Preterm prelabour amniorrhexis: relation to histological chorioamnionitis

Area of Science:

• Obstetrics and Gynecology
• Perinatal Medicine
• Infectious Diseases in Pregnancy

Background:

• Preterm prelabour amniorrhexis (PPROM) is a leading cause of preterm birth.
• Infection and inflammation are implicated in the pathophysiology of PPROM.
• The precise role of inflammation versus infection in PPROM requires further elucidation.

Purpose of the Study:

• To investigate the association between histological evidence of inflammation and infection in the placenta and umbilical cord with the timing of delivery in PPROM.
• To determine whether inflammation or infection is a better predictor of short interval to delivery in PPROM.

Main Methods:

• Histological examination of placental and umbilical cord tissues from 54 pregnancies with PPROM.
• Amniocentesis and cordocentesis performed at presentation for microbiological cultures.
• Correlation analysis between histological findings, culture results, and interval to delivery.

Main Results:

• Histological chorioamnionitis was more frequent in cases with positive amniotic fluid or fetal blood cultures.
• Cases with histological evidence of inflammation showed a significantly shorter interval to delivery.
• This association between inflammation and shorter delivery interval persisted irrespective of microbiological culture results.

Conclusions:

• Histological evidence of inflammation in the placenta and umbilical cord is a strong predictor of imminent delivery in PPROM.
• Inflammation, rather than infection alone, may be the critical factor driving rapid progression to delivery in PPROM.
• These findings highlight the importance of assessing inflammatory markers in managing PPROM to predict delivery timing.