Placental blood sampling: an aid to the diagnosis of neonatal sepsis.
OBJECTIVE
To determine the usefulness of placental blood cultures in establishment of the diagnosis of early onset sepsis.


METHODS
Babies born to mothers with suspected intraamniotic fluid infection had blood cultures obtained from a branch of the umbilical vein on the fetal surface of the placenta immediately after delivery. The babies at highest risk (n = 35) had subsequent neonatal blood cultured from a peripheral vein (group 1), whereas 26 newborns at a lower risk did not (group 2). A group of 20 term babies born after uncomplicated labor and vaginal delivery or by elective cesarean delivery served as control subjects.


RESULTS
Placental blood cultures were more often positive for pathogens in group 1 (7 of 35; 20%; 0.09 to 0.36) than in group 2 (0 of 26; 0 to 0.11) or control subjects (0 of 20; 0 to 0.14; p < 0.02). Within group 1, placental blood cultures were more often positive (7 of 35; 20%; 0.09 to 0.36) than subsequent neonatal blood cultures (1 of 35; 3%; 0 to 0.15; p < 0.05). Contaminants were cultured in 3 of 81 (4%; 01 to 0.11) placental samples (all from group 1) compared with 1 of 35 (3%; 0 to 0.11) neonatal samples (difference not significant).


CONCLUSIONS
A carefully obtained culture of placental blood may be a useful addition or substitute for neonatal blood culturing in newborns at risk for early-onset sepsis by virtue of maternal risk factors.
Herson
V C
VC
Department of Pediatrics, Connecticut Children's Medical Center, Hartford 06102, USA.
Block
C
C
McLaughlin
J C
JC
Tetreault
J
J
Eisenfeld
L I
LI
Krause
P J
PJ
D001431:Bacteriological Techniques; D002821:Chorioamnionitis / Q000175:diagnosis* / Q000382:microbiology; D005260:Female; D005312:Fetal Blood / Q000382:microbiology*; D006801:Humans; D007231:Infant, Newborn; D007235:Infant, Premature, Diseases / Q000175:diagnosis* / Q000382:microbiology; D008297:Male; D010920:Placenta / Q000098:blood supply*; D011247:Pregnancy; D018566:Pregnancy, High-Risk; D012680:Sensitivity and Specificity; D018805:Sepsis / Q000175:diagnosis* / Q000382:microbiology