A microbiologic and clinical study of placental inflammation at term

Ylze Dong, Patrzcza J.St Clazr, Zbrahzm Ramzy, Kathleen S. Kagan-Hallet, Ronald S. Gibbs

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81 Scopus citations

Abstract

This study describes the relationships between histologically evident inflammation of the placenta, membranes, and umbilical cords, and correlates these lesions with clinical outcome and with amniotic fluid and amniotic membrane cultures in pregnancies at risk for clinical infection. The overall frequency of inflammation in 123 placentas was 85.45%. There were good interrelationships between inflammatory lesions at various sites. Membrane infiltrates of 3 f were seen in 90.9% of intra-amniotic infection cases, but in only 18.4% of asymptomatic patients (P <.001). Conversely, 76.9% of patients with 3f inflammation had intra-amniotic infection, whereas only 7% with lesser degrees of inflammation had intra-amniotic infection. Inflammation of any degree (1–3+) had a low specificity (28%) for febrile maternal outcome. Bacteria were recovered in 117 (95.1%) of the amniotic fluids. The grade of histologic lesions was associated with total colony count of bacteria in amniotic fluid (P <.05) and with high-virulence bacteria in amniotic fluid (P <.05), and Mycoylnsrnn lionIIIris in amniotic fluid (P <.05). Bacteria were found in 67.6% and mycoplasnias in 18.6% of amniotic membrane cultures. ChnIIIydin trnchoriintis was not recovered in any of 35 amniotic membrane cultures. No significant correlation was seen between organisms in the amniotic membrane and histologic inflammation. Thus, positive amniotic fluid culture results are associated with histologic inflammation, and may cause the inflammatory response. A logistic regression model revealed that predictors of histologic inflammation include maternal diagnosis, amniotic fluid colony count, and M lioiriiriis in amniotic fluid.

Original languageEnglish (US)
Pages (from-to)175-182
Number of pages8
JournalObstetrics and gynecology
Volume70
Issue number2
StatePublished - Aug 1987

ASJC Scopus subject areas

  • Obstetrics and Gynecology

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