Stillbirths and intrauterine infection, histologic chorioamnionitis and microbiological findings

• Published in: International journal of gynecology and obstetrics Vol. 54; no. 2; pp. 115 - 123
• Main Authors: Moyo, S.R., Hägerstrand, I., Nyström, L., Tswana, S.A., Blomberg, J., Bergström, S., Ljungh, Å.
• Format: Journal Article
• Language: English
• Published: Shannon Elsevier Ireland Ltd 01.08.1996; Elsevier Science
• Subjects: Biological and medical sciences; Cause of Death; Chorioamnionitis; Chorioamnionitis - epidemiology; Chorioamnionitis - microbiology; Chorioamnionitis - pathology; Developing Countries; Developing country; Diseases of mother, fetus and pregnancy; Female; Fetal Death - epidemiology; Fetal Death - etiology; Gynecology. Andrology. Obstetrics; Humans; Medical sciences; Placenta - microbiology; Placenta - pathology; Pregnancy; Pregnancy Complications, Infectious - epidemiology; Pregnancy Complications, Infectious - microbiology; Pregnancy Complications, Infectious - pathology; Pregnancy. Fetus. Placenta; Prevalence; Risk Factors; Stillbirths; Tropical medicine; Vasculitis; Zimbabwe; Zimbabwe - epidemiology; Zimbabwe; Africa; Zimbabwe; Stillbirths; Chorioamnionitis; Vasculitis; Developing country; Human; Stillborn; Pregnancy disorders; Microbiology; Developing countries; Histology; Placenta diseases; Pathology; Fetal diseases; Placenta; Analysis; Delivery disorders; Female
• ISSN: 0020-7292; 1879-3479
• DOI: 10.1016/0020-7292(96)02705-1

Objective: To analyze whether placental inflammation is associated with stillbirth in Zimbabwe. Method: Placentas from 66 stillbirths (> 22 weeks' gestation; patients with congenital malformations, diabetes or preeclampsia were excluded) and 66 term live births were studied for the presence and severity of chorioamnionitis. The morphological results were compared with earlier presented microbiological findings in the same material. Results: Chorioamnionitis was present in 79% of stillbirths and 30% of live births (O.R. 8.5, 95% C.I. 4.0–18). Nine percent of stillbirths but no live births presented vasculitis of the chorionic plate, which verified an inflammatory response from the infant (O.R. 14, 95% C.I. 2.8–72). The same types of microorganisms were isolated from stillbirths and liveborns, but Escherichia coli and group B streptococci were more frequent among stillbirths. Conclusions: Morphological chorioamnionitis occurred 2.6 times more often in women with stillbirths than in women with live births. In 9% of stillbirths the infant showed an inflammatory response. Thus the infant was alive when the infection occurred and it is therefore reasonable to assume that infection was the cause of death.