Original ArticlesClinical chorioamnionitis and histologic placental inflammation1☆,
Section snippets
Materials and methods
This was a retrospective cohort study with institutional review board approval. Study subjects were identified by review of discharge diagnoses of women who delivered at St. Peter’s University Hospital, New Brunswick, New Jersey, in 1996. All women with discharge diagnoses of chorioamnionitis were eligible for inclusion. Only singleton gestations delivered after 20 weeks’ gestation with histologic placental examinations were included. Maternal and neonatal medical records were reviewed for
Results
Among 6294 women who delivered in 1996, 189 (3%) had hospital discharge diagnoses of maternal chorioamnionitis. Of the identified pregnancies, 139 (73.5%) had maternal and infant records available and placental histologic examinations. Histologic evidence of chorioamnionitis was identified in 86 (61.9%, 95% CI 53.8%, 70%) of those pregnancies and was absent in 53 (38.1%, 95% CI 30%, 46.2%). Demographic features of cases with and without chorioamnionitis are presented in Table 1. Significant
Discussion
True clinical chorioamnionitis is a difficult diagnosis. Standardized clinical criteria have been suggested, including maternal temperature of at least 100.4F, with or without additional features such as maternal tachycardia, fetal tachycardia, uterine tenderness, foul-smelling AF, and maternal leukocytosis (more than 15,000 cells/mm3).9, 10 Unfortunately, a variety of clinical management practices can alter the reliability of some of those features, especially in preterm gestations.11, 12, 13,
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Predicting chorioamnionitis in patients with preterm premature rupture of membranes using inflammatory indexes: a retrospective study
2023, Taiwanese Journal of Obstetrics and GynecologyAn evaluation into the use of procalcitonin levels as a biomarker of bacterial sepsis to aid the management of intrapartum pyrexia and chorioamnionitis
2022, AJOG Global ReportsCitation Excerpt :Evidence is emerging that challenges the correlation between clinical chorioamnionitis and histologic chorioamnionitis.33–35 A study by Smulian et al34 focused on clinical chorioamnionitis and histologic placental inflammation in 139 pregnancies. They concluded that clinical chorioamnionitis and possible neonatal infection were not supported by histologic evidence of infection in 38.1% and 26.8% of cases, respectively, suggesting other noninflammatory causes of signs and symptoms.
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Dr. Ananth is supported, in part, by a grant from the Robert Wood Johnson Foundation, New Jersey, awarded to The Center for Perinatal Health Initiatives (Grant #-029553).
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The opinions, views, and conclusions expressed in this manuscript are those of the author(s) and not necessarily those of the Robert Wood Johnson Foundation.