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Related Experiment Videos

Chorioamnionitis: a comparative histologic, bacteriologic, and clinical study.

J M Zhang1, F T Kraus, T I Aquino

  • 1Department of Laboratory Medicine, St. John's Mercy Medical Center, St. Louis, Missouri 63141.

International Journal of Gynecological Pathology : Official Journal of the International Society of Gynecological Pathologists
|January 1, 1985
PubMed
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Chorioamnionitis, an infection of the placenta, significantly increases neonatal morbidity and mortality, especially in premature infants. Histological grading reveals higher infection severity correlates with worse outcomes, even when pathogens aren't identified.

Area of Science:

  • Obstetrics
  • Neonatalogy
  • Infectious Diseases

Background:

  • Chorioamnionitis is a placental infection that can lead to adverse neonatal outcomes.
  • Histological examination of placentas is crucial for diagnosing chorioamnionitis.

Purpose of the Study:

  • To investigate the correlation between histological chorioamnionitis severity and neonatal morbidity/mortality.
  • To evaluate the effectiveness of different bacteriologic culture techniques.

Main Methods:

  • Morphologic and bacteriologic examination of 224 placentas.
  • Histological grading of chorioamnionitis based on inflammatory infiltrate intensity.
  • Comparison of surface swab versus deep culture techniques for pathogen recovery.

Main Results:

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  • Chorioamnionitis was present in 111 placentas, with 43% neonatal morbidity compared to 12% without.
  • Neonatal morbidity/mortality was 58% with positive cultures and 32% with negative cultures but histological evidence of infection.
  • Severe chorioamnionitis (grades II-III) showed significantly higher neonatal morbidity/mortality (62-82%) than mild/no chorioamnionitis (grades I-0; 43-36%).
  • Deep culture techniques reduced contamination.
  • Perinatal mortality was 64% in premature infants (<30 weeks) with infection.

Conclusions:

  • Higher grades of histological chorioamnionitis are significantly associated with increased neonatal morbidity and mortality.
  • Pathogens are frequently not recovered using standard bacteriologic methods.
  • Further investigation into non-bacterial infectious agents is warranted.