Forensic and Legal Medicine Unit, Department of Pathology, College of Medicine, King Saud University, Riyadh 12372, Saudi Arabia.
Ann Diagn Pathol. 2022 Feb;56:151874. doi: 10.1016/j.anndiagpath.2021.151874. Epub 2021 Dec 7.
The histologic diagnosis of acute ascending intrauterine infection permits a higher-efficacy identification of both subclinical infection and clinical chorioamnionitis, but procedures for placental pathology need to adopt a unified approach and work toward reproducible grading and staging systems. We conducted a retrospective chart review of 696 placental records from single and multiple deliveries between January 2011 and February 2020. Then, we compared original diagnoses with diagnoses based on Redline criteria, which is an internationally recognized system of staging and grading. Of the 696 cases available for review, 255 had complete medical records. Findings showed a strong degree of agreement (90%-100%) between original investigators' histological diagnoses of acute ascending intrauterine infection and a review by researchers using Redline criteria. Although interobserver agreement was good, more education is needed on Redline criteria to avoid missed cases (primarily Stage 1), support protocols for pathologists and obstetricians/gynecologists in determining which cases need to be investigated, and the development of reporting standards for acute ascending intrauterine infection and feedback mechanisms during follow-up.
急性上行性宫内感染的组织学诊断可以更有效地识别亚临床感染和临床绒毛膜羊膜炎，但胎盘病理学程序需要采用统一的方法，并努力实现可重复的分级和分期系统。我们对 2011 年 1 月至 2020 年 2 月期间单胎和多胎分娩的 696 份胎盘记录进行了回顾性图表审查。然后，我们将原始诊断与基于 Redline 标准的诊断进行了比较，Redline 标准是一种国际公认的分期和分级系统。在可用于审查的 696 例中，有 255 例有完整的病历。研究结果显示，原始研究者对急性上行性宫内感染的组织学诊断与使用 Redline 标准的研究人员进行的回顾之间具有很强的一致性（90%-100%）。尽管观察者间的一致性很好，但仍需要更多关于 Redline 标准的教育，以避免漏诊（主要是 1 期），支持病理学家和妇产科医生确定需要调查哪些病例的方案，并制定急性上行性宫内感染的报告标准和随访期间的反馈机制。
