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Correlation between placental bacterial culture results and histological chorioamnionitis: a prospective study on 376 placentas
  1. Vanessa Queiros da Mota1,
  2. Guy Prodhom2,
  3. Pu Yan1,
  4. Patrick Hohlfheld3,
  5. Gilbert Greub2,
  6. Caroline Rouleau1
  1. 1Department of Pathology, Institute of Pathology, University of Lausanne and University Hospital Centre, Lausanne, Switzerland
  2. 2Laboratory of Clinical Bacteriology, Institute of Microbiology, University of Lausanne and University Hospital Centre, Lausanne, Switzerland
  3. 3Department of Obstetrics and Gynaecology, University of Lausanne and University Hospital Centre, Lausanne, Switzerland
  1. Correspondence to Dr Caroline Rouleau, Department of Pathology, Institute of Pathology, Lausanne University Hospital, rue du Bugnon 25, Lausanne 1011, Switzerland; r-caroline{at}hotmail.fr

Abstract

Objective To study the correlation between the bacteriological and histopathological findings in placentas from women with suspected or proven chorioamnionitis (CA).

Methods Over a 1-year period, 376 placentas were prospectively collected and processed for bacteriological and pathological studies in cases of confirmed or suspected maternal or neonatal infection.

Results Histological CA was diagnosed in 26.9% of placentas (101/376), and 27.7% (28/101) of these placentas had positive bacteriological cultures. A monomicrobial culture, mainly represented by Gram-positive cocci and Gram-negative bacilli, was identified in 27% of the positive bacterial cultures. The proportion of positive cultures was higher (p=0.03) when CA was associated with funisitis, as compared with placental samples with early CA. In placentas without histological CA, bacteriological cultures were mostly negative (230/275), although pathogenic bacteria were identified in 16.3% of them (45/275).

Conclusions The histological and bacteriological results were concordant in about 70% of the examined placentas, with 61.1% negative cases (CA absent and negative bacterial cultures), and only 7.4% placentas with positive histological and bacteriological results. Discordant results (positive histology with negative bacteriology) were obtained in placentas with early CA documented by histology although possibly in relation with antibiotic prophylaxis and the presence of fastidious bacteria. Conversely, negative histology with positive bacteriology could be explained by the presence of an early-stage bacterial infection that has not yet led to detectable microscopic lesions.

  • Placenta
  • Bacteriology
  • Infections

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