Preterm labor and preterm premature rupture of membranes have a different pattern in the involved compartments of acute histologoic chorioamnionitis and/or funisitis: Patho-physiologic implication related to different clinical manifestations
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- 作者：Chan-Wook Park ; Joong Shin Park ; Kyung Chul Moon ; Jong Kwan Jun and Bo Hyun Yoon
- 刊名：Pathology International
- 出版年：2016
- 出版时间：June 2016
- 年：2016
- 卷：66
- 期：6
- 页码：325-332
- 全文大小：1645K
- ISSN：1440-1827
文摘
It is unknown whether histo-topographic findings about the involved compartments (i.e., choriodecidua, amnion, chorionic-plate) of acute-histologic chorioamnionitis (acute-HCA) and/or funisitis according to the presence or absence of intra-amniotic inflammation (IAI) and/or fetal inflammatory response syndrome (FIRS) are different between preterm labor and intact membranes (PTL) and preterm premature rupture of membranes (preterm-PROM). The involved compartments of acute-HCA and/or funisitis were examined in 161 singleton preterm-births (<34 weeks) due to PTL (n = 88) and preterm-PROM (n = 73). The study-population was divided into IAI(−)/FIRS(−), IAI(+)/FIRS(−), and IAI(+)/FIRS(+) groups according to the presence or absence of IAI (amniotic-fluid MMP-8 ≥ 23 ng/ml) and/or FIRS (umbilical-cord plasma CRP ≥ 200 ng/ml). Histological inflammation was not detected in any-compartment except choriodecidua in IAI(−)/FIRS(−) group with PTL while inflammation appeared in all-compartment0s (choriodeciduitis-46.2 %; amnionitis-23.1 %; funisitis-30.8 %; chorionic-plate inflammation-7.7 %) in IAI(−)/FIRS(−) group with preterm-PROM. IAI(+)/FIRS(−) group had a significantly higher frequency of inflammation in each-compartment than IAI(−)/FIRS(−) group in PTL (each-for P < 0.01), but not preterm-PROM (each-for P > 0.1). However, IAI(+)/FIRS(+) group had a significantly higher rate of inflammation in each compartment than IAI(+)/FIRS(−) group in both PTL and preterm-PROM (each-for P < 0.05). We first demonstrated that PTL and preterm-PROM had a different pattern in the involved compartments of acute-HCA and/or funisitis in the IAI(−)/FIRS(−-) group and in the change of involved compartments from IAI(−)/FIRS(−) to IAI(+)/FIRS(−)