• Title/Summary/Keyword: Funisitis

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Influence of histologic chorioamnionitis and funisitis on the level of peripheral blood C-reactive protein at birth in preterm infants (조산아에서 조직학적 융모양막염 및 제대 혈관염이 출생 직후 말초 혈액 C-반응성 단백의 농도에 미치는 영향)

  • Kim, Do-Hyun;Lee, Heun Ji;Kim, Hee Sup;Yoo, Byoung Hoon
    • Clinical and Experimental Pediatrics
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    • v.53 no.1
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    • pp.33-40
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    • 2010
  • Purpose : The objective of this study is to determine the change of C-reactive protein (CRP) levels in the peripheral blood of preterm infants at birth according to the stage of intrauterine inflammation. Methods : A total of 187 infants (<32 weeks of gestation) were divided into a "no histologic chorioamnionitis" [HCAM (-), n=85] group and a "histologic chorioamnionitis" [HCAM (+), n=102] group according to placental pathologic findings. Furthermore, the HCAM (+) group was subdivided into a "funisitis" [F (+), n=49] group and a "no funisitis" [F (-), n=53] group and also into a "funisitis/amnionitis" [FA (+), n=58] group and an "isolated chorio-deciduitis" [FA (-), n=44] group. High-sensitivity CRP levels in the peripheral blood at birth were measured.Results : Peripheral blood CRP levels were significantly higher in the HCAM (+), F (+), F (-), and FA (+) groups than in the HCAM (-) group, but were not significantly different between the FA (-) and HCAM (-) groups. In addition, peripheral blood CRP levels were significantly higher in the F (+) and FA (+) groups than in the F (-) and FA (-) groups, respectively. For identification of amnionitis or funisitis, a cut-off value of 0.02 mg/dL was chosen. Clinical chorioamnionitis, proven early onset sepsis, histologic chorioamnionitis, and funisitis had higher incidences in infants with peripheral blood CRP levels higher than 0.02 mg/dL. Conclusion : The present study shows that peripheral blood CRP levels at birth in preterm infants born before 32 weeks' gestation is significantly increased in amnionitis or funisitis and might reflect the progress of histologic chorioamnionitis.

Placental histopathology in late preterm infants: clinical implications

  • Ericksen, Kristina;Fogel, Joshua;Verma, Rita P.
    • Clinical and Experimental Pediatrics
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    • v.63 no.2
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    • pp.48-51
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    • 2020
  • Background: The etiopathogenesis of late preterm (LPT) birth is undetermined. Placental histopathology, which reflects an adverse intrauterine environment and is reportedly associated with preterm labor and neonatal morbidities, has not been studied in LPT infants. Purpose: We investigated placental pathological lesion as markers of an adverse intrauterine environment during LPT labor. Methods: This retrospective case-control study compared placental histopathological and clinical variables between LPT and term neonates. Placental variables included chorioamnionitis, funisitis, hemorrhage, abruption, infarction, calcification, and syncytial knots. Maternal variables included age, substance abuse, pregnancyassociated diabetes mellitus and hypertension, duration of rupture of membrane, antibiotic use, and magnesium sulfate, whereas, those of neonates included gestational age, birth weight, race, sex, and Apgar scores. Standard statistical proedures were applied to analyze the data. Results: Chorioamnionitis (50% vs. 17.8%, P<0.001) and funisitis (20% vs. 4.4%, P=0.002) were more common in term infants. Placental infarction rate was insignificantly higher in LPT infants (25.6% vs. 14.3%, P=0.08). The mothers in the LPT group were older (30.4 years vs. 28.1 years, P=0.05; odds ratio [OR], 1.06; 95% confidence interval [CI], 0.998-1.12, P=0.056) and more often suffered from hypertension (28.9 vs. 12.9 %, P=0.02), and received magnesium sulfate (48.9 vs. 20%, P< 0.001; OR, 2.86; 95% CI, 1.12-7.29, P<0.05). Duration of rupture of membrane was higher in term infants (13.6 hours vs. 9.1 hours, P<0.001). Chorioamnionitis (OR, 0.33; 95% CI, 0.13-0.79; P<0.05) was associated with a lower risk of LPT delivery. Conclusion: Placental infection is not a risk factor for LPT births. There is a nonsignificant predominance of vascular anomalies in LPT placentas. Higher maternal age, magnesium sulfate therapy, and maternal hypertension are clinical risk factors for LPT labor.