Clinical predictive factors of histological chorioamnionitis: case-control study

Area of Science:

• Obstetrics and Gynecology
• Perinatal Medicine
• Pathology

Background:

• Histological chorioamnionitis, also known as intrauterine inflammation or infection (Triple I), is an acute inflammation affecting the amniotic membrane, chorionic plate, and umbilical cord.
• This condition can occur even in the absence of clear clinical symptoms.

Purpose of the Study:

• To identify clinical predictive factors associated with histological chorioamnionitis.
• To evaluate the association between clinical presentation and placental inflammation.

Main Methods:

• A prospective study involving the histopathological analysis of 100 placentas (50 from aberrant pregnancies, 50 from normal deliveries).
• Placentas were evaluated for the presence and severity of chorioamnionitis using conventional histopathology.
• Clinical and histopathological data were statistically analyzed.

Main Results:

• Histological chorioamnionitis was observed in 72% of placentas from aberrant pregnancies and 22% of normal deliveries.
• A statistically significant association was found between histological chorioamnionitis and premature rupture of membranes (PROM) lasting over 12 hours (p < 0.001).
• Funisitis was frequently associated with chorioamnionitis in aberrant pregnancies.

Conclusions:

• Histological chorioamnionitis is more prevalent in clinically suspected cases and can be present even in normal deliveries.
• Premature rupture of membranes (PROM) exceeding 12 hours is a key clinical indicator associated with histological chorioamnionitis.
• Morphological placental examination is crucial for confirming chorioamnionitis, which may be clinically silent.