足月分娩产妇临床绒毛膜羊膜炎体征的准确性。
Accuracy of signs of clinical chorioamnionitis in the term parturient.
机构信息
Department of Obstetrics and Gynecology, University of Rochester School of Medicine and Dentistry, Rochester, NY, USA.
出版信息
J Perinatol. 2013 Jun;33(6):422-8. doi: 10.1038/jp.2012.135. Epub 2012 Nov 15.
OBJECTIVE
Uniform histopathologic guidelines were applied to diagnose chorioamnionitis and estimate the accuracy of clinical signs in term parturients.
STUDY DESIGN
A retrospective cohort study utilized slides from term parturient placentas with Amniotic Fluid Infection Nosology Committee guidelines as the gold standard. Sensitivity, specificity and accuracy for fever, maternal tachycardia and fetal tachycardia were calculated.
RESULT
Of 641 placentas, 367 (57.3%) had histologic chorioamnionitis and 274 (42.7%) were negative. Fever had a sensitivity of 42%, specificity of 86.5% and accuracy of 61%. Fever, maternal tachycardia and fetal tachycardia had a sensitivity of 18.3%, specificity of 98.2% and accuracy of 52.4%.
CONCLUSION
Histologic chorioamnionitis, frequently asymptomatic, is a common finding in placentas examined from term parturients. Clinical signs are not accurate in the diagnosis. Adoption of uniform pathologic guidelines will facilitate research into the clinical significance of these lesions in the future.
目的
应用统一的组织病理学标准诊断绒毛膜羊膜炎，并评估足月产妇临床体征的准确性。
研究设计
本回顾性队列研究利用了符合羊水感染分类委员会标准的足月产妇胎盘切片作为金标准。计算了发热、母体心动过速和胎儿心动过速的敏感性、特异性和准确性。
结果
在 641 个胎盘中有 367 个（57.3%）存在组织学绒毛膜羊膜炎，274 个（42.7%）为阴性。发热的敏感性为 42%，特异性为 86.5%，准确性为 61%。发热、母体心动过速和胎儿心动过速的敏感性为 18.3%，特异性为 98.2%，准确性为 52.4%。
结论
组织学绒毛膜羊膜炎常无症状，是检查足月产妇胎盘时常见的发现。临床体征在诊断中并不准确。采用统一的病理标准将有助于未来研究这些病变的临床意义。
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