Abstract
Chronic chorioamnionitis is one the three major chronic inflammatory lesions of the placenta, with the involved compartment being the chorioamniotic membranes. The other two major chronic inflammatory lesions are villitis of unknown aetiology and chronic deciduitis, with the involved compartments being the villous tree and the basal decidua, respectively. These chronic inflammatory lesions are frequently seen together and are characterized by maternal cellular infiltration. While some may result from subclinical infection of an as yet identified nature, a growing body of evidence supports these lesions as resulting from maternal anti-fetal rejection. Chronic chorioamnionitis is more frequent in spontaneous preterm compared to term deliveries and is the most frequently identified placental lesion in late spontaneous preterm birth. It is also associated with unexplained fetal death. Chronic chorioamnionitis is characterized by infiltration of CD8+ cytotoxic T cells into the chorioamnionic membranes, resulting in trophoblastic injury. The maternal T lymphocytes are believed to migrate from the decidua into the chorioamnionic membranes as a result of a chemotactic gradient caused by dysregulated T cell chemokines in the amnionic fluid favouring migration of T cells.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Similar content being viewed by others
References
Kim CJ, Romero R, Kusanovic JP, Yoo W, Dong Z, Topping V, et al. The frequency, clinical significance, and pathological features of chronic chorioamnionitis: a lesion associated with spontaneous preterm birth. Mod Pathol. 2010;23:1000–11.
Gersell DJ, Phillips NJ, Beckerman K. Chronic chorioamnionitis: a clinicopathologic study of 17 cases. Int J Gynecol Pathol. 1991;10:217–29.
Jacques SM, Qureshi F. Chronic chorioamnionitis: a clinicopathologic and immunohistochemical study. Hum Pathol. 1998;29:1457–61.
Lee JH, Romero R, Xu Y, Kim J-S, Park JY, Kusanovic JP, et al. Maternal HLA panel-reactive antibodies in early gestation positively correlate with chronic chorioamnionitis: evidence in support of the chronic nature of maternal anti-fetal rejection. Am J Reprod Immunol. 2011;66:510–26.
Lee J, Kim J-S, Park JW, Park C-W, Park JS, Jun JK, et al. Chronic chorioamnionitis is the most common placental lesion in late preterm birth. Placenta. 2013;34:681–9.
Kim CJ, Romero R, Chaemsaithong P, Kim J-S. Chronic inflammation in the placenta: definition, classification, pathogenesis, and clinical significance. Am J Obstet Gynecol. 2015;213:S53–69.
Lee JH, Romero R, Xu Y, Kim J-S, Topping V, Yoo W, et al. A signature of maternal anti-fetal rejection in spontaneous preterm birth: chronic chorioamnionitis, anti-human leukocyte antigen antibodies, and C4d. PLoS One. 2011;6:e16806.
Oggé G, Romero R, Lee D-C, Gotsch F, Than NG, Lee JH, et al. Chronic chorioamnionitis displays distinct alterations of the amniotic fluid proteome. J Pathol. 2011;223:553–65.
Lee JH, Romero R, Dong Z, Xu FY, Qureshi F, Jacques S, et al. Unexplained fetal death has a biological signature of maternal anti-fetal rejection: chronic chorioamnionitis and alloimmune anti-human leucocyte antigen antibodies. Histopathology. 2011;59:928–38.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2019 Springer Nature Switzerland AG
About this chapter
Cite this chapter
Jacques, S.M., Qureshi, F. (2019). Chronic Inflammation. In: Khong, T., Mooney, E., Nikkels, P., Morgan, T., Gordijn, S. (eds) Pathology of the Placenta. Springer, Cham. https://doi.org/10.1007/978-3-319-97214-5_45
Download citation
DOI: https://doi.org/10.1007/978-3-319-97214-5_45
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-319-97213-8
Online ISBN: 978-3-319-97214-5
eBook Packages: MedicineMedicine (R0)