

Transvaginal ultrasound revealed a cervical length of 0 mm and the presence of amniotic fluid ‘sludge’ in the portion of the amniotic sac protruding into the cervical canal (Figure 2 and Videoclip S2). Case reportĪ 31-year-old woman, gravida 5 para 2, with a history of a sonographic short cervix at 25 weeks (8 mm), was admitted at 27 + 2 weeks of gestation because of cervical dilatation (2–3 cm) and bulging membranes. Rendered three-dimensional transvaginal ultrasound image demonstrating the presence of amniotic fluid ‘sludge’ in close proximity to the cervix.

To determine the nature of amniotic fluid ‘sludge’, the material collected under sonographic guidance was examined under the microscope and microbiological studies were performed. Moreover, amniotic fluid ‘sludge’ has been identified in asymptomatic women at risk for spontaneous preterm delivery in the mid-trimester of pregnancy and is also an independent risk factor for preterm prelabor rupture of membranes (PROM) and spontaneous preterm delivery 3. We have proposed the term amniotic fluid ‘sludge’ to refer to this sonographic finding and provided evidence that ‘sludge’ is an independent risk factor for impending preterm delivery, histological chorioamnionitis and microbial invasion of the amniotic cavity in patients with spontaneous preterm labor and intact membranes 1.

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