Correlation between placental bacterial PCR results and histological chorioamnionitis: a prospective study on 41 placentas

Abstract

Chorioamnionitis or intra-uterine inflammation is considered the most common infection diagnosed in labor and delivery units worldwide. It is a leading cause of maternal morbidity and mortality, as well as neonatal death and sepsis. The heterogeneity of this clinical syndrome has been recently reported. The objectives of this study were to determine: 1) placental microbiology using molecular microbiological techniques; 2) diagnostic accuracy of the clinical criteria used to identify patients with placental bacterial infection; 3) relationship between placental bacterial infection and histological chorioamnionitis. This prospective cross-sectional study included 41 women diagnosed with clinical and histological chorioamnionitis. The presence of microorganisms in the placenta was determined by conducting placental analysis using a broad range of polymerase chain reactions (PCR). Bacterial placental infection (defined as the presence of the 16S gene detected in placental tissue using the molecular technique PCR) was observed in 63% (26/41) of parturients diagnosed with histological chorioamnionitis. The traditional criteria for diagnosing clinical chorioamnionitis exhibit poor diagnostic performance in accurately identifying proven intra-amniotic infection. The molecular analysis (PCR) of the placenta has suggested that acute chorioamnionitis commonly has a bacterial origin.

Keywords

• Placenta
• clinical chorioamnionitis
• histological chorioamnionitis
• polymerase chain reaction
• bacterial placental infection