Chorioamnionitis laboratory findings: Difference between revisions

	Chorioamnionitis Microchapters
Home
Patient Information
Overview
Historical Perspective
Classification
Pathophysiology
Causes
Differentiating Chorioamnionitis from other Diseases
Epidemiology and Demographics
Risk Factors
Screening
Natural History, Complications and Prognosis
Diagnosis
Diagnostic Study of Choice
History and Symptoms
Physical Examination
Laboratory Findings
Electrocardiogram
X-ray
Echocardiography and Ultrasound
CT scan
MRI
Other Imaging Findings
Other Diagnostic Studies
Treatment
Medical Therapy
Surgery
Primary Prevention
Secondary Prevention
Cost-Effectiveness of Therapy
Future or Investigational Therapies
Case Studies
Case #1
Chorioamnionitis laboratory findings On the Web
Most recent articles
Most cited articles
Review articles
CME Programs
Powerpoint slides
Images
American Roentgen Ray Society Images of Chorioamnionitis laboratory findings All Images X-rays Echo & Ultrasound CT Images MRI
Ongoing Trials at Clinical Trials.gov
US National Guidelines Clearinghouse
NICE Guidance
FDA on Chorioamnionitis laboratory findings
CDC on Chorioamnionitis laboratory findings
Chorioamnionitis laboratory findings in the news
Blogs on Chorioamnionitis laboratory findings
Directions to Hospitals Treating Chorioamnionitis
Risk calculators and risk factors for Chorioamnionitis laboratory findings

VisualWikitext

Latest revision as of 16:02, 12 June 2021

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] ; Associate Editor(s)-in-Chief: Adnan Ezici, M.D [2]

Overview

Laboratory findings consistent with the diagnosis of chorioamnionitis include maternal leukocytosis, left shift or elevated band count, amniotic fluid findings (e.g., positive amniotic fluid microbiological culture results, bacteria or white blood cells on gram stain, decreased glucose level, elevated IL-6 level, etc.), and histologic findings such as neutrophilic infiltration of chorioamniotic membranes.

Laboratory findings

Complete Blood Cell Count

Laboratory findings consistent with the diagnosis of chorioamnionitis include:^[1]

Maternal leukocytosis (> 12,000-15,000 per mm3)
Left shift or elevated band count (> 9%)

Histology

Histologic findings consistent with the diagnosis of chorioamnionitis include:^[2]^[3]

Neutrophilic infiltration of chorioamniotic membranes
Edema and necrosis of the amniotic epithelium (findings consistent with the necrotizing chorioamnionitis)
Microabscesses involving the subchorionic fibrin
Umbilical vasculitis with or without neutrophilic infiltration of Wharton's Jelly (acute funisitis)

Amniotic Fluid Testing

Amniotic fluid findings consistent with the diagnosis of chorioamnionitis include:^[1]

Positive microbiological culture results (diagnostic gold standard)
Bacteria or white blood cells (> 6/HPF) on gram stain
Decreased glucose level (< 15 mg/dl)
Elevated IL-6 level (> 7.9 ng/ml)
Positive matrix metalloproteinase
Elevated white blood cell count (> 30/cubic mm)
Positive leukocyte esterase on dipstick

References

↑ ^1.0 ^1.1 Tita AT, Andrews WW (June 2010). "Diagnosis and management of clinical chorioamnionitis". Clin Perinatol. 37 (2): 339–54. doi:10.1016/j.clp.2010.02.003. PMC 3008318. PMID 20569811.
↑ Kim CJ, Romero R, Chaemsaithong P, Chaiyasit N, Yoon BH, Kim YM (October 2015). "Acute chorioamnionitis and funisitis: definition, pathologic features, and clinical significance". Am J Obstet Gynecol. 213 (4 Suppl): S29–52. doi:10.1016/j.ajog.2015.08.040. PMC 4774647. PMID 26428501.
↑ Aljerian K (2020). "Chorioamnionitis: Establishing a correlation between clinical and histological diagnosis". Indian J Pathol Microbiol. 63 (1): 44–48. doi:10.4103/IJPM.IJPM_464_19. PMID 32031121 Check |pmid= value (help).

Template:WH Template:WS

[pmid20569811-1] 1.0 ^1.1 Tita AT, Andrews WW (June 2010). "Diagnosis and management of clinical chorioamnionitis". Clin Perinatol. 37 (2): 339–54. doi:10.1016/j.clp.2010.02.003. PMC 3008318. PMID 20569811.

[pmid26428501-2] Kim CJ, Romero R, Chaemsaithong P, Chaiyasit N, Yoon BH, Kim YM (October 2015). "Acute chorioamnionitis and funisitis: definition, pathologic features, and clinical significance". Am J Obstet Gynecol. 213 (4 Suppl): S29–52. doi:10.1016/j.ajog.2015.08.040. PMC 4774647. PMID 26428501.

[pmid32031121-3] Aljerian K (2020). "Chorioamnionitis: Establishing a correlation between clinical and histological diagnosis". Indian J Pathol Microbiol. 63 (1): 44–48. doi:10.4103/IJPM.IJPM_464_19. PMID 32031121 Check |pmid= value (help).

