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Related Experiment Videos

Intrauterine inflammation at term: a histopathologic study.

L Keski-Nisula1, M L Aalto, M L Katila

  • 1Department of Obstetrics and Gynaecology, Kuopio University Hospital, Finland.

Human Pathology
|August 3, 2000
PubMed
Summary

Subclinical inflammation in uterine and gestational tissues occurs in nearly 20% of women at term gestation. This inflammation, particularly in the decidua, is linked to cervical dilation and meconium-stained amniotic fluid.

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Area of Science:

  • Obstetrics and Gynecology
  • Reproductive Medicine
  • Pathology

Background:

  • Subclinical inflammation of uterine and gestational tissues can impact pregnancy outcomes.
  • Histopathological examination is crucial for identifying inflammatory lesions.
  • Understanding inflammation's correlation with clinical variables is essential for clinical management.

Purpose of the Study:

  • To determine the prevalence of histologically defined inflammation in uterine and gestational tissues.
  • To evaluate the association between inflammation and clinical variables in term gestation.
  • To assess the correlation of inflammation with maternal and neonatal clinical outcomes.

Main Methods:

  • Analysis of 216 clinically noninfected, term parturients undergoing cesarean section with intact membranes.

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  • Histopathological examination of 981 samples: chorion, umbilical cord, placenta, myometrium, and decidua.
  • Microbiological cultures, Gram stain for leukocytes, and leukocyte esterase activity (LEA) of amniotic fluid (AF) were performed.
  • Main Results:

    • Leukocytic infiltrations were found in 19% of examined tissue samples.
    • Low-grade decidual inflammation was observed in 29% of cases after labor onset.
    • Cervical dilation (OR 4.7) and meconium-stained AF (OR 5.3) were significantly associated with decidual inflammation, independent of microbial or leukocyte markers.

    Conclusions:

    • Subclinical inflammation of uterine and gestational tissues is present in a significant proportion of term pregnancies.
    • Decidual inflammation is associated with clinical indicators like cervical dilation and meconium-stained AF.
    • These findings highlight the importance of histopathological assessment and suggest potential clinical predictors of intra-amniotic inflammation.