The relationship between acute inflammatory lesions of the preterm placenta and amniotic fluid microbiology

Roberto Romero, Carolyn M. Salafia, Apostolos P. Athanassiadis, Shuichi Hanaoka, Moshe Mazor, Waldo Sepulveda, Michael B. Bracken

Research output: Contribution to journalArticlepeer-review

209 Scopus citations

Abstract

OBJECTIVE: Our objective was to determine the relationship between microbial invasion of the amniotic cavity and the presence and severity of acute inflammatory lesions in the placenta. STUDY DESIGN: Placental histologic and amniotic fluid microbiologic studies were performed in 92 consecutive patients who were admitted with preterm labor and intact membranes and delivered within 48 hours after amniocentesis. RESULTS: The prevalence of a positive amniotic fluid culture was 38% (35 of 92). There was a strong association between the presence and severity of inflammation in the amnion, chorion-decidua, umbilical cord, and chorionic plate and the results of the amniotic fluid culture (p < 0.0001 for each tissue section). Three patterns of inflammation of the chorion-decidua were identified: marginating, nonmarginating, and a mixed pattern. The marginating and the mixed patterns of inflammation were strongly associated with the presence of a positive amniotic fluid culture. Acute inflammation of the chorionic plate was the most sensitive indicator of a microbial invasion of the amniotic cavity (sensitivity 96.6%), and funisitis and umbilical vasculitis had the highest specificity (85.7%). CONCLUSION: The presence of acute inflammatory lesions of the chorioamniotic membranes can serve as a marker of microbial invasion of the amniotic cavity.

Original languageEnglish
Pages (from-to)1382-1388
Number of pages7
JournalAmerican Journal of Obstetrics and Gynecology
Volume166
Issue number5
DOIs
StatePublished - 1 Jan 1992
Externally publishedYes

Keywords

  • Chorioamnionitis
  • inflammation
  • intraamniotic infection
  • parturition
  • placenta
  • prematurity
  • preterm labor

ASJC Scopus subject areas

  • Obstetrics and Gynecology

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