Document Detail


The histologic fetoplacental inflammatory response in fatal perinatal group B-streptococcus infection.
MedLine Citation:
PMID:  15141264     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To determine the rate of histologic fetoplacental inflammation in fetuses and newborns with fatal perinatal Group B-Streptococcus (GBS) infection. STUDY DESIGN: Autopsy files (1990 to 2002) were searched for fetuses and newborns with GBS-positive post-mortem blood and/or lung cultures. The rate of histological fetoplacental inflammation in preterm (< 36 weeks gestational age) and term (> or =36 weeks) fetuses/infants was compared using chi(2) test. RESULTS: GBS infection was diagnosed in 4.9% (61/1236) of perinatal autopsies and was considered the exclusive cause of death in 58 cases (16 to 41 weeks gestation, median: 26 weeks). A total of 43 fetuses/infants (74%) were preterm, 24 (41%) were male and 33 (57%) stillborn. The histologic fetoplacental inflammatory response was age-dependent for the following variables: acute chorioamnionitis (seen in 67% of preterm vs 33% of term fetuses/infants, p < 0.05), multiple-vessel umbilical vasculitis (37 vs 7%, p < 0.05), funisitis (37 vs 13%, p < 0.05), and the presence of neutrophils in the gastrointestinal tract (35% vs none, p < 0.05). Neutrophils in the pulmonary airspaces (47 vs 33%) and pneumonia (16 vs 27%) were found with similar frequency in both groups. CONCLUSION: Histologic fetoplacental inflammation is a poor indicator of perinatal GBS infection; the sensitivity is 67% in preterm and 33% in term fetuses/newborns (overall sensitivity 59%). The higher rate of histologic inflammation in preterm fetuses/newborns suggests age-specific interactions between microorganism, host and placenta.
Authors:
Monique E De Paepe; Rebecca M Friedman; Fusun Gundogan; Halit Pinar; Calvin E Oyer
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of perinatology : official journal of the California Perinatal Association     Volume:  24     ISSN:  0743-8346     ISO Abbreviation:  J Perinatol     Publication Date:  2004 Jul 
Date Detail:
Created Date:  2004-06-29     Completed Date:  2004-10-26     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  8501884     Medline TA:  J Perinatol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  441-5     Citation Subset:  IM    
Affiliation:
Department of Pathology, Women and Infants Hospital and Brown Medical School, 101 Dudley Street, Providence, RI 02905, USA.
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MeSH Terms
Descriptor/Qualifier:
Chorioamnionitis / pathology
Female
Fetal Diseases / pathology*
Gestational Age
Humans
Infant, Newborn
Placenta / pathology*
Pregnancy
Retrospective Studies
Sensitivity and Specificity
Streptococcal Infections / mortality,  pathology*
Streptococcus agalactiae*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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