Fetal heart rate monitoring as a predictor of histopathologic chorioamnionitis in the third trimester.
Chorioamnionitis (CAM) has been recognized as a common cause of neonatal morbidity and mortality. The effect of CAM on fetal heart rate (FHR) remains unclear. The purpose of this descriptive retrospective study was to evaluate the clinical significance of the FHR pattern in cases that involved delivery during the third trimester and the diagnosis of histopathological CAM. The study group consisted of 65 singleton live births delivered at 28 to 41 weeks gestation from January 2003 through December 2005 in which histopathological CAM was diagnosed at the Nippon Medical School Tama Nagayama Hospital. We reviewed the cases using medical records and examined FHR data and the severity of histopathological CAM. The rate of tachycardia according to the severity of CAM was as follows: 3.0% (1 of 33 cases) in intervillositis, 12.5% (3 of 24 cases) in chorionitis, 37.5% (3 of 8 cases) in CAM (in a narrow sense); however, this tendency had no statistical significance. Baseline variability and decelerations were not correlated with the severity of histopathological CAM. Maternal fever exceeded 38.0 degrees C in only 3 cases, and 1 fetus had exhibited an abnormal FHR pattern. The present study suggests that FHR monitoring is not a reliable means of diagnosing histopathological CAM, because the FHR pattern was normal in most cases of histopathological CAM.
Miyake
Hidehiko
H
Department of Female Reproductive and Developmental Medicine, Nippon Medical School, Graduate School of Medicine, Japan. hidehiko@pluto.dti.ne.jp
Nakai
Akihito
A
Takeshita
Toshiyuki
T
D000328:Adult; D002821:Chorioamnionitis / Q000175:diagnosis*; D005260:Female; D005323:Fetal Monitoring / Q000379:methods*; D006340:Heart Rate, Fetal / Q000502:physiology*; D006801:Humans; D011247:Pregnancy; D011263:Pregnancy Trimester, Third