HOMEPRODUCTSCOMPANYCONTACTFAQResearchDictionaryPharmaSign Up FREE or Login

The Maternal-Fetal Medicine Units cesarean registry: chorioamnionitis at term and its duration-relationship to outcomes.

AbstractOBJECTIVE:
The purpose of this study was to evaluate the relationship between chorioamnionitis and its duration to adverse maternal, fetal, and neonatal outcomes.
STUDY DESIGN:
This was a 13-university center, prospective observational study. All women at term carrying a singleton gestation who underwent primary cesarean from January 1, 1999 to December 31, 2000 were eligible. Data abstraction was systematic and performed by trained research nurses. Selected adverse outcomes were compared between pregnancies with, and without, clinically diagnosed chorioamnionitis using relative risks (RRs) and 95% CIs. The duration of chorioamnionitis was stratified into 5 intervals (<or=3 h,>3-6 h,>6-9 h,>9-12 h, and>12 h), and respective outcomes compared by Mantel-Haenszel test for trend. Additionally, regression analysis was used to compute odds ratios (ORs) and 95% CIs for chorioamnionitis duration length as a continuous explanatory variable.
RESULTS:
16,650 pregnancies were analyzed, 1965 (12%) with chorioamnionitis, which was associated with significantly increased risks of maternal blood transfusion, uterine atony, septic pelvic thrombophlebitis, and pelvic abscess (RR 2.3-3.7), as well as 5-minute Apgar <or=3, neonatal sepsis, and seizures (RR 2.1-2.8). By test of trend, only uterine atony (P <.01), maternal blood transfusion (P=.03), maternal admission to intensive care unit (P=.02), and 5-minute Apgar <or=3 (P <.01) were associated with duration of chorioamnionitis. By logistic analysis, only uterine atony (OR for each hour of chorioamnionitis 1.03, 95% CI 1.00-1.06), 5-minute Apgar <or=3 (OR 1.09, 95% CI 1.00-1.16), and neonatal mechanical ventilation within 24 hours of birth (OR 1.07, 95% CI 1.01-1.12) were significantly associated with chorioamnionitis duration.
CONCLUSION:
Chorioamnionitis was associated with increased rates of morbidity after cesarean at term. The duration of chorioamnionitis, however, was not related to most measures of adverse maternal or fetal-neonatal outcome.
AuthorsDwight J Rouse, Mark Landon, Kenneth J Leveno, Sharon Leindecker, Michael W Varner, Steve N Caritis, Mary Jo O'Sullivan, Ronald J Wapner, Paul J Meis, Menachem Miodovnik, Yoram Sorokin, Atef H Moawad, William Mabie, Deborah Conway, Steven G Gabbe, Catherine Y Spong, National Institute of Child Health And Human Development, Maternal-Fetal Medicine Units Network
JournalAmerican journal of obstetrics and gynecology (Am J Obstet Gynecol) Vol. 191 Issue 1 Pg. 211-6 (Jul 2004) ISSN: 0002-9378 [Print] United States
PMID15295368 (Publication Type: Journal Article, Multicenter Study, Research Support, U.S. Gov't, P.H.S.)
Topics
  • Adult
  • Cesarean Section (adverse effects)
  • Chorioamnionitis (complications, therapy)
  • Female
  • Humans
  • Infant, Newborn
  • Labor, Obstetric
  • Pregnancy
  • Pregnancy Outcome
  • Prospective Studies
  • Puerperal Disorders (etiology)
  • Registries
  • Time Factors
  • Treatment Outcome

Join CureHunter, for free Research Interface BASIC access!

Take advantage of free CureHunter research engine access to explore the best drug and treatment options for any disease. Find out why thousands of doctors, pharma researchers and patient activists around the world use CureHunter every day.
Realize the full power of the drug-disease research graph!


Choose Username:
Email:
Password:
Verify Password:
Enter Code Shown: