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Revista Brasileira de Ginecologia e Obstetrícia. 2012;34(4):153-157
DOI 10.1590/S0100-72032012000400003
PURPOSE: To evaluate the influence of maternal complications, prematurity, fetal anthropometric parameters and conditions of the newborn on different degrees of chorioamnionitis. METHODS: We analyzed 90 placentas from deliveries performed at the General Hospital of Triângulo Mineiro Federal University with a diagnosis of inflammation in the anatomopathological exams. We reviewed the medical records to obtain relevant maternal and fetal information. The infections were classified as grade I - deciduitis; grade II - chorioamnionitis; grade III - chorioamnionitis and vasculitis; grade IV - neonatal sepsis and grade V - fetal death and pneumonitis. RESULTS: Among the pregnant women analyzed, 50.0% had no complications, 15.0% had ruptured membranes, 15.0% urinary tract infection, 7.5% hypertensive disorders, 7.5% transvaginal infection, 5.0% hematogenous infection, and 11.1% other complications. More than a half the neonates were males and 72.2% were born at term. Analysis of the degree of chorioamnionitis showed that 56.7% had grade I, 22.2% grade II, 4.4% grade III, 10.0% grade IV, and 6.7% grade V. Data were analyzed statistically by the Χ2 test for qualitative variables and by the Spearman test for correlation analysis. The higher grades of chorioamnionitis were observed in cases of maternal complications. We observed negative correlations between all parameters and the degree of fetal chorioamnionitis, which were significant regarding weight, length, thoracic circumference and Apgar score in the first and fifth minutes. CONCLUSIONS: The different patterns of chorioamnionitis were related to different maternal and fetal clinical features, affecting the life conditions of the newborn and the severity of morphological lesions found in stillbirths.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2012;34(4):153-157
DOI 10.1590/S0100-72032012000400003
PURPOSE: To evaluate the influence of maternal complications, prematurity, fetal anthropometric parameters and conditions of the newborn on different degrees of chorioamnionitis. METHODS: We analyzed 90 placentas from deliveries performed at the General Hospital of Triângulo Mineiro Federal University with a diagnosis of inflammation in the anatomopathological exams. We reviewed the medical records to obtain relevant maternal and fetal information. The infections were classified as grade I - deciduitis; grade II - chorioamnionitis; grade III - chorioamnionitis and vasculitis; grade IV - neonatal sepsis and grade V - fetal death and pneumonitis. RESULTS: Among the pregnant women analyzed, 50.0% had no complications, 15.0% had ruptured membranes, 15.0% urinary tract infection, 7.5% hypertensive disorders, 7.5% transvaginal infection, 5.0% hematogenous infection, and 11.1% other complications. More than a half the neonates were males and 72.2% were born at term. Analysis of the degree of chorioamnionitis showed that 56.7% had grade I, 22.2% grade II, 4.4% grade III, 10.0% grade IV, and 6.7% grade V. Data were analyzed statistically by the Χ2 test for qualitative variables and by the Spearman test for correlation analysis. The higher grades of chorioamnionitis were observed in cases of maternal complications. We observed negative correlations between all parameters and the degree of fetal chorioamnionitis, which were significant regarding weight, length, thoracic circumference and Apgar score in the first and fifth minutes. CONCLUSIONS: The different patterns of chorioamnionitis were related to different maternal and fetal clinical features, affecting the life conditions of the newborn and the severity of morphological lesions found in stillbirths.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2014;36(1):23-28
DOI 10.1590/S0100-72032014000100006
To evaluate changes in body and internal organ weight of autopsied children in the perinatal period and their relationship with the cause of death.
One hundred and fifty three cases of perinatal autopsies performed at a university hospital in Southeastern Brazil ere included. Information about cause of perinatal death, date of autopsy, gestational age, perinatal weight and organ weight was obtained from the autopsy protocols and medical records of the mother and/or the newborn. Four groups of causes of death were defined: congenital malformations, perinatal hypoxia/anoxia, ascending infection and hyaline membrane. Brain, liver, lungs, heart, spleen, thymus and adrenals were analyzed.
The weight of children with perinatal hypoxia/anoxi (1,834.6±1,090.1 g versus 1,488 g), hyaline membranes (1,607.2±820.1 g versus 1,125 g) and ascending infection (1,567.4±1,018.9 g versus 1,230 g) was higher than expected for the population. Lung weight was higher in cases with ascending infection (36.6±22.6 g versus 11 g) and lower in cases with congenital malformations (22.0±9.5 g versus 40 g). Spleen weight was higher in children with ascending infection (8.6±8.9 g versus 3.75 g ) and adrenal weight was lower in cases with congenital malformations (3.9±2.1 g versus 5.5 g). Thymus weight was lower in cases with miscellaneous causes (3.7±1.2 g versus 7.5 g) and spleen weight was lower in patients with lung immaturity (0.4±0.1 g versus 1.7 g). All results showed significant differences.
