[Chorioamniotic dissociation and C-reactive protein as predictors of early premature amniotic rupture]

In 30 cases of cervical incompetence in pregnancy morphological and infectious factors of the amnial membranes were examined with regard to a predictive function versus premature rupture of membranes (PROM). The sonographically visible chorioamniotic dissociation (CAD, cut-off-value greater than or equal to 3 mm) and the C-reactive protein (CRP, cut-off-value greater than or equal to 6 mg/l) showed an sufficient predictive force. The combination of CAD and CRP could predict all cases of PROM. In addition, it could be shown that ascending infections are not only cause of PROM but also of morphological changes of the cervix and the amnial membranes in cervical incompetence. So therapy of an incompetent cervix should include competent vaginal sanitation. An immunological model of premature cervical ripening and damage of the membranes by proteases, kinins and prostaglandins started by phagocytosis activity is discussed.