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胎盘膜和脐带的冰冻切片:早期新生儿败血症管理的有效诊断工具。

Frozen Section of Placental Membranes and Umbilical Cord: A Valid Diagnostic Tool for Early-Onset Neonatal Sepsis Management.

作者信息

Parrella Veronica, Paudice Michele, Pittaluga Michela, Allodi Alessandra, Fulcheri Ezio, Buffelli Francesca, Barra Fabio, Ferrero Simone, Arioni Cesare, Vellone Valerio Gaetano

机构信息

Department of Integrated Surgical and Diagnostic Sciences (DISC), University of Genoa, Viale Benedetto XV, 14, 16132 Genoa, Italy.

Pathology University Unit, IRCCS Ospedale Policlinico San Martino, Largo R.Benzi, 10, 16132 Genoa, Italy.

出版信息

Diagnostics (Basel). 2024 May 31;14(11):1157. doi: 10.3390/diagnostics14111157.

Abstract

Early-onset neonatal sepsis (EONS), a serious infection in newborns within 3 days, is challenging to diagnose. The current methods often lack accuracy, leading to unnecessary antibiotics or delayed treatment. This study investigates the role of the frozen section examination of placental membranes and umbilical cord (FSMU) to improve EONS diagnosis in the daily lab practice. This retrospective study reviewed data from 59 neonates with EONS risk factors who underwent FSMU according to our institutional protocol. Concordance between the FSMU and the Final Pathological Report (FPR) was assessed. The FSMU demonstrated a high concordance (Kappa = 0.88) for funisitis diagnosis, with excellent accuracy (98.3%). A moderate concordance was observed for chorioamnionitis stage and grade. The FSMU shows promise as a rapid and accurate tool for diagnosing EONS, particularly for funisitis. This study suggests that the FSMU could be a valuable tool for EONS diagnosis, enabling a more judicious antibiotic use and potentially improving outcomes for newborns.

摘要

早发型新生儿败血症(EONS)是指新生儿在出生3天内发生的严重感染,诊断具有挑战性。目前的方法往往缺乏准确性,导致不必要的抗生素使用或治疗延迟。本研究探讨胎盘胎膜和脐带冰冻切片检查(FSMU)在日常实验室实践中对改善EONS诊断的作用。这项回顾性研究回顾了59例具有EONS危险因素并根据我们机构方案接受FSMU检查的新生儿的数据。评估了FSMU与最终病理报告(FPR)之间的一致性。FSMU对脐带炎诊断显示出高度一致性(Kappa = 0.88),准确性极佳(98.3%)。对于绒毛膜羊膜炎的分期和分级观察到中度一致性。FSMU有望成为诊断EONS的快速准确工具,尤其是对于脐带炎。本研究表明,FSMU可能是EONS诊断的有价值工具,能够更明智地使用抗生素,并可能改善新生儿的预后。

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