Placental pathology compared with clinical outcome: a retrospective blind review

The usefulness of the microscopic examination of the placenta, associated membranes, and umbilical cord was tested in a retrospective clinical review. Fifty-nine patients with inflammation were matched by sex, race, and gestation with 59 patients without inflammation. Blind review of the clinical course of these infants revealed five cases of culture-positive septicemia, 28 cases of probable sepsis, 39 cases of possible sepsis, and 46 normal infants. The clinical categorization was significantly correlated with the microscopic appearance of the placenta, membranes, and cord. Triple vessel vasculitis in the umbilical cord vessels and chorionic microabscesses were significantly related to the incidence of proven, probable, and possible clinical sepsis. The microscopic examination of the umbilical cord and placenta provides a useful, but not infallible, tool in the evaluation of sepsis in the newly born infant.