Shahshahan Zahra, Zarean Elahe, Jahanfar Samaneh, Hedayat Pegah
Department of Obstetrics and Gynecology, School of Medicine, Isfahan University of Medicine, Isfahan, Iran.
Department of Obstetrics and Gynecology, Al-Zahra Hospital, Isfahan, Iran.
Adv Biomed Res. 2024 Apr 27;13:33. doi: 10.4103/abr.abr_300_21. eCollection 2024.
Histological chorioamnionitis (HCA) is a histologic response to intra-uterine inflammation that is usually confirmed by pathology examination after pre-term delivery and characterized by acute granulocyte infiltration into the fetal-maternal or fetal tissues. This study aimed to compare the HCA in pre-term delivery with and without pre-term rupture of membrane for assessment of its role on early neonatal outcomes and fetal heart rate patterns.
This case-control study was conducted on placenta, chorionamnion, and cord of 100 cases with and without pre-term rupture of membrane between 28 0/7 and 36 6/7 weeks delivered between March 2018 and February 2021. The kind of delivery, gestational age, neonatal intensive care unit admission, a 5 min Apgar score <7, and fetal heart rate patterns in two groups with and without HCA were assessed.
The odds ratio (OR) for HCA was adjusted for fetal heart rate patterns, gestational age, and delivery mode (vaginal delivery or cesarean section). Vaginal delivery, gestational age, neonatal intensive care unit admission, and a 5 min Apgar score <7 were associated with HCA [OR: 2.4, 95% confidence interval (CI): 1.2-9.5, < 0.05; OR: 0.8, 95% CI: 0.5-1.1, < 0.05; OR: 1.1, 95% CI: 0.6-2.1, < 0.05; and OR: 0.9, 95% CI: 0.7-1.3, < 0.05), respectively. However, there were no specific fetal heart rate patterns associated with HCA.
Placental histology examination in pre-term infants with low Apgar scores may be useful to investigate the association between neonatal complications in pre-term delivery and asymptomatic chorioamnionitis.
组织学绒毛膜羊膜炎（HCA）是对宫内炎症的一种组织学反应，通常在早产分娩后通过病理检查确诊，其特征为急性粒细胞浸润到母胎或胎儿组织中。本研究旨在比较有胎膜早破和无胎膜早破的早产分娩中的HCA，以评估其对早期新生儿结局和胎儿心率模式的作用。
本病例对照研究对2018年3月至2021年2月期间分娩的100例孕28⁰/₇至36⁶/₇周有胎膜早破和无胎膜早破的胎盘、绒毛膜羊膜和脐带进行了研究。评估了两组有无HCA的分娩方式、孕周、新生儿重症监护病房收治情况、5分钟阿氏评分<7以及胎儿心率模式。
对HCA的比值比（OR）进行了胎儿心率模式、孕周和分娩方式（阴道分娩或剖宫产）的校正。阴道分娩、孕周、新生儿重症监护病房收治情况和5分钟阿氏评分<7与HCA相关[OR分别为：2.4，95%置信区间（CI）：1.2 - 9.5，P < 0.05；OR：0.8，95% CI：0.5 - 1.1，P < 0.05；OR：1.1，95% CI：0.6 - 2.1，P < 0.05；OR：0.9，95% CI：0.7 - 1.3，P < 0.05]。然而，没有与HCA相关的特定胎儿心率模式。
对阿氏评分低的早产儿进行胎盘组织学检查，可能有助于研究早产分娩中新生儿并发症与无症状绒毛膜羊膜炎之间的关联。
