Chorioamnionitis laboratory findings
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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
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