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Histologic Chorioamnionitis

Alan Roberto Hatanaka, Marcelo Santucci Franca, Tatiana Emy Nishimoto Kawanami Hamamoto, Liliam Cristine Rolo, Rosiane Mattar, Antonio Fernandes Moron
INTRODUCTION: Amniotic fluid "sludge" has been associated with an increased rate of spontaneous preterm delivery before 35 weeks, a higher frequency of clinical chorioamnionitis, and histologic chorioamnionitis in a high-risk population. Only one study evaluating the use of antibiotics in the presence of amniotic fluid "sludge" showed reduced rates of spontaneous preterm birth at <34 weeks. The objective of this study was to evaluate routine antibiotic treatment in the presence of amniotic fluid "sludge" for prevention of preterm delivery...
March 5, 2019: Acta Obstetricia et Gynecologica Scandinavica
Elif E Gultekin-Elbir, Catherine Ford, Mehmet R Genç
Objective To assess the value of incorporating amniotic fluid (AF) analysis in the management of patients with clinical chorioamnionitis. Methods This was a retrospective cohort study of all women carrying a singleton fetus and managed at our center between 2000 and 2009. We included only those women suspected of chorioamnionitis based on one or more of the following: (1) uterine tenderness, (2) maternal fever, (3) maternal and/or fetal tachycardia and (4) purulent discharge. The management was deemed to be justified if (1) pregnancy was terminated <24 weeks and histology confirmed chorioamnionitis; (2) delivery was performed expeditiously after initial assessment and histology confirmed chorioamnionitis; (3) delivery was delayed for 2-7 days and the patient completed a course of antenatal steroids before 34 weeks; and (4) delivery was delayed ≥7 days and histology was not indicative of chorioamnionitis, or delivery occurred after 37 weeks...
February 28, 2019: Journal of Perinatal Medicine
Lily He, Gene T Lee, Helen Zhou, Irina A Buhimschi, Catalin S Buhimschi, Carl P Weiner, Clifford W Mason
OBJECTIVE: Calmodulin (CaM) plays a key role in the orchestration of Ca2+ signaling events, and its regulation is considered an important component of cellular homeostasis. The control of uterine smooth muscle function is largely dependent on the regulation of Ca2+ and CaM signaling. The objective of this study was to investigate the expression, function, and regulation of CaM regulatory proteins in myometrium during pregnancy. STUDY DESIGN: Myometrium was obtained from nonpregnant women and 4 groups of pregnant women at the time their primary cesarean delivery: (i) preterm not in labor, (ii) preterm in labor with clinical and/or histological diagnosis of chorioamnionitis, (3) term not in labor; and (4) term in labor...
February 11, 2019: Reproductive Sciences
Maxim D Seferovic, Michelle Turley, Gregory C Valentine, Martha Rac, Eumenia C C Castro, Angela M Major, Brianna Sanchez, Catherine Eppes, Magdalena Sanz-Cortes, James Dunn, Tiffany F Kautz, James Versalovic, Kenneth L Muldrew, Timothy Stout, Michael A Belfort, Gail Demmler-Harrison, Kjersti M Aagaard
Contemporaneous Zika virus (ZIKV) strains can cause congenital Zika syndrome (CZS). Current ZIKV clinical laboratory testing strategies are limited and include IgM serology (which may wane 12 weeks after initial exposure) and nucleic acid testing (NAT) of maternal serum, urine, and placenta for (+) strand ZIKV RNA (which is often transient). The objectives of this study were to determine if use of additional molecular tools, such as quantitative PCR and microscopy, would add to the diagnostic value of current standard placental ZIKV testing in cases with maternal endemic exposure and indeterminate testing...
