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Ginecología y Obstetricia de México

Federación Mexicana de Ginecología y Obstetricia, A.C.
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2021, Number 03

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Ginecol Obstet Mex 2021; 89 (03)

Histopathological characteristics of the placenta with premature rupture of preterm fetal membranes in a university hospital in Colombia

Mejía FA, Hernández-Flórez CE, Sandoval DK
Full text How to cite this article

Language: Spanish
References: 22
Page: 212-221
PDF size: 284.77 Kb.


Key words:

Fetal membranes premature rupture, placenta, placenta diseases, chorioamnionitis, placental circulation.

ABSTRACT

Objective: To evaluate whether there are histopathologic differences between preterm premature rupture of fetal membranes, chronic chorioamnionitis, and ascending intraamniotic infection in placentas of patients a diagnosed with preterm premature rupture of fetal membranes among different gestational age groups.
Materials and Methods: A descriptive cross-sectional observational study was made with the placentas obtained by premature rupture of preterm fetal membranes in the Hospital Universitario de Santander, Colombia, during the year 2016. The clinical variables and histopathological findings were related to gestational age and analyzed by reasons and proportions, applying measures of statistical significance (t test, chi square), with acceptance of statistical significance for p ‹ 0.05.
Results: Sixty-five placentas were obtained between 22 and 36.6 weeks of gestation. Nine were found with a diagnosis of chorioamnionitis, 30 with ascending intra-amniotic infection and 26 with a fetal inflammatory response, more frequent in early gestational ages. Of the placentas without ascending intraamniotic infection, 14 had maternal vascular malperfusion changes.
Conclusions: The ascending intra-amniotic infection and the maternal vascular malperfusion the main causes of premature rupture of preterm fetal membranes in the population studied.


REFERENCES

  1. López-Osma FA, Ordoñez-Sánchez SA. Ruptura prematura de membranas fetales: de la fisiopatología hacia los marcadores tempranos de la enfermedad. Rev Colomb Obstet Ginecol. 2006; 57 (4): 279-90. https://doi.org/10.18597/ rcog.466.

  2. Palmsten K, Nelson KK, Laurent LC, Park S, Chambers CD, Parast MM. Subclinical and Clinical Chorioamnionitis, Fetal Vaculitis, and Risk for Preterm Birth: A Cohort Study. Placenta. 2018; (67): 54-60. https://doi.org/10.1016/j. placenta.2018.06.001.

  3. Galinsky R, Polglase GR, Hooper SB, Black MJ, Moss TJM. The Consequences of Chorioamnionitis: Preterm Birth and Effects on Development. J Pregnancy. 2013; 2013: 1-11. https://doi.org/10.1155/2013/412831.

  4. Lahra MM, Beeby PJ, Jeffery HE. Maternal versus fetal inflammation and respiratory distress syndrome: a 10- year hospital cohort study. Arch Dis Child - Fetal Neonatal Ed. 2008; 94 (1): F13-F16. http://dx.doi.org/10.1136/ adc.2007.135889.

  5. Suzuki S. Association between clinical chorioamnionitis and histological funisitis at term. J Neonatal Perinat Med. 2019; 12 (1): 37-40. doi:10.3233/NPM-17155.

  6. Morgan T. Role of the Placenta in Preterm Birth: A Review. Am J Perinatol. 2016; 33 (03): 258-66. doi:10.1055/s-0035-1570379.

  7. Aljerian K. Chorioamnionitis: Establishing a correlation between clinical and histological diagnosis. Indian J Pathol Microbiol. 2020; 63 (1): 44. doi:10.4103/IJPM.IJPM_464_19.

  8. Dammann O, Leviton A, Gappa M, Dammann CEL. Lung and brain damage in preterm newborns, and their association with gestational age, prematurity subgroup, infection/ inflammation and long term outcome. BJOG An Int J Obstet Gynaecol. 2005; 112: 4-9. https://doi.org/10.1111/j.1471- 0528.2005.00576.x.

