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Histologic chorioamnionitis: an occult marker of severe pulmonary hypertension in the term newborn.
J Perinatol. 2005 Mar; 25(3):189-92.JP

Abstract

OBJECTIVE

To determine whether the presence of histologic chorioamnionitis is associated with the severity of Persistent Pulmonary Hypertension of the Newborn (PPHN) as evidenced by the use of exogenous nitric oxide (iNO), high-frequency oscillatory ventilation (HFOV), extra-corporeal membrane oxygenation (ECMO) and/or death.

METHODS

Retrospective chart review of term neonates > or =37 weeks gestation with PPHN. Placental pathology was reviewed. Primary outcome is the use of iNO. Secondary outcomes include the use of HFOV, ECMO and death.

RESULTS

Over 2 years, 29 neonates fulfilled the entry criteria for the study. Interventions included iNO use n=14 (48%), HFOV n=7 (24%) and ECMO n=3 (10%); two neonates died. Histologic chorioamnionitis and/or funisitis was noted in 16 (55%) neonates. The presence of chorioamnionitis and/or funisitis (n=16) versus neither (n=13) was significantly associated with iNO use 11/16 (78%) versus 3/13 (22%) (p=0.02) and HFOV 7/16 (43%) versus 0/13 (0%) (p=0.008) but not to ECMO or death.

CONCLUSION

The presence of histologic chorioamnionitis and/or funisitis is associated with more severe PPHN as indicated by the use of iNO as well as an increased requirement for more advanced respiratory support, that is, HFOV. The mechanism/s contributing to these findings are unclear.

Authors+Show Affiliations

Woldesenbet M
Department of Pediatrics, UT Southwestern Medical Center, Dallas, TX 75390-9063, USA.
Perlman JM
No affiliation info available

MeSH

ChorioamnionitisExtracorporeal Membrane OxygenationFemaleHigh-Frequency VentilationHumansInfant, NewbornMaleNitric OxidePersistent Fetal Circulation SyndromePregnancyProspective StudiesRetrospective Studies

Pub Type(s)

Journal Article

Language

eng

PubMed ID

15592427

Citation

Woldesenbet, Mesfin, and Jeffrey M. Perlman. "Histologic Chorioamnionitis: an Occult Marker of Severe Pulmonary Hypertension in the Term Newborn." Journal of Perinatology : Official Journal of the California Perinatal Association, vol. 25, no. 3, 2005, pp. 189-92.
Woldesenbet M, Perlman JM. Histologic chorioamnionitis: an occult marker of severe pulmonary hypertension in the term newborn. J Perinatol. 2005;25(3):189-92.
Woldesenbet, M., & Perlman, J. M. (2005). Histologic chorioamnionitis: an occult marker of severe pulmonary hypertension in the term newborn. Journal of Perinatology : Official Journal of the California Perinatal Association, 25(3), 189-92.
Woldesenbet M, Perlman JM. Histologic Chorioamnionitis: an Occult Marker of Severe Pulmonary Hypertension in the Term Newborn. J Perinatol. 2005;25(3):189-92. PubMed PMID: 15592427.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Histologic chorioamnionitis: an occult marker of severe pulmonary hypertension in the term newborn. AU - Woldesenbet,Mesfin, AU - Perlman,Jeffrey M, PY - 2004/12/14/pubmed PY - 2005/6/23/medline PY - 2004/12/14/entrez SP - 189 EP - 92 JF - Journal of perinatology : official journal of the California Perinatal Association JO - J Perinatol VL - 25 IS - 3 N2 - OBJECTIVE: To determine whether the presence of histologic chorioamnionitis is associated with the severity of Persistent Pulmonary Hypertension of the Newborn (PPHN) as evidenced by the use of exogenous nitric oxide (iNO), high-frequency oscillatory ventilation (HFOV), extra-corporeal membrane oxygenation (ECMO) and/or death. METHODS: Retrospective chart review of term neonates > or =37 weeks gestation with PPHN. Placental pathology was reviewed. Primary outcome is the use of iNO. Secondary outcomes include the use of HFOV, ECMO and death. RESULTS: Over 2 years, 29 neonates fulfilled the entry criteria for the study. Interventions included iNO use n=14 (48%), HFOV n=7 (24%) and ECMO n=3 (10%); two neonates died. Histologic chorioamnionitis and/or funisitis was noted in 16 (55%) neonates. The presence of chorioamnionitis and/or funisitis (n=16) versus neither (n=13) was significantly associated with iNO use 11/16 (78%) versus 3/13 (22%) (p=0.02) and HFOV 7/16 (43%) versus 0/13 (0%) (p=0.008) but not to ECMO or death. CONCLUSION: The presence of histologic chorioamnionitis and/or funisitis is associated with more severe PPHN as indicated by the use of iNO as well as an increased requirement for more advanced respiratory support, that is, HFOV. The mechanism/s contributing to these findings are unclear. SN - 0743-8346 UR - https://www.unboundmedicine.com/medline/citation/15592427/Histologic_chorioamnionitis:_an_occult_marker_of_severe_pulmonary_hypertension_in_the_term_newborn_ DB - PRIME DP - Unbound Medicine ER -