Acute chorioamnionitis and intra-amniotic inflammation are more severe according to outside-in neutrophil migration within the same chorio-deciduaopen access
- Authors
- Oh, Jeong-Won; Moon, Kyung Chul; Park, Chan-Wook; Park, Joong Shin; Jun, Jong Kwan
- Issue Date
- Jul-2021
- Publisher
- Elsevier Taiwan
- Keywords
- Ascending intra-uterine infection; Chorio-deciduitis; Histologic chorio-amnionitis; Intra-amniotic inflammation; Neutrophil migration
- Citation
- Taiwanese Journal of Obstetrics and Gynecology, v.60, no.4, pp 639 - 652
- Pages
- 14
- Journal Title
- Taiwanese Journal of Obstetrics and Gynecology
- Volume
- 60
- Number
- 4
- Start Page
- 639
- End Page
- 652
- URI
- https://scholarworks.bwise.kr/sch/handle/2021.sw.sch/18735
- DOI
- 10.1016/j.tjog.2021.05.011
- ISSN
- 1028-4559
1875-6263
- Abstract
- Objective: No information exists about whether acute histologic chorioamnionitis (acute-HCA) is more advanced and severe, and intra-amniotic inflammation is more frequent and intense according to outside in neutrophil migration within the same chorio-decidua. The objective of current study is to examine this issue. Materials and methods: We included 106 singleton preterm-births (gestational age at delivery: 20-34 weeks) due to either preterm-labor or preterm-PROM in the context of acute chorio-deciduitis. Studypopulation was divided into 3 groups according to outside-in neutrophil migration within choriodecidua as follows: 1) group-1: 'inflammation restricted to the decidua' (n = 22); 2) group-2: 'inflammation restricted to the MT of chorion and the decidua' (n = 31); 3) group-3: 'inflammation in the CT of chorion' (n = 53). We examined the frequency of inflammation in each placental compartment beyond chorio-decidua (i.e., amnion, umbilical cord, and chorionic-plate), and total grade (1-8) of acute-HCA. Moreover, the frequency of intra-amniotic infection (defined as positive amniotic-fluid culture for aerobic and anaerobic bacteria and genital mycoplasmas) and intra-amniotic inflammation (defined as amniotic fluid WBC > 19 cells/mm3), and an intra-amniotic inflammatory response gauged by amnioticfluid WBC count (cells/mm3) were examined in 50 amniotic fluid samples within 7 days of birth. Results: Amnionitis, funisitis and chorionic plate inflammation were more frequent (each for P < 0.01) and median total grade of acute-HCA was increased (P < 0.001) according to outside-in neutrophil migration within chorio-decidua (group-1vs.group-2vs.group-3). Moreover, intra-amniotic infection and inflammation were more frequent (each-for P < 0.05) and median amniotic-fluid WBC count was increased (P < 0.01) according-to outside-in neutrophil-migration within chorio-decidua (group-1 vs. group-2 vs. group-3). Conclusion: Acute-HCA is more advanced and severe, and intra-amniotic inflammation is more frequent and intense according to outside in neutrophil migration within the same chorio-decidua. This finding suggests that what is now acute chorio-deciduitis should be subdivided. (c) 2021 Taiwan Association of Obstetrics & Gynecology. Publishing services by Elsevier B.V. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
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