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Incidence of histologic chorioamnionitis in a rural community hospital

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Abstract

Background

Histological chorioamnionitis (HCA) is a pathological condition defined as an acute inflammation of the amniochorionic membranes which has been linked to a wide range of adverse neonatal events.

Aim

The purpose of this study is to identify the incidence of HCA in the rural population and evaluate whether there are significant differences in these incidences within the different clinical parameters of delivery method, gravidity, gestational age, previous cesarean section, reason for cesarean section and body mass index (BMI).

Methods

A retrospective chart review was conducted on 462 consecutive deliveries that occurred in a rural hospital during a four-year period. Data collected was analyzed using independent sample T-tests, chi-squared tests, and descriptive statistics, with a p-value of < 0.05.

Results

Overall incidence of HCA was 15.9% (73/459), with a term incidence of 16.2% (68/421) and preterm incidence of 13.2% (5/38). The incidence of HCA was significantly higher in vaginal deliveries (18.8%; n = 54/288) than C-section deliveries (11.1%; n = 19/171) (p = 0.03). Incidence of clinical chorioamnionitis was 0.43% (2/462), with 2.74% (2/73) of HCA manifesting clinically.

Conclusions

Evaluation of the incidence of HCA and associated clinical parameters in this study showed a marked decrease in the incidence of HCA when compared to other studies. Strategies to reduce the incidence of HCA include reducing the length of labor via active labor management. We hypothesize that these findings are due to the consistent use of active labor management and our rural study population, but further investigation is required to confirm this.

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Data availability

The data that support the findings of this study are available from the corresponding author Franziska Leutsch upon reasonable request.

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Authors and Affiliations

  1. Florida State University College of Medicine, Tallahassee, FL, USA

    Franziska Leutsch

  2. Obstetrics and Gynecology, Crystal River, FL, USA

    Anastasia Solovieva

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  1. Franziska Leutsch
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  2. Anastasia Solovieva
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Contributions

Franziska Leutsch and Anastasia Solovieva contributed to the study conception and design. Material preparation, data collection, analysis, and writing of the manuscript was performed by Franziska Leutsch. Franziska Leutsch and Anastasia Solovieva edited the manuscript. Franziska Leutsch and Anastasia Solovieva read and approved the final manuscript.

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Correspondence to Franziska Leutsch.

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The authors declare that no funds, grants, or other support were received in the preparation of this manuscript. The authors declare they have no financial or non-financial interests in any material discussed in this article to disclose.

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What does this study add to the clinical work?

In this paper, we identify the incidence of histologic chorioamnionitis in our rural study population. We also identify a subset that might be more at risk for chorioamnionitis and potential protective factors. This is significant because there are no current diagnostic standards in place to identify histologic chorioamnionitis before birth, despite the significant associated neonatal risk factors. Our study is also one of a kind on a rural population, compared to other histologic chorioamnionitis studies on urban populations, thus increasing the body of knowledge on histologic chorioamnionitis and making further steps towards understanding this disease and its implications.

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Leutsch, F., Solovieva, A. Incidence of histologic chorioamnionitis in a rural community hospital. Ir J Med Sci 193, 791–796 (2024). https://doi.org/10.1007/s11845-023-03505-4

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