Histologic Funisitis and Likelihood of Intrauterine Inflammation or Infection: A Case-Control Study

Morgen S. Doty, Carolyn Salafia, Susan Shen-Schwarz, Edwin Guzman, George Saade, Suneet P. Chauhan

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4 Scopus citations

Abstract

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.

Original languageEnglish (US)
Pages (from-to)858-864
Number of pages7
JournalAmerican Journal of Perinatology
Volume35
Issue number9
DOIs
StatePublished - Jul 1 2018

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Keywords

  • histologic chorioamnionitis with funisitis
  • intrauterine inflammation or infection
  • triple I

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Obstetrics and Gynecology

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