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Difference between revisions of "Chorioamnionitis"
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# | {{ Infobox diagnosis | ||
| Name = {{PAGENAME}} | |||
| Image = Chorioamnionitis_-2-_very_high_mag.jpg | |||
| Width = | |||
| Caption = Chorioamnionitis. [[H&E stain]]. | |||
| Micro = | |||
| Subtypes = | |||
| LMDDx = | |||
| Stains = | |||
| IHC = | |||
| EM = | |||
| Molecular = | |||
| IF = | |||
| Gross = | |||
| Grossing = | |||
| Site = [[placenta]] | |||
| Assdx = [[funisitis]] | |||
| Syndromes = | |||
| Clinicalhx = | |||
| Signs = fetal tachycardia, maternal fever | |||
| Symptoms = | |||
| Prevalence = common | |||
| Bloodwork = | |||
| Rads = | |||
| Endoscopy = | |||
| Prognosis = good | |||
| Other = | |||
| ClinDDx = | |||
}} | |||
'''Chorioamnionitis''' is a common pathology of the [[placenta]]. | |||
==General== | |||
*Associated with pre-term labour.<ref name=pmid22958008>{{Cite journal | last1 = Martinelli | first1 = P. | last2 = Sarno | first2 = L. | last3 = Maruotti | first3 = GM. | last4 = Paludetto | first4 = R. | title = Chorioamnionitis and prematurity: a critical review. | journal = J Matern Fetal Neonatal Med | volume = 25 Suppl 4 | issue = | pages = 29-31 | month = Oct | year = 2012 | doi = 10.3109/14767058.2012.714981 | PMID = 22958008 }}</ref> | |||
**Classically described as due to an ascending infection. | |||
*At term usually non-infectious.<ref name=pmid22412842>{{Cite journal | last1 = Roberts | first1 = DJ. | last2 = Celi | first2 = AC. | last3 = Riley | first3 = LE. | last4 = Onderdonk | first4 = AB. | last5 = Boyd | first5 = TK. | last6 = Johnson | first6 = LC. | last7 = Lieberman | first7 = E. | title = Acute histologic chorioamnionitis at term: nearly always noninfectious. | journal = PLoS One | volume = 7 | issue = 3 | pages = e31819 | month = | year = 2012 | doi = 10.1371/journal.pone.0031819 | PMID = 22412842 }}</ref> | |||
Clinical features: | |||
*Maternal fever. | |||
*Premature rupture of membranes (PROM). | |||
*Non-reassuring fetal heart rate (NRFHR). | |||
Management: | |||
*Antibiotics - usually ampicillin and gentamicin.<ref name=pmid20569811>{{Cite journal | last1 = Tita | first1 = AT. | last2 = Andrews | first2 = WW. | title = Diagnosis and management of clinical chorioamnionitis. | journal = Clin Perinatol | volume = 37 | issue = 2 | pages = 339-54 | month = Jun | year = 2010 | doi = 10.1016/j.clp.2010.02.003 | PMID = 20569811 | PMC = 3008318 }}</ref> | |||
==Gross== | |||
*Fetal membranes dull/opaque. | |||
==Microscopic== | |||
Features: | |||
*Neutrophils in the amnion. | |||
**Amnion: | |||
***The simple cuboidal epithelium and the paucicellular underlying connective tissue | |||
***Separated from the chorion by an artefactual cleft. | |||
*+/-Microorganisms (e.g. cocci<ref>{{Cite journal | last1 = Murdoch | first1 = DA. | title = Gram-positive anaerobic cocci. | journal = Clin Microbiol Rev | volume = 11 | issue = 1 | pages = 81-120 | month = Jan | year = 1998 | doi = | PMID = 9457430 | PMC = 121377}} | |||
</ref>) - very uncommon to see. | |||
Note: | |||
*Severe cases may have umbilical cord vasculitis or [[funisitis]]. | |||
===Images=== | |||
<gallery> | |||
Image:Chorioamnionitis_-_low_mag.jpg | Chorioamnionitis - low mag. (WC) | |||
Image:Chorioamnionitis_-_high_mag.jpg | Chorioamnionitis - high mag. (WC) | |||
Image:Chorioamnionitis_-2-_very_high_mag.jpg | Chorioamnionitis - very high mag. (WC) | |||
</gallery> | |||
===Grading chorioamnionitis=== | |||
Chorioamnionitis:<ref name=Ref_Sternberg4_2311>{{Ref Sternberg4|2311}}</ref> | |||
# placental chorionic plate only. | |||
# 1 + subamniotic tissue. | |||
# 1 or 2 + necrosis ''or'' abscess. | |||
==Sign out== | |||
<pre> | |||
PLACENTA, UMBILICAL CORD AND FETAL MEMBRANES, CESAREAN SECTION: | |||
- CHORIOAMNIONITIS. | |||
- FETAL MEMBRANES NEGATIVE FOR MECONIUM. | |||
- THREE VESSEL UMBILICAL CORD WITHIN NORMAL LIMITS. | |||
- PLACENTAL DISC WITH THIRD TRIMESTER VILLI. | |||
- THROMBUS OF THE PLACENTAL DISC (1.3 CM - MAXIMAL DIMENSION). | |||
</pre> | |||
===Chorioamnionitis and funisitis=== | |||
<pre> | |||
PLACENTA, UMBILICAL CORD AND FETAL MEMBRANES, CESAERIAN SECTION: | |||
- CHORIOAMNIONITIS, MODERATE. | |||
- THREE VESSEL UMBILICAL CORD WITH FUNISITIS, MILD. | |||
- FETAL MEMBRANES NEGATIVE FOR MECONIUM. | |||
- PLACENTAL DISC WITH THIRD TRIMESTER VILLI. | |||
- THROMBUS OF THE PLACENTAL DISC (1.3 CM - MAXIMAL DIMENSION). | |||
</pre> | |||
==See also== | |||
*[[Membranitis]]. | |||
*[[Funisitis]]. | |||
*[[Placenta]]. | |||
*[[Meconium]]. | |||
==References== | |||
{{Reflist|2}} | |||
[[Category:Diagnosis]] | [[Category:Diagnosis]] | ||
[[Category:Placenta]] | |||