February 7, 2019: International Journal of Molecular Sciences
Carlo Pietrasanta, Lorenza Pugni, Daniela Merlo, Barbara Acaia, Dario Consonni, Andrea Ronchi, Manuela Wally Ossola, Beatrice Ghirardi, Ilaria Bottino, Fulvia Milena Cribiù, Silvano Bosari, Fabio Mosca
OBJECTIVE: To investigate the impact of different stages of intrauterine inflammation (IUI) on neonatal outcomes, before and after adjusting for gestational age (GA) and other perinatal confounders. METHODS: This was an observational, prospective, single-center cohort study including all eligible neonates with GA < 35 weeks and/or birth weight ≤ 1500 g born at a 3rd level Neonatal Intensive Care Unit between 2011 and 2014. Pathological patterns of placenta, membranes and cord were classified according to Redline's criteria...
2019: PloS One
Hadas Ganer Herman, Letizia Schreiber, Hadas Miremberg, Masha Ben Zvi, Jacob Bar, Michal Kovo
OBJECTIVE: To study the incidence of histological chorioamnionitis (HCA) in term pregnancies according to labor onset. STUDY DESIGN: During 2013-6, term pregnancy placentas were prospectively sent to histopathology evaluation, and compared between patients with spontaneous onset labor, pre-labor ROM, labor induction and elective cesarean deliveries. RESULTS: A total of 260 placentas were obtained, 65 from each group. Rates of HCA for the spontaneous labor, PROM, induction and CD groups were: 49, 32, 24 and 4%, respectively (p < 0...
February 5, 2019: Journal of Perinatology: Official Journal of the California Perinatal Association
Liyin Qiu, Mian Pan, Ronglian Zhang, Kunhai Ren
BACKGROUND: Histological chorioamnionitis (HCA) is one of the leading causes of spontaneous preterm birth, thus, to identify novel biomarkers for the early diagnosis of HCA is in a great need. OBJECTIVE: To investigate the diagnostic value of maternal peripheral blood platelet-to-white blood cell ratio (PLT/WBC) and platelet (PLT) counts in HCA-related preterm birth. METHODS: A total of 400 patients with preterm birth were enrolled in this study: non-HCA group (n = 193) and HCA group (n = 207), and 87 full-term pregnancies were enrolled as the control...
February 4, 2019: Journal of Clinical Laboratory Analysis
Jeong Woo Park, Kyo Hoon Park, Song Yi Kook, Young Mi Jung, Yu Mi Kim
PURPOSE: To determine whether various selected immune-related proteins in maternal plasma, alone or in combination, can predict histologic chorioamnionitis (HCA) in women with preterm labor, and to compare the predictive abilities of these biomarkers with that of serum C-reactive protein (CRP). METHODS: This retrospective cohort study included 74 consecutive women with preterm labor (23-34 gestational weeks) who delivered within 96 h of blood sampling. Their serum CRP levels were also measured...
January 31, 2019: Archives of Gynecology and Obstetrics
Olga Pustotina
OBJECTIVE: The aim of this prospective study was to assess the efficacy of antibiotic therapy for the prevention of adverse pregnancy outcomes in women with the amniotic fluid "sludge" at 15-24 weeks of gestation. METHODS: 245 women underwent transvaginal ultrasound cervical length measurement at 15-24 weeks of pregnancy and 29 out of them with amniotic fluid "sludge" were included in the study. Eight women with the "sludge" had cervical length >25 mm (Group I), seven-an asymptomatic short cervix (Group IIa) and 14 women with a short cervix had symptoms like low abdominal pain, back pain, and menstrual-like cramps (Group IIb)...
January 27, 2019: Journal of Maternal-fetal & Neonatal Medicine
Ufuk Çakir, Duran Yildiz, Dilek Kahvecioğlu, Emel Okulu, Serdar Alan, Ömer Erdeve, Aylin Okçu Heper, Begüm Atasay, Saadet Arsan
OBJECTIVE: The microscopic and macroscopic features of the placenta can contribute to the clinical understanding of premature delivery. The aim of our study was to figure out the relationship between the histopathological findings of the placentas of premature deliveries and its effects on neonatal morbidity and mortality. MATERIAL AND METHOD: The placentas of 284 singleton preterm infants with < 35 weeks of gestation were examined. Three groups were created as the normal, chorioamnionitis and vasculopathy groups according to the histopathological findings in the placentas of the subjects...
