RCOG World Congress 2023

RETROSPECTIVE STUDY ON CONFIRMED CHORIOAMNIONITIS ON HISTOLOGY

Marufa Sultana (SAS Doctor); Saranya Elancheran (Senior Clinical Fellow); Alia Bashir (ST7); Sajitha Parveen (Consultant)

Grange University Hospital, Cwmbran, NP44 8YN

INTRODUCTION

Chorioamnionitis refers to the inflammation of the chorion and

the amnion. It can lead to adverse perinatal outcomes including

cerebral palsy and it is one of the leading causes of non-hypoxic

damage in the fetuses. There are criteria for clinical diagnosis of

chorioamnionitis including maternal pyrexia, maternal or fetal

tachycardia or both, uterine fundal tenderness, purulent or foul

amniotic fluid and elevated C-reactive protein.

AIMS

We have performed a retrospective observational cohort study

at Aneurin Bevan University Health Board (ABUHB) to look at

maternal and perinatal outcome in confirmed chorioamnionitis

on placental histology.

Moreover, to also check the CTG changes in chorioamnionitis.

METHODS

The study period included 169 cases from January 2016 to June

2021 (5 and a half years), where placental histology confirmed

chorioamnionitis.

We excluded <24 weeks so finally we

analyzed 161 cases.

We looked at maternal such as mode of delivery, intrapartum

and postpartum maternal

complications; and neonatal

outcomes, namely meconium aspiration syndrome (MAS),

admission to special care baby unit (SCBU) and HIE (Hypoxic

ischaemic encephalopathy).

The CTG features of Chorioamnionitis in our study are:

a) Persistent rise in baseline foetal heart rate of >10%

b) Loss of acceleration and cycling.

c) Reduced variability.

d) Saltatory pattern.

Discussion and Conclusion

In our study chorioamnionitis is associated with pyrexia, pre-labour

rupture of membranes, increased caesarean section and increased

admission to SCBU.

The CTG changes of chorioamnionitis in our study were similar to

existing literature on chorioamnionitis.

The CTG changes during the intrapartum period were analyzed by

two obstetricians who have reviewed each CTG.

Early recognition of CTG changes in chorioamnionitis with adequate

training in physiological interpretation of CTG in our unit and timely

intervention had resulted in better neonatal outcomes.

RCOG World Congress 2023

RETROSPECTIVE STUDY ON CONFIRMED CHORIOAMNIONITIS ON HISTOLOGY

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