TY - JOUR
T1 - Histologic Funisitis and Likelihood of Intrauterine Inflammation or Infection
T2 - A Case-Control Study
AU - Doty, Morgen S.
AU - Salafia, Carolyn
AU - Shen-Schwarz, Susan
AU - Guzman, Edwin
AU - Saade, George R.
AU - Chauhan, Suneet P.
N1 - Funding Information:
This article was presented at the Central Association of Obstetricians and Gynecologists (CAOG) annual conference, Las Vegas, Nevada, October 26–29, 2016 and was the recipient of FAR (Fellows and Residents) Research Network Award.
Publisher Copyright:
© 2018 by Thieme Medical Publishers, Inc.
PY - 2018/7/1
Y1 - 2018/7/1
N2 - Objective The objective of this study was to ascertain the likelihood of isolated maternal fever and suspected intrauterine inflammation or infection or both (Triple I) among cases of histologic chorioamnionitis with funisitis (HCF) at term. Study Design In this case-control study, placental pathology records were reviewed to identify term singleton laboring patients with HCF. Controls (1:1) were matched for gestational age. Results During the 6-month period, there were 2,399 term deliveries of laboring women. Of 1,552 (65%) term placentas examined, 4% (n = 60) had HCF. Features of Triple I were significantly more common among cases than controls: (1) isolated maternal fever of ≥100.4°F, twice, at least 30 minutes apart (p = 0.014); (2) fever with fetal tachycardia (p = 0.029); 3) fever with either fetal tachycardia or white blood cell count greater than 15,000 per mm 3 (p = 0.034). The feature of Triple I with the highest sensitivity at 10% (95% confidence intervals [CI] 4-21%) was isolated maternal fever using ≥100.4°F on two occasions. The specificity for all features was consistently 100% (95% CI 91-100%). Conclusion To our knowledge, this is the first report on HCF and Triple I features. Though the sensitivity of Triple I to identify HCF is low, specificity is excellent.
AB - Objective The objective of this study was to ascertain the likelihood of isolated maternal fever and suspected intrauterine inflammation or infection or both (Triple I) among cases of histologic chorioamnionitis with funisitis (HCF) at term. Study Design In this case-control study, placental pathology records were reviewed to identify term singleton laboring patients with HCF. Controls (1:1) were matched for gestational age. Results During the 6-month period, there were 2,399 term deliveries of laboring women. Of 1,552 (65%) term placentas examined, 4% (n = 60) had HCF. Features of Triple I were significantly more common among cases than controls: (1) isolated maternal fever of ≥100.4°F, twice, at least 30 minutes apart (p = 0.014); (2) fever with fetal tachycardia (p = 0.029); 3) fever with either fetal tachycardia or white blood cell count greater than 15,000 per mm 3 (p = 0.034). The feature of Triple I with the highest sensitivity at 10% (95% confidence intervals [CI] 4-21%) was isolated maternal fever using ≥100.4°F on two occasions. The specificity for all features was consistently 100% (95% CI 91-100%). Conclusion To our knowledge, this is the first report on HCF and Triple I features. Though the sensitivity of Triple I to identify HCF is low, specificity is excellent.
KW - histologic chorioamnionitis with funisitis
KW - intrauterine inflammation or infection
KW - triple I
UR - http://www.scopus.com/inward/record.url?scp=85041109237&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85041109237&partnerID=8YFLogxK
U2 - 10.1055/s-0037-1620232
DO - 10.1055/s-0037-1620232
M3 - Article
C2 - 29365327
AN - SCOPUS:85041109237
SN - 0735-1631
VL - 35
SP - 858
EP - 864
JO - American Journal of Perinatology
JF - American Journal of Perinatology
IS - 9
ER -