2019: Türk Patoloji Dergisi
Jiyoung Chun, Sang Hoon Chun, Yea Seul Han, Tae-Jung Sung
BACKGROUND: Ureaplasma spp. is a known risk factor for bronchopulmonary dysplasia (BPD). However, little is known about the effect of different degrees of maternal Ureaplasma colonization and their adverse outcomes. Hence, the aim of this study was to determine the effects of different degrees of maternal Ureaplasma colonization on BPD. METHODS: A retrospective cohort study of preterm infants delivered at <32 weeks' gestational age (GA) was performed. The infants were divided according to maternal Ureaplasma status as follows: high-colonization (≥104  CCU/ml, UUH), low-colonization (<104  CCU/ml, UUL), and noncolonization (controls)...
November 27, 2018: Pediatrics and Neonatology
Tara A Lynch, Courtney Olson-Chen, Sarah Colihan, Jeffrey Meyers, Conisha Holloman, Dongmei Li, Heather Link, Paola Torres, Annie Kim, Devon J King, Cari Eckman, Anna Varlamov, Scott Dexter, Eva K Pressman, Eleazar Soto-Torres, Amol Malshe
OBJECTIVE:  To evaluate outcomes with expectant management of preterm prelabor rupture of membranes (PROM) until 35 weeks versus immediate delivery at ≥34 weeks. STUDY DESIGN:  This was a multicenter retrospective cohort study of singletons with preterm PROM at >20 weeks from 2011 through 2017. Groups were defined as expectant management until 35 weeks versus immediate delivery at ≥34 weeks. Primary outcome was composite neonatal morbidity: need for respiratory support, culture positive neonatal sepsis, or antibiotic administration for >72 hours...
December 15, 2018: American Journal of Perinatology
Unzila Ali Nayeri, Catalin S Buhimschi, Guomao Zhao, Irina A Buhimschi, Vineet Bhandari
We aimed to test the hypothesis that determinants of the perinatal clinical exposome related to the underlying etiology of premature birth (PTB) impact differently on select neonatal outcomes. We conducted a prospective longitudinal study of 377 singleton preterm neonates [gestational age (GA) at birth: 23-34 weeks] separated into three distinct contemporaneous newborn cohorts: i) spontaneous PTB in the setting of intra-amniotic infection/inflammation (yes-IAI, n = 116); ii) spontaneous PTB in the absence of IAI (no-IAI, n = 130), and iii) iatrogenic PTB for preeclampsia (iPTB-PE, n = 131)...
2018: PloS One
Ifeyinwa Mary Asuzu, Olaejirinde Olaniyi Olaofe
The study is a retrospective cross-sectional study carried out in the Department of Pathology of Premier Hospital, Abuja, on specimens received over a one-year period. Four hundred and eighty-six samples of endometrial biopsies and curettings from women presenting with abnormal uterine bleeding sent to the histopathology laboratory were analyzed. The most common biopsies were those of product of conception which accounted for 304 cases (62.6%). Most of the cases of endometrial hyperplasia were typical. Endometritis and chorioamnionitis were the inflammatory conditions seen...
2018: International Journal of Reproductive Medicine
Anne Marie Singh, Michael G Sherenian, Kwang-Youn Kim, Kristin A Erickson, Amy Yang, Karen Mestan, Linda M Ernst, Rajesh Kumar
Background: Chorioamnionitis is a risk factor for future asthma development. Animal models of chorioamnionitis demonstrate increased TH 17-to-Treg ratios associated with proinflammatory cytokine elevations. The association of chorioamnionitis on human neonatal immune cells systemically and within tissues is not known. Methods: We enrolled two cohorts to evaluate TH 17 and regulatory T cell (Treg ) phenotypic markers in chorioamnionitis. From a cohort of 19 live birth infants, we collected cord blood and placenta samples to evaluate for signs of acute and chronic histologic inflammation and cell phenotype characterization...
