Chorioamnionitis: Establishing a correlation between clinical and histological diagnosis

ABSTRACT

Introduction: Chorioamnionitis that is associated with high rates of morbidity and mortality needs an early diagnosis for effective treatment. However, views are conflicting on the effectiveness of a clinical versus a histological diagnosis of the disease. The accuracy of clinical diagnoses should be evaluated by determining their correlation with histopathological data. Methods: A total of 696 placental records from single and multiple pregnancies between January 2011 and February 2018 were collected and reviewed to determine if chorioamnionitis was present. Results: Of the 696 records, 255 had histological data available, and of these, histological evidence for chorioamnionitis was recorded in 135 (52.9%). Clinical chorioamnionitis diagnosis was insensitive (26.7%; 95% confidence interval 19.43%–34.96%) and inaccurate (61.1%; 95% confidence interval 54.90%–67.19%). As well, 73.3% of histologically positive chorioamnionitis cases were missed using clinical indicators. Discussion: Clinical diagnosis for chorioamnionitis is inaccurate; in our study, most of the positive cases were not diagnosed using clinical indicators. However, of the clinical indicators examined, maternal and fetal tachycardia were the most reliable.