Correlation of histologic chorioamnionitis and intra-partum leukocytosis

Abstract Background Histologic chorioamnionitis (HCA) is the most common placental lesion measuring maternal/fetal responses to intraamniotic bacterial infection. Study design We reviewed 1400 placentas referred for placental examination and explored the relationship of HCA with clinical information and with total white cells (WBC), differentials, and whether maternal admission WBC and differentials predict HCA.Results The frequency of HCA of the 1400 placentas was 38.8% (543 of 1400), and funisitis 16.9% (237 of 1400). Abnormal white blood count (total WBC >10.3) within this population was 41.1% with abnormal neutrophil differential of 39.1% and lymphopenia of 33.9%. There is an association between HCA and elevated WBC, neutrophil differentials, and preterm delivery 32 weeks or earlier. The predictive value of WBC, differentials and gestational age was 59% using ROC analysis.Conclusion Prediction of HCA using WBC and differential is suboptimal. Molecular solution to HCA is required to identify patients at risk for maternal/fetal complications.