2018: Allergy, Asthma, and Clinical Immunology
Pawel T Schubert, Deidre Mason, Roosacelis Martines, Marlene Deleon-Carnes, Sherif R Zaki, Drucilla J Roberts
Fetal bacterial infections are a common cause of fetal/neonatal morbidity and mortality. The pathologic correlates of congenital bacterial infection include acute chorioamnionitis, acute villitis, and acute intervillositis. The strength of the association of congenital bacterial infection differs among these pathologies. Acute chorioamnionitis results usually from an ascending infection, and damage to the fetus is thought to be cytokine driven rather than damage secondary to bacteremia. Acute villitis is strongly associated with fetal sepsis due to congenital infections...
October 18, 2018: Pediatric and Developmental Pathology
Shenandoah Robinson, Fatu S Conteh, Akosua Y Oppong, Tracylyn R Yellowhair, Jessie C Newville, Nagat El Demerdash, Christine L Shrock, Jessie R Maxwell, Stephen Jett, Frances J Northington, Lauren L Jantzie
Posthemorrhagic hydrocephalus of prematurity (PHHP) remains a global challenge. Early preterm infants (<32 weeks gestation), particularly those exposed to chorioamnionitis (CAM), are prone to intraventricular hemorrhage (IVH) and PHHP. We established an age-appropriate, preclinical model of PHHP with progressive macrocephaly and ventriculomegaly to test whether non-surgical neonatal treatment could modulate PHHP. We combined prenatal CAM and postnatal day 1 (P1, equivalent to 30 weeks human gestation) IVH in rats, and administered systemic erythropoietin (EPO) plus melatonin (MLT), or vehicle, from P2 to P10...
2018: Frontiers in Cellular Neuroscience
Eduardo Villamor-Martinez, Monica Fumagalli, Owais Mohammed Rahim, Sofia Passera, Giacomo Cavallaro, Pieter Degraeuwe, Fabio Mosca, Eduardo Villamor
Although chorioamnionitis (CA) is a well-known risk factor for white matter disease of prematurity, the association with intraventricular hemorrhage (IVH) is controversial and has not been yet systematically reviewed. We performed a systematic review and meta-analysis of studies exploring the association between CA and IVH. A comprehensive literature search was conducted using PubMed/MEDLINE and EMBASE, from their inception to 1 July 2017. Studies were included if they examined preterm infants and reported primary data that could be used to measure the association between exposure to CA and the presence of IVH...
2018: Frontiers in Physiology
Z Benzon, S Benzon, S Z Tomaš, I K Prusac, L Vulić, M Vulić, V Stefanovic
We investigated whether chorioamnionitis affects immunohistochemical demonstration of RECK protein and interleukin-6 (IL-6) expression in fetal placental membranes following late preterm delivery with intact membranes. Fetal membranes of 28 women with single pregnancy, preterm delivery and histologically documented chorioamnionitis at gestational age 34-366/7  weeks constituted the chorioamnionitis study group. The control group consisted of 28 fetal membranes from women with preterm deliveries at the same gestational age without histological chorioamnionitis...
September 19, 2018: Biotechnic & Histochemistry: Official Publication of the Biological Stain Commission
S Suzuki
To predict the presence of histological funisitis at term, we examined the symptoms of clinical chorioamnionitis in 251 cases of maternal fever of 38 degrees or higher during labor at term. The examined symptoms in this study were clinical maternal findings (uterine fundal tenderness, maternal tachycardia, purulent or foul amniotic fluid or cervical discharge, and maternal white blood cell count) and fetal tachycardia. In these cases, microscopic histopathological analysis of the placenta was performed after delivery...
July 19, 2018: Journal of Neonatal-perinatal Medicine
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