  9. Raghavan R, Helfrich BB, Cerda SR, et al. Preterm birth subtypes, placental pathology findings, and risk of neurodevelopmental disabilities during childhood. Placenta. 2019; 83: 17-25. https://doi.org/10.1016/j.placenta.2019.06.374.

  10. Hockney R, Waring GJ, Taylor G, et al. Fetal membrane bacterial load is increased in histologically confirmed inflammatory chorioamnionitis: A retrospective cohort study: Fetal membrane bacterial load is increased in HCA. Placenta. 2020; 91: 43-51. https://doi.org/10.1016/j.placenta.2020.01.006.

  11. Redline RW, Faye-Petersen O, Heller D, Qureshi F, Savell V, Vogler C. Amniotic Infection Syndrome: Nosology and Reproducibility of Placental Reaction Patterns. Pediatr Dev Pathol. 2003; 6 (5): 435-48. https://doi.org/10.1007/s10024-003-7070-y.

  12. Cornette L. Fetal and neonatal inflammatory response and adverse outcome. Semin Fetal Neonatal Med. 2004; 9 (6): 459-70. doi:10.1016/j.siny.2004.08.004.

  13. Khong TY, Mooney EE, Ariel I, et al. Sampling and Definitions of Placental Lesions: Amsterdam Placental Workshop Group Consensus Statement. Arch Pathol Lab Med. 2016; 140 (7): 698-713. https://doi.org/10.5858/arpa.2015-0225-CC.

  14. Kovo M, Schreiber L, Ben-Haroush A, et al. The placental factor in spontaneous preterm labor with and without premature rupture of membranes. J Perinat Med. 2011; 39 (4): 423-29. https://doi.org/10.1515/jpm.2011.038.

  15. Gündoğan F, De Paepe ME. Ascending Infection. Surg Pathol Clin. 2013; 6 (1): 33-60. https://doi.org/10.1016/j. path.2012.11.002.

  16. Smulian J. Clinical chorioamnionitis and histologic placental inflammation. Obstet Gynecol. 1999; 94 (6): 1000-1005. https://doi.org/10.1016/S0029-7844(99)00416-0.

  17. Garmi G, Okopnik M, Keness Y, Zafran N, Berkowitz E, Salim R. Correlation between Clinical, Placental Histology and Microbiological Findings in Spontaneous Preterm Births. Fetal Diagn Ther. 2016; 40 (2): 141-49. https://doi. org/10.1159/000441518.

  18. Moraes M, Cancela M, Repetto M, Gutierrez C, Fiol V, Piriz G. Corioamnionitis histológica en el recién nacido menor de 1000 gramos. Incidencia y resultados perinatales. Rev Chil Pediatr. 2008; 79 (1): 53-59. doi:10.4067/S0370- 41062008000100014.

  19. Armstrong-Wells J, Post MD, Donnelly M, Manco- Johnson MJ, Fisher BM, Winn VD. Patterns of placental pathology in preterm premature rupture of membranes. J Dev Orig Heal Dis. 2013; 4 (3): 249-55. 10.1017/ S2040174413000056.

  20. Lee Y, Kim H-J, Choi S-J, et al. Is there a stepwise increase in neonatal morbidities according to histological stage (or grade) of acute chorioamnionitis and funisitis?: effect of gestational age at delivery. J Perinat Med. 2015; 43 (2): 259-67. https://doi.org/10.1515/jpm-2014-0035.

  21. Lee J, Kim J-S, Park JW, et al. Chronic chorioamnionitis is the most common placental lesion in late preterm birth. Placenta. 2013; 34 (8): 681-89. https://doi.org/10.1016/j. placenta.2013.04.014.

  22. Kim YM, Chaemsaithong P, Romero R, et al. Placental lesions associated with acute atherosis. J Matern Fetal Neonatal Med. 2015; 28 (13): 1554-62. https://doi.org/1 0.3109/14767058.2014.960835.




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Ginecol Obstet Mex. 2021;89