Related Experiment Videos
Clinical chorioamnionitis and histologic placental inflammation
J C Smulian1, S Shen-Schwarz, A M Vintzileos
1Department of Obstetrics, Gynecology and Reproductive Sciences, University of Medicine and Dentistry of New Jersey, Robert Wood Johnson Medical School, New Jersey, USA.
Obstetrics and Gynecology
|November 27, 1999
Summary
Clinical chorioamnionitis is often not confirmed by placental histology. Many cases of suspected neonatal infection also lack histologic evidence, suggesting non-inflammatory causes for these conditions.
Area of Science:
- Obstetrics and Gynecology
- Perinatal Medicine
- Pathology
Background:
- Clinical chorioamnionitis is a common diagnosis in pregnancy.
- Histologic examination of the placenta is the gold standard for diagnosing chorioamnionitis.
- The correlation between clinical diagnosis and histologic findings requires further investigation.
Purpose of the Study:
- To determine the rate of histologic chorioamnionitis in pregnancies with a clinical diagnosis.
- To assess the association between clinical markers of maternal and neonatal infection and histologic chorioamnionitis.
Main Methods:
- Retrospective review of singleton pregnancies with a discharge diagnosis of clinical chorioamnionitis.
- Analysis of maternal and neonatal records for clinical signs of infection.
- Examination of placentas for acute histologic chorioamnionitis.
Main Results:
- 61.9% of clinical chorioamnionitis cases were supported by histologic evidence.
- Histologic chorioamnionitis was linked to earlier gestational age at delivery and reduced medical interventions.
- 26.8% of infants with suspected neonatal sepsis lacked placental histologic evidence of infection.
Conclusions:
- A significant proportion of clinical chorioamnionitis diagnoses are not supported by histologic findings.
- Clinical signs of neonatal infection may stem from non-inflammatory causes.
- Further research is needed to understand the etiology of these discrepancies.