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Histological chorioamnionitis associated with preterm prelabour rupture of membranes at Kingston General Hospital: a practice audit.
J Obstet Gynaecol Can. 2013 Dec; 35(12):1083-1089.JO

Abstract

OBJECTIVE

To determine the prevalence of histological chorioamnionitis associated with preterm prelabour rupture of membranes (PPROM) in women following spontaneous onset of labour, urgent delivery or planned delivery after 34 weeks' gestation.

METHODS

Charts of all women admitted to Kingston General Hospital with PPROM prior to 34 weeks' gestation over five years were collected. Obstetrical outcomes and histopathology reports were reviewed.

RESULTS

Two hundred forty-four women with PPROM were identified and reviewed. The majority of women (169; 69%) went into spontaneous labour and, of those, 24 (14%) had clinical chorioamnionitis and 79 (47%) had histological chorioamnionitis. Of the 45 women (18%) who required urgent delivery, 27 (60%) had clinical chorioamnionitis and 31 (69%) had histological chorioamnionitis. Only 26 of the original 244 women with PPROM (11%) were managed expectantly until 34 weeks' gestation and then had a planned delivery. The prevalence of histological chorioamnionitis in this group whose placentas were sent for histopathologic review was 24%. Overall, the clinical suspicion of chorioamnionitis was found to be specific (91%) but not sensitive (37%) for identifying chorioamnionitis on the basis of histopathology.

CONCLUSION

Histological chorioamnionitis complicates almost one half of all cases of PPROM that occur prior to 34 weeks' gestation. Most women will progress to spontaneous labour or require urgent delivery for clinical chorioamnionitis or other complications related to ruptured membranes before reaching 34 weeks' gestation. Only a subset of women remain pregnant long enough to have labour induced, but among those the prevalence of histological chorioamnionitis is lower (24%).

Authors+Show Affiliations

Department of Obstetrics and Gynaecology, Queen's University, Kingston ON.Department of Obstetrics and Gynaecology, Queen's University, Kingston ON.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

24405875

Citation

Magee, Bryden, and Graeme Smith. "Histological Chorioamnionitis Associated With Preterm Prelabour Rupture of Membranes at Kingston General Hospital: a Practice Audit." Journal of Obstetrics and Gynaecology Canada : JOGC = Journal D'obstetrique Et Gynecologie Du Canada : JOGC, vol. 35, no. 12, 2013, pp. 1083-1089.
Magee B, Smith G. Histological chorioamnionitis associated with preterm prelabour rupture of membranes at Kingston General Hospital: a practice audit. J Obstet Gynaecol Can. 2013;35(12):1083-1089.
Magee, B., & Smith, G. (2013). Histological chorioamnionitis associated with preterm prelabour rupture of membranes at Kingston General Hospital: a practice audit. Journal of Obstetrics and Gynaecology Canada : JOGC = Journal D'obstetrique Et Gynecologie Du Canada : JOGC, 35(12), 1083-1089. https://doi.org/10.1016/S1701-2163(15)30758-1
Magee B, Smith G. Histological Chorioamnionitis Associated With Preterm Prelabour Rupture of Membranes at Kingston General Hospital: a Practice Audit. J Obstet Gynaecol Can. 2013;35(12):1083-1089. PubMed PMID: 24405875.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Histological chorioamnionitis associated with preterm prelabour rupture of membranes at Kingston General Hospital: a practice audit. AU - Magee,Bryden, AU - Smith,Graeme, PY - 2014/1/11/entrez PY - 2014/1/11/pubmed PY - 2014/4/25/medline KW - chorioamnionitis KW - fetal membranes KW - premature birth KW - premature rupture SP - 1083 EP - 1089 JF - Journal of obstetrics and gynaecology Canada : JOGC = Journal d'obstetrique et gynecologie du Canada : JOGC JO - J Obstet Gynaecol Can VL - 35 IS - 12 N2 - OBJECTIVE: To determine the prevalence of histological chorioamnionitis associated with preterm prelabour rupture of membranes (PPROM) in women following spontaneous onset of labour, urgent delivery or planned delivery after 34 weeks' gestation. METHODS: Charts of all women admitted to Kingston General Hospital with PPROM prior to 34 weeks' gestation over five years were collected. Obstetrical outcomes and histopathology reports were reviewed. RESULTS: Two hundred forty-four women with PPROM were identified and reviewed. The majority of women (169; 69%) went into spontaneous labour and, of those, 24 (14%) had clinical chorioamnionitis and 79 (47%) had histological chorioamnionitis. Of the 45 women (18%) who required urgent delivery, 27 (60%) had clinical chorioamnionitis and 31 (69%) had histological chorioamnionitis. Only 26 of the original 244 women with PPROM (11%) were managed expectantly until 34 weeks' gestation and then had a planned delivery. The prevalence of histological chorioamnionitis in this group whose placentas were sent for histopathologic review was 24%. Overall, the clinical suspicion of chorioamnionitis was found to be specific (91%) but not sensitive (37%) for identifying chorioamnionitis on the basis of histopathology. CONCLUSION: Histological chorioamnionitis complicates almost one half of all cases of PPROM that occur prior to 34 weeks' gestation. Most women will progress to spontaneous labour or require urgent delivery for clinical chorioamnionitis or other complications related to ruptured membranes before reaching 34 weeks' gestation. Only a subset of women remain pregnant long enough to have labour induced, but among those the prevalence of histological chorioamnionitis is lower (24%). SN - 1701-2163 UR - https://www.unboundmedicine.com/medline/citation/24405875/Histological_chorioamnionitis_associated_with_preterm_prelabour_rupture_of_membranes_at_Kingston_General_Hospital:_a_practice_audit_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1701-2163(15)30758-1 DB - PRIME DP - Unbound Medicine ER -