Clinical implications of a short cervix in preterm premature rupture of membranes patients

Preterm premature rupture of membranes (pPROMs) affect 3%–4% of pregnancies, leading to preterm births and neonatal morbidity. A short cervix is linked to increased risk of intra-amniotic infection and inflammation, exacerbating adverse outcomes. This review examines the relationship between cervical length (CL), pPROM, and intra-amniotic infection and inflammation. CL measurement is a valuable tool in predicting preterm delivery (PTD), with a threshold of 25 mm or less. Studies show a short cervix is associated with increased risk of PTD, intra-amniotic infection, and inflammation. The predictive value of CL measurement has been demonstrated in various populations, including asymptomatic women and those with threatened preterm labor. The relationship between CL and intra-amniotic inflammation may be influenced by gestational age (GA), with earlier GAs associated with higher risk. A short cervix may predispose women to ascending infection, and microbial invasion can trigger cervical shortening and inflammatory responses. Identifying women with a short cervix and providing targeted interventions may reduce the risk of PTD and associated adverse outcomes. This comprehensive review highlights the importance of CL measurement in predicting PTD and intra-amniotic infection and inflammation in pPROM patients. By synthesizing existing evidence, we can better understand the complex relationships between CL, pPROM, and intra-amniotic infection and inflammation, informing clinical practice and guiding future research.