[1]

[2]

[3]

@@ Line 1: / Line 1: @@
 __NOTOC__
 {{Chorioamnionitis}}
-==Laboratory findings==
+{{CMG}} ; {{AE}} {{Adnan Ezici}}
-===Histology===
+==Overview==
-*Neutrophil infiltration.
+Laboratory findings consistent with the diagnosis of chorioamnionitis include maternal [[leukocytosis]], [[left shift]] or elevated band count, amniotic fluid findings (e.g., positive amniotic fluid [[microbiological culture]] results, [[bacteria]] or [[white blood cells]] on [[gram stain]], decreased [[glucose]] level, elevated [[IL-6]] level, etc.), and histologic findings such as [[Neutrophil|neutrophilic infiltration]] of chorioamniotic membranes.
-*Necrosis
-*Thickening of amnion basement membrane.
-*Chorionic microabscesses.
-*Chrionic or umblical vasculitis with neutrophils infiltration.
-*Inflammation of the matrix of the umblical cord (necrotizing funisitis).
-===Amniotic fluid culture===
+==Laboratory findings==
-It is the standard diagnosis for the infection, but the delay in results and lack of enough data support its morbidity and mortality prognostic value for both mother and neonates has limited its benefit as a routine test.
+===Complete Blood Cell Count===
+[[Laboratory]] findings consistent with the diagnosis of chorioamnionitis include:<ref name="pmid20569811">{{cite journal |vauthors=Tita AT, Andrews WW |title=Diagnosis and management of clinical chorioamnionitis |journal=Clin Perinatol |volume=37 |issue=2 |pages=339–54 |date=June 2010 |pmid=20569811 |pmc=3008318 |doi=10.1016/j.clp.2010.02.003 |url=}}</ref>
+*Maternal [[leukocytosis]] (> 12,000-15,000 per mm3)
+*[[Left shift]] or elevated band count (> 9%)
-===Other Tests===
+===Histology===
+[[Histologic]] findings consistent with the diagnosis of chorioamnionitis include:<ref name="pmid26428501">{{cite journal |vauthors=Kim CJ, Romero R, Chaemsaithong P, Chaiyasit N, Yoon BH, Kim YM |title=Acute chorioamnionitis and funisitis: definition, pathologic features, and clinical significance |journal=Am J Obstet Gynecol |volume=213 |issue=4 Suppl |pages=S29–52 |date=October 2015 |pmid=26428501 |pmc=4774647 |doi=10.1016/j.ajog.2015.08.040 |url=}}</ref><ref name="pmid32031121">{{cite journal |vauthors=Aljerian K |title=Chorioamnionitis: Establishing a correlation between clinical and histological diagnosis |journal=Indian J Pathol Microbiol |volume=63 |issue=1 |pages=44–48 |date=2020 |pmid=32031121 |doi=10.4103/IJPM.IJPM_464_19 |url=}}</ref>
+*[[Neutrophil|Neutrophilic infiltration]] of chorioamniotic membranes
+*[[Edema]] and [[necrosis]] of the amniotic epithelium (findings consistent with the necrotizing chorioamnionitis)
+*Microabscesses involving the subchorionic fibrin
+*Umbilical vasculitis with or without [[Neutrophil|neutrophilic infiltration]] of Wharton's Jelly (acute funisitis)
+===Amniotic Fluid Testing===
-'''Blood culture''':limited or no benefit due to lack of supporting evidence.
+[[Amniotic fluid]] findings consistent with the diagnosis of chorioamnionitis include:<ref name="pmid20569811">{{cite journal |vauthors=Tita AT, Andrews WW |title=Diagnosis and management of clinical chorioamnionitis |journal=Clin Perinatol |volume=37 |issue=2 |pages=339–54 |date=June 2010 |pmid=20569811 |pmc=3008318 |doi=10.1016/j.clp.2010.02.003 |url=}}</ref>
+*Positive [[microbiological culture]] results (diagnostic [[Gold standard (test)|gold standard]])
-'''High vaginal swabs''':as for blood culture, no proven benefit has been shown to use.
+*[[Bacteria]] or [[white blood cells]] (> 6/HPF) on [[gram stain]]
+*Decreased [[glucose]] level (< 15 mg/dl)
-'''Glucose measurement of low amniotic fluid''':values<5 mg/ml have predictive value for women with PPROM and infection, but lack sensitivity.
+*Elevated [[IL-6]] level (> 7.9 ng/ml)
+*Positive matrix metalloproteinase
-'''Biomarkers''': like fetal fibronectin, thrombin-antithromin complex and salivary proteases have more specificity for preterm births and PPROM than chorioamnionitis.
+*Elevated [[white blood cell]] count (> 30/cubic mm)
+*Positive [[leukocyte esterase]] on dipstick
 ==References==
@@ Line 30: / Line 34: @@
 {{WH}}
 {{WS}}
-[[Category:Needs content]]
+[[Category:NeedsEnglishReview]]
 [[Category:Disease]]
-[[Category:Infectious disease]]
 [[Category:Obstetrics]]
 [[Category:Inflammations]]
 [[Category:Bacterial diseases]]