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1339 The Value of Placental Pathological and Microbiological Aspects on Preterm Delivery and Outcome
  1. A Korraa1,
  2. Z Nabil2,
  3. N Samir3,
  4. E El Geriany1
  1. 1Pediatrics
  2. 2Microbiology, Faculty of Medicine for Girls, Al Azhar University
  3. 3Pathology, Ain Shams University, Cairo, Egypt

Abstract

Background Both clinical findings and the high incidence of decidual inflammation/infection in placentasare associated with preterm deliveries.

Objectives To find out the relation of histopathology and microbiology findings of the placenta and preterm birth and to document the association of placental changes and neonatal outcome.

Methods and results A comparative, analytical study was carried out on Placentas from 100 mothers, 50 with preterm delivery (case group), and 50 with full term delivery(control group). Pathology of the placentas and PCR to detect bacterial SrDNA were performed for the placentae and neonates. Preterm Placentas showed a significantly higher inflammatory lesions than those of full term placentas, (68% in preterm versus 4% in full term). The percentage of bacterial isolation by PCR from preterm placenta was significantly higher than full term placenta (75% vs 22%), suggesting that most of unexplained preterm delivery is inflammation and/or infection related. The study demonstrated significant association between placental and neonatal bacterialSrDNA. Our results showed that placental inflammatory lesions were significantly associated with lower gestational age, lower weight and length of preterm neonates. On follow up of the preterm neonates, the percentage of RDS, SGA, BPD and neonatal mortality rate were higher among preterm with placental inflammation/infection than those without.

Conclusion Infection of the placenta is associated strongly with histological chorioamnionitis and preterm birth Placental pathology is very useful in identifying undiagnosed subclinical maternal infection. The percentage of neonatal morbidity and neonatal mortality were higher in cases with positive placental findings for inflammation and infection.

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