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Histologic chorioamnionitis, microbial infection, and prematurity.

F J Zlatnik1, T M Gellhaus, J A Benda

  • 1Department of Obstetrics and Gynecology, University of Iowa, College of Medicine, Iowa City.

Obstetrics and Gynecology
|September 1, 1990
PubMed
Summary

Histologic chorioamnionitis is often found in early preterm birth but doesn't always mean infection is present. Microbial testing is crucial for accurate diagnosis, especially in the second trimester.

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Area of Science:

  • Obstetrics and Gynecology
  • Perinatal Medicine
  • Infectious Disease

Background:

  • Histologic chorioamnionitis is a common finding in preterm deliveries.
  • The relationship between histologic findings and microbial presence is not fully understood, particularly in early preterm birth.

Purpose of the Study:

  • To investigate the association between histologic chorioamnionitis and the isolation of microorganisms from the chorioamnion in women experiencing early preterm delivery.
  • To determine if histologic chorioamnionitis reliably indicates intrauterine infection.

Main Methods:

  • Studied 95 women with spontaneous preterm labor before 35 weeks' gestation.
  • Collected chorioamnion specimens for histologic examination and microbial cultures (aerobic/anaerobic bacteria, yeasts, mycoplasmas, Chlamydia).

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  • Analyzed the correlation between histologic chorioamnionitis and positive microbial culture results.

    • Main Results:

    • Histologic chorioamnionitis was present in 51% of subjects and was more frequent in the second trimester (72%) than later in gestation (33%).
    • Microorganisms were recovered from 38 subjects, with a significant association between histologic chorioamnionitis and positive cultures (68% vs. 39%).
    • Third-trimester chorioamnionitis showed a higher association with positive cultures (92%) compared to the second trimester (54%).

    Conclusions:

    • Histologic chorioamnionitis is not always indicative of infection, particularly in the second trimester of pregnancy.
    • Microbial cultures are essential for confirming infection in cases of suspected chorioamnionitis.
    • The diagnostic significance of histologic chorioamnionitis varies with gestational age.