Chorioamnionitis in pregnancy: a comparative study of HIV-positive and HIV-negative parturients

Ocheke, Amaka N; Agaba, Patricia A; Imade, Godwin; Silas, Olugbenga A.; Ajetunmobi, Olanrewaju I; Echejoh, GO; Ekere, Clement; Sendht, Ayuba; Bitrus, James; Agaba, Emmanuel I; Sagay, Atiene S.

doi:10.1177/0956462415580887

Cited by 6 publications

(4 citation statements)

References 27 publications

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“…Both the inclusion of pre-term deliveries and the more comprehensive microscopic examination would be expected to show a higher prevalence of ACA and thus this might explain why our study showed such, when compared to the previous Ugandan cohort study. Indeed, a recent study that utilized similar diagnostic criteria to ours documented a similarly high prevalence of histologic ACA in both HIV infected (61.6%) and HIV uninfected (57.1%) Nigerian women [24].…”

Section: Discussionmentioning

confidence: 71%

The prevalence of histologic acute chorioamnionitis among HIV infected pregnant women in Uganda and its association with adverse birth outcomes

et al. 2019

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Background Preterm birth (PTB) is a leading cause of neonatal mortality and longer-term morbidity. Acute chorioamnionitis (ACA) is a common cause of PTB, however, there are limited data on the prevalence of ACA and its association with PTB in resource limited settings. Methods Data and samples came from a clinical trial evaluating novel strategies for the prevention of malaria in HIV infected pregnant women in Uganda. Women were enrolled between 12–28 weeks of gestation and followed through delivery. For each placenta delivered, three placental tissue types (membrane roll, umbilical cord and chorionic plate/villous parenchyma) were collected. Slides were assessed for diagnosis of maternal and fetal ACA by microscopic evaluation of neutrophilic infiltration using a standardized grading scale. The primary outcomes were PTB (<37 weeks), low birth weight (LBW, <2500 grams), and small-for-gestational age (SGA, birth weight <10 th percentile for age). Univariate and multivariate logistic regression were used to estimate associations between 1) maternal characteristics (age, education, wealth, gravidity, gestational age at enrollment, placental malaria, anti-malarial prophylaxis treatment regimen, HIV disease parameters) and ACA, and 2) associations between ACA and adverse birth outcomes. Findings A total of 193 placentas were included in the analysis. The prevalence of maternal and fetal ACA was 44.5% and 28.0%, respectively. HIV infected women between 28–43 years of age had a higher risk of maternal ACA compared to those between 17–21 years of age (50.9% vs. 19.1%; aOR = 4.00 (1.10–14.5), p = 0.04) and the diagnosis of severe maternal ACA was associated with a significantly higher risk of PTB (28.6% vs. 6.0%; aOR = 6.04 (1.87–19.5), p = 0.003), LBW (33.3% vs. 9.4%; aOR = 4.86 (1.65–14.3); p = 0.004), and SGA (28.6% vs. 10.1%; aOR = 3.70 (1.20–11.4), p = 0.02). No maternal characteristics were significantly associated with fetal ACA and the diagnosis of fetal ACA was not associated with adverse birth outcomes. Conclusions Histological evidence of severe maternal ACA was associated with an increased risk of PTB, LBW, and SGA in HIV infected, pregnant Ugandan women.

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Section: Discussionmentioning

confidence: 71%

The prevalence of histologic acute chorioamnionitis among HIV infected pregnant women in Uganda and its association with adverse birth outcomes

et al. 2019

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“…Details of the study have been previously published 11 . This cross-sectional study was carried out at the delivery suite of the Jos University Teaching Hospital (JUTH), Plateau State Specialist Hospital, Bingham University Teaching Hospital and Faith Alive Hospital, all in Jos.…”

