Histological chorioamnionitis at term according to labor onset: a prospective controlled study.

OBJECTIVE

To study the incidence of histological chorioamnionitis (HCA) in term pregnancies according to labor onset.

STUDY

DESIGN

During 2013-6, term pregnancy placentas were prospectively sent to histopathology evaluation, and compared between patients with spontaneous onset labor, pre-labor ROM, labor induction and elective cesarean deliveries.

RESULTS

A total of 260 placentas were obtained, 65 from each group. Rates of HCA for the spontaneous labor, PROM, induction and CD groups were: 49, 32, 24 and 4%, respectively (p < 0.001). Composite neonatal outcome was non-significant between the study groups, and between cases with and without HCA. In a logistic regression model, after controlling for parity - gestational age, mode of delivery, ROM > 12 h and spontaneous onset of labor were found to be independent risk factors for HCA.

CONCLUSION

HCA at term is prevalent in spontaneous labor and supports the association between the inflammatory processes and activation of the physiological signals of parturition.