Association between clinical chorioamnionitis and histological funisitis at term

Article type: Research Article

Authors: Suzuki, S.^{; *}

Affiliations: Department of Obstetrics and Gynecology, Japanese Red Cross Katsushika Maternity Hospital, Tokyo, Japan

Correspondence: [*] Address for correspondence: Shunji Suzuki, MD, Department of Obstetrics and Gynecology, Japanese Red Cross Katsushika Maternity Hospital, 5-11-12 Tateishi, Katsushika-ku, Tokyo 124-0012, Japan. Tel.: +81 3 3693 5211; Fax: +81 3 3694 8725; E-mail: [email protected].

Abstract: To predict the presence of histological funisitis at term, we examined the symptoms of clinical chorioamnionitis in 251 cases of maternal fever of 38 degrees or higher during labor at term. The examined symptoms in this study were clinical maternal findings (uterine fundal tenderness, maternal tachycardia, purulent or foul amniotic fluid or cervical discharge, and maternal white blood cell count) and fetal tachycardia. In these cases, microscopic histopathological analysis of the placenta was performed after delivery. The positive predictive value for histological funisitis in cases of maternal fever of 38 degrees or higher was only 15.5%. In cases of maternal fever with uterine fundal tenderness and purulent or foul amniotic fluid or cervical discharge at term, the positive predictive value for histological chorioamnionitis was 100%. Therefore, uterine fundal tenderness and amniotic fluid or cervical discharge with a foul odor are important symptoms to predict the presence of funisitis in cases of maternal fever of 38 degrees or higher.

Keywords: Clinical chorioamnionitis, uterine fundal tenderness, purulent or foul amniotic fluid or cervical discharge, histological funisitis

DOI: 10.3233/NPM-17155

Journal: Journal of Neonatal-Perinatal Medicine, vol. 12, no. 1, pp. 37-40, 2019