足月产时根据临产与否的组织学绒毛膜羊膜炎：一项前瞻性对照研究。
Histological chorioamnionitis at term according to labor onset: a prospective controlled study.
机构信息
Department of Obstetrics & Gynecology, affiliated with the Sackler Faculty of Medicine, Tel Aviv University, the Edith Wolfson Medical Center, Holon, Israel.
Department of Pathology, affiliated with the Sackler Faculty of Medicine, Tel Aviv University, the Edith Wolfson Medical Center, Holon, Israel.
出版信息
J Perinatol. 2019 Apr;39(4):581-587. doi: 10.1038/s41372-019-0327-8. Epub 2019 Feb 5.
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 < 0.001). Composite neonatal outcome was non-significant between the study groups, and between cases with and without HCA. In a logistic regression model, after controlling for parity - gestational age, mode of delivery, ROM > 12 h and spontaneous onset of labor were found to be independent risk factors for HCA.
CONCLUSION
HCA at term is prevalent in spontaneous labor and supports the association between the inflammatory processes and activation of the physiological signals of parturition.
目的
根据分娩发动情况，研究足月妊娠中组织学绒毛膜羊膜炎（HCA）的发生率。
研究设计
2013 年 6 月期间，前瞻性地将足月妊娠胎盘送检组织病理学评估，并比较自发性临产、胎膜早破、引产和择期剖宫产患者之间的差异。
结果
共获得 260 个胎盘，每组 65 个。自发性临产、胎膜早破、引产和剖宫产组的 HCA 发生率分别为：49%、32%、24%和 4%（p<0.001）。研究组之间以及 HCA 阳性和阴性病例之间的复合新生儿结局无显著差异。在逻辑回归模型中，在校正了产次-胎龄、分娩方式、胎膜早破>12 小时和自发性临产等因素后，发现胎膜早破>12 小时和自发性临产是 HCA 的独立危险因素。
结论
足月时 HCA 很常见，支持炎症过程与分娩生理信号激活之间的关联。
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