This study demonstrates that variations in the weight of children and the weight of their organs are related to the types of cause of perinatal death. These data may contribute to a better interpretation of autopsy findings and their anatomical and clinical relationship.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2014;36(1):23-28
DOI 10.1590/S0100-72032014000100006
To evaluate changes in body and internal organ weight of autopsied children in the perinatal period and their relationship with the cause of death.
One hundred and fifty three cases of perinatal autopsies performed at a university hospital in Southeastern Brazil ere included. Information about cause of perinatal death, date of autopsy, gestational age, perinatal weight and organ weight was obtained from the autopsy protocols and medical records of the mother and/or the newborn. Four groups of causes of death were defined: congenital malformations, perinatal hypoxia/anoxia, ascending infection and hyaline membrane. Brain, liver, lungs, heart, spleen, thymus and adrenals were analyzed.
The weight of children with perinatal hypoxia/anoxi (1,834.6±1,090.1 g versus 1,488 g), hyaline membranes (1,607.2±820.1 g versus 1,125 g) and ascending infection (1,567.4±1,018.9 g versus 1,230 g) was higher than expected for the population. Lung weight was higher in cases with ascending infection (36.6±22.6 g versus 11 g) and lower in cases with congenital malformations (22.0±9.5 g versus 40 g). Spleen weight was higher in children with ascending infection (8.6±8.9 g versus 3.75 g ) and adrenal weight was lower in cases with congenital malformations (3.9±2.1 g versus 5.5 g). Thymus weight was lower in cases with miscellaneous causes (3.7±1.2 g versus 7.5 g) and spleen weight was lower in patients with lung immaturity (0.4±0.1 g versus 1.7 g). All results showed significant differences.
This study demonstrates that variations in the weight of children and the weight of their organs are related to the types of cause of perinatal death. These data may contribute to a better interpretation of autopsy findings and their anatomical and clinical relationship.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2004;26(10):807-812
DOI 10.1590/S0100-72032004001000008
PURPOSE: placental villitis has been correlated with perinatal infection, although a percentage of cases remains etiologically unknown. The present study was aimed at the systematic morphological study of placentas for imunohistochemical characterization of villitis and assessment of its possible correlation with maternal and fetal outcome. METHODS: a hundred and twenty-eight placentas were studied. Gross examination was performed and all collected fragments were analyzed microscopically by the hematoxylin-eosin method. Villits was classified according to the inflammatory degree in to mild, moderate and severe. The immunohistochemical study to identify infectious agents was performed using monoclonal antibodies against Toxoplasma gondii and Cytomegalovirus. For inflammatory cell phenotype identification monoclonal antibodies against CD68, CD57, CD3, and CD20 were used. Statistical analysis was performed with the variables: maternal age and fetal gestational age, fetal and placental weight, and fetal and maternal outcomes. To compare the two groups we used the Mann-Whitney test and for proportions we used the chi2 test. The differences in the mean values between the treatment groups were considered statistically significant when p<0.05 (5%). RESULTS: villitis was identified in 11.7% of the cases. In 40% of the cases the children were stillborn (p=0.003). One case showed positive staining for toxoplasmosis while the remaining cases were negative. Imunohistochemical staining showed CD68+ cells, PanT+ cells and negative CD57 and PanB cells. CONCLUSION: we concluded that the intensity of the inflammatory process in the placenta was correlated with the severity of the fetal disease. The inflammatory cells in the villitis focus were macrophages; however, we could not identify infectious agents correlated with the villitis.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2004;26(10):807-812
DOI 10.1590/S0100-72032004001000008
PURPOSE: placental villitis has been correlated with perinatal infection, although a percentage of cases remains etiologically unknown. The present study was aimed at the systematic morphological study of placentas for imunohistochemical characterization of villitis and assessment of its possible correlation with maternal and fetal outcome. METHODS: a hundred and twenty-eight placentas were studied. Gross examination was performed and all collected fragments were analyzed microscopically by the hematoxylin-eosin method. Villits was classified according to the inflammatory degree in to mild, moderate and severe. The immunohistochemical study to identify infectious agents was performed using monoclonal antibodies against Toxoplasma gondii and Cytomegalovirus. For inflammatory cell phenotype identification monoclonal antibodies against CD68, CD57, CD3, and CD20 were used. Statistical analysis was performed with the variables: maternal age and fetal gestational age, fetal and placental weight, and fetal and maternal outcomes. To compare the two groups we used the Mann-Whitney test and for proportions we used the chi2 test. The differences in the mean values between the treatment groups were considered statistically significant when p<0.05 (5%). RESULTS: villitis was identified in 11.7% of the cases. In 40% of the cases the children were stillborn (p=0.003). One case showed positive staining for toxoplasmosis while the remaining cases were negative. Imunohistochemical staining showed CD68+ cells, PanT+ cells and negative CD57 and PanB cells. CONCLUSION: we concluded that the intensity of the inflammatory process in the placenta was correlated with the severity of the fetal disease. The inflammatory cells in the villitis focus were macrophages; however, we could not identify infectious agents correlated with the villitis.