Section: Study Area and Designmentioning

confidence: 99%

An Audit of Perineal Trauma and Vertical Transmisson Of HIV

Ocheke

Samuels

Ocheke

et al. 2017

Afr J Reprod Health

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Restrictive episiotomy is recommended for the prevention of vertical transmission of HIV. The study compared the frequency of episiotomy use and the occurrence of perineal tears; and related factors in HIV positive and HIV negative women and to assess their effect on Mother-to-child transmission (MTCT) of HIV. A total of 110 HIV positive and 134 HIV negative parturients were enrolled in the study. The incidence of episiotomy was more in the HIV negative group (p=0.0000) while that of perineal tear was not affected by HIV status (p=0.17). The rate of episiotomy was significantly affected by primigravidity in HIV negative subjects (OR= 0.032, 95% CI 0.0072-0.13). The rate of perineal tear was significantly affected by primigravidity in HIV positive subjects (OR=8.55, 95% CI 1.91-38.7) and multigravidity in HIV negative subjects (OR= 0.030, 95% CI 0.133-0.71). Gestational age and mean birth weight had no effect on the rate of episiotomy (p value =0.57 and 0.30) and perineal tear (p value= 0.79 and 0.061). There was no mother-to-child HIV transmission. Episiotomies should be given when needed irrespective of HIV status because of the risk of consequent perineal tear and with HAART the risk of MTCT from perineal trauma is minimal. RésuméL'épisiotomie restrictive est recommandée pour la prévention de la transmission verticale du VIH. L'étude a comparé la fréquence d'utilisation de l'épisiotomie et l'apparition de larmes périnéales; et les facteurs connexes chez les femmes séropositives et séronégatives et pour évaluer leur effet sur la transmission de la mère à l'enfant (TME) du VIH. Au total, 110 parturientes séropositives et 134 parturientes séronégatives ont été incluses dans l'étude. L'incidence de l'épisiotomie était plus élevée dans le groupe séronégatif (p = 0,0000), alors que celle de la déchirure périnéale n'était pas affectée par le statut VIH (p = 0,17). Le taux d'épisiotomie était significativement affecté par la primigravité chez les sujets séronégatifs (OR = 0,032, IC 95% 0,0072-0,13). Le taux de déchirure périnéale était significativement affecté par la primigravité chez les sujets séropositifs (OR = 8,55, IC 95% 1,91-38,7) et la multigravidité chez les sujets seronégatifs (OR = 0,030, IC à 95% 0,71). L'âge gestationnel et le poids moyen à la naissance n'ont eu aucun effet sur le taux d'épisiotomie (valeur p = 0,57 et 0,30) et sur la déchirure périnéale (valeur p = 0,79 et 0,061). Il n'y avait pas de transmission du VIH de la mère à l'enfant. Des épisiotomies doivent être administrées au besoin, quel que soit l'état sérologique en raison du risque de déchirure périnéale qui en résulte et, en cas de multithérapie antirétrovirale, le risque de la TME dû à un traumatisme périnéal est minime. (Afr J Reprod Health 2017; 21[4]: 67-72).

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“…infection of fetal membranes and amniotic fluid) is commonly observed in pregnant women with PPROM and may cause neonatal sepsis, preterm birth, pulmonary diseases, and neonatal brain injury. Therefore, early diagnosis of chorioamnionitis is very important (18,19). PCT is a peptide precursor of the calcitonin hormone, which is typically produced by monocytes and hepatocytes (20).…”

Section: Discussionmentioning

confidence: 99%

Predictive Value of Maternal Serum Level of Procalcitonin in Diagnosing Chorioamnionitis in Mothers with Preterm Premature Rupture of Membrane (PROM)

Seivani

Broumand

Naji

2017

IMMINV

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Background: Premature rupture of membrane (PROM) is the rupture of fetal membranes at least 1 hour before the onset of labor pain. In this study, we sought to determine the predictive value of maternal serum level of procalcitonin (PCT) in the early diagnosis of chorioamnionitis in women with preterm PROM (PPROM). Methods: In this prospective cohort study, owing to limited financial resources, 48 patients with PPROM in the Kosar Ward of Motahari Hospital in Urmia, Iran were selected to comprise the sample. Inclusion criteria were amniotic fluid leak, positive ferning and nitrazine tests, gestational age 28-33 weeks, and lack of fetal tachycardia. Exclusion criteria were chronic and congenital heart disease and use of non-steroidal antiinflammatory drugs. Data were analyzed using SPSS v. 19 software; descriptive statistics, independent t-tests, and the Pearson test were also performed. Results: We studied 48 pregnant women and their neonates. Approximately 40% of women had chorioamnionitis; approximately 60% of women did not have chorioamnionitis. Moreover, approximately 69% of the neonates had a 5-minute Apgar score ≥7. A significant correlation was observed between women who had histopathology confirmed chorioamnionitis and neonate hospitalization in the neonatal intensive care unit (P<0.001). The sensitivity, specificity, and positive and negative predictive values of PCT inflammatory indices were 100%, 79%, 57.5%, and 100%, respectively, for the histopathologic diagnosis of chorioamnionitis. Conclusion: In pregnant women, we found a significant correlation between PCT index at delivery and histopathologic chorioamnionitis.

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Chorioamnionitis in pregnancy: a comparative study of HIV-positive and HIV-negative parturients

Cited by 6 publications

References 27 publications

The prevalence of histologic acute chorioamnionitis among HIV infected pregnant women in Uganda and its association with adverse birth outcomes

The prevalence of histologic acute chorioamnionitis among HIV infected pregnant women in Uganda and its association with adverse birth outcomes

An Audit of Perineal Trauma and Vertical Transmisson Of HIV

Predictive Value of Maternal Serum Level of Procalcitonin in Diagnosing Chorioamnionitis in Mothers with Preterm Premature Rupture of Membrane (PROM)

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