RESUMEN
OBJECTIVE: Acute inflammatory lesions in the placenta is one of the most common histopathologic lesions of women with preterm premature rupture of membrane. But there is a few scientific evidence to support the association between amniotic fluid white blood cell count and the presence and severity of acute placental inflammation in preterm premature rupture of membrane. To evaluate the relationship between amniotic fluid white blood cell count and the presence and severity of acute placental inflammatory lesions in preterm premature rupture of membrane. METHODS: The relationship between amniotic fluid white blood cell count and placental histologic finding was examined in 89 consecutive patients who were admitted with the diagnosis of preterm premature rupture of membrane and who delivered singleton gestation within 3 days. RESULTS: The prevalence of acute histologic chorioamnionitis was 68.5%(61/89) and that of positive amniotic fluid culture was 32.6%(29/89). The prevalence of positive amniotic fluid culture increased according to the higher severity of inflammation in each type of placental section(p<0.05 for each). The median amniotic fluid white blood cell count increased significantly according to the presence and higher severity of inflammation in each type of placental section(p<0.01 for each). The median amniotic fluid white blood cell count increased significantly according to the higher total grade of inflammation in placental histologic examination(p<0.01). CONCLUSION: Both the presence and higher severity of acute histologic chorioamnionitis are associated with an elevated amniotic fluid white blood cell count. The total grade of acute histologic chorioamnionitis is associated with an elevated amniotic fluid white blood cell count. Amniotic fluid white blood cell count is a reliable prenatal marker of histologic chorioamnionitis."
Asunto(s)
Femenino , Humanos , Embarazo , Líquido Amniótico , Corioamnionitis , Diagnóstico , Inflamación , Recuento de Leucocitos , Leucocitos , Membranas , Placenta , Prevalencia , RoturaRESUMEN
This study was performed to review and evaluate a series of 1,118 patients who und-erwent microsurgical reanastomosis of previously sterilized fallopian tubes in the 134-month span encompassing January, 1980 to Febrary, 1991 at Seoul National University Hospital. Clinical characteristics of patients, pregnancy rates, and factors influencing the outcome of microsurgical tubal reversal were analyzed. Of 1,118 patients, 633(56.6%) had been sterilized by laparoscopic cautery. Loss of ch- ildren was a leading reason for requesting tubal reversal. The mean interval between tubal sterilization and reversal was 51.9 months. The postoperative tubal length was 6 cm or more in 76.0%. Nine hundred and twenty-two(82.5%) patients were followed up for more than 5 years. Overall pregnancy rate after microsurgical tubal reanastomosis was 54.8%(505 /922) with delivery rate of 71.5%(418/585), and the estimated anatomical success rate was 88.2%(814/922). In 505 pregnant cases, mean age of patients was younger and postoperati- ve tubal length was longer with statistical significance compared with 417 nonpregnant cases. Pregnancy rate was significantly correlated with postoperative tubal length, but not with method and duration of sterilization or operative procedure. These data suggest that only the postoperative tubal length is a factor influencing si- gnificantly pregnancy rate after microsurgical reversal of tubal sterilization.