Chorioamnionitis laboratory findings: Difference between revisions

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Revision as of 11:48, 6 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

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 (test)gold standard)
Bacteria or white blood cells (> 6/HPF) on gram stain
Decreased glucose level (< 15 mg/dl)
Elevated IL-6 (> 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).

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[2]

[3]

@@ Line 1: / Line 1: @@
 __NOTOC__
 {{Chorioamnionitis}}
-==Laboratory findings==
+{{CMG}} ; {{AE}} {{Adnan Ezici}}
-===Histology===
+==Overview==
-*Neutrophil infiltration.
-*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
-'''Blood culture''':limited or no benefit due to lack of supporting evidence and delay of results.
+*[[Edema]] and [[necrosis]] of the amniotic epithelium (findings consistent with the necrotizing chorioamnionitis)
+*Microabscesses involving the subchorionic fibrin
-'''High vaginal swabs''':as for blood culture, no proven benefit has been shown to use.
+*Umbilical vasculitis with or without [[Neutrophil|neutrophilic infiltration]] of Wharton's Jelly (acute funisitis)
-'''Glucose measurement of low amniotic fluid''':values<5 mg/ml have predictive value for women with PPROM and infection, but lack sensitivity.
-'''Biomarkers''': like fetal fibronectin, thrombin-antithromin complex and salivary proteases have more specificity for preterm births and PPROM than chorioamnionitis.
+==Amniotic Fluid Testing==
+[[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]])
+*[[Bacteria]] or [[white blood cells]] (> 6/HPF) on [[gram stain]]
+*Decreased [[glucose]] level (< 15 mg/dl)
+*Elevated [[IL-6]] (> 7.9 ng/ml)
+*Positive matrix metalloproteinase
+*Elevated [[white blood cell]] count (> 30/cubic mm)
+*Positive [[leukocyte esterase]] on dipstick
 ==References==