Aljerian Khaldoon
Department of Pathology, College of Medicine, King Saud University, Riyadh 12372, Saudi Arabia.
Indian J Pathol Microbiol. 2020 Jan-Mar;63(1):44-48. doi: 10.4103/IJPM.IJPM_464_19.
Chorioamnionitis that is associated with high rates of morbidity and mortality needs an early diagnosis for effective treatment. However, views are conflicting on the effectiveness of a clinical versus a histological diagnosis of the disease. The accuracy of clinical diagnoses should be evaluated by determining their correlation with histopathological data.
A total of 696 placental records from single and multiple pregnancies between January 2011 and February 2018 were collected and reviewed to determine if chorioamnionitis was present.
Of the 696 records, 255 had histological data available, and of these, histological evidence for chorioamnionitis was recorded in 135 (52.9%). Clinical chorioamnionitis diagnosis was insensitive (26.7%; 95% confidence interval 19.43%-34.96%) and inaccurate (61.1%; 95% confidence interval 54.90%-67.19%). As well, 73.3% of histologically positive chorioamnionitis cases were missed using clinical indicators.
Clinical diagnosis for chorioamnionitis is inaccurate; in our study, most of the positive cases were not diagnosed using clinical indicators. However, of the clinical indicators examined, maternal and fetal tachycardia were the most reliable.
与高发病率和死亡率相关的绒毛膜羊膜炎需要早期诊断以进行有效治疗。然而，对于该疾病临床诊断与组织学诊断的有效性，观点存在冲突。临床诊断的准确性应通过确定其与组织病理学数据的相关性来评估。
收集并回顾了2011年1月至2018年2月期间单胎和多胎妊娠的696份胎盘记录，以确定是否存在绒毛膜羊膜炎。
在696份记录中，有255份有组织学数据，其中135份（52.9%）记录有绒毛膜羊膜炎的组织学证据。临床绒毛膜羊膜炎诊断不敏感（26.7%；95%置信区间19.43%-34.96%）且不准确（61.1%；95%置信区间54.90%-67.19%）。此外，使用临床指标漏诊了73.3%组织学阳性的绒毛膜羊膜炎病例。
绒毛膜羊膜炎的临床诊断不准确；在我们的研究中，大多数阳性病例未通过临床指标诊断出来。然而，在所检查的临床指标中，母体和胎儿心动过速是最可靠的。
