Salafia C M, Weigl C, Silberman L
Department of Laboratory Medicine, Danbury Hospital, Connecticut.
Obstet Gynecol. 1989 Mar;73(3 Pt 1):383-9.
The clinical relevance of histologic evidence of acute ascending intrauterine infection has been called into question by descriptions of "silent" chorioamnionitis. The described frequencies of silent chorioamnionitis in normal and abnormal pregnancies vary widely because of differences in the definition of a normal pregnancy, methods of placental examination, and pathologic criteria. Therefore, we examined placentas from 161 uncomplicated gestations for the presence and severity of acute inflammation in the amnion, chorion-decidua, chorionic plate, and umbilical cord using strict gross and microscopic protocols. Indicators of amniotic fluid infection, specifically umbilical cord inflammation, amnionitis, and inflammation within the chorionic plate were present in 0, 1.2, and 4% of the cases, respectively. Silent chorioamnionitis was rare. There was a statistical association between the presence of acute inflammation and the occurrence of labor at term. Methods of tissue sampling that included a more extensive examination of the site of membrane rupture resulted in an increased frequency of diagnosis of acute inflammation at the site of rupture in vaginal deliveries at term.
“无症状”绒毛膜羊膜炎的描述对急性上行性宫内感染组织学证据的临床相关性提出了质疑。由于正常妊娠定义、胎盘检查方法和病理标准的差异，文献中报道的正常和异常妊娠中无症状绒毛膜羊膜炎的发生率差异很大。因此，我们使用严格的大体和显微镜检查方案，检查了161例无并发症妊娠的胎盘，以确定羊膜、绒毛膜 - 蜕膜、绒毛膜板和脐带中急性炎症的存在和严重程度。羊水感染的指标，特别是脐带炎症、羊膜炎和绒毛膜板内炎症，分别在0%、1.2%和4%的病例中出现。无症状绒毛膜羊膜炎很少见。急性炎症的存在与足月分娩的发生之间存在统计学关联。包括对胎膜破裂部位进行更广泛检查的组织取样方法，导致足月阴道分娩时破裂部位急性炎症的诊断频率增加。
