title: Histologic chorioamnionitis at term: implications for the progress of labor and neonatal wellbeing.
abstract: OBJECTIVE
  The aim of the present study was to evaluate: i) the rate of histologic chorioamnionitis in relation to the onset of labor and mode of delivery; ii) influence of clinical parameters on the risk of histologic chorioamnionitis in laboring women; iii) neonatal outcome in relation to histologic chorioamnionitis.
  
  
  METHODS
  A cohort study was conducted on 395 healthy women at term, with singleton uneventful pregnancy, of which 195 with spontaneous onset of labor and 200 with elective cesarean section. All placentas, collected after delivery, were examined for the diagnosis of histologic chorioamnionitis. Mode of delivery, presence of bacterial infection of placenta and membranes, maternal clinical parameters and neonatal outcome were recorded.
  
  
  RESULTS
  The rate of histologic chorioamnionitis in women with spontaneous onset of labor was significantly higher than in those experiencing elective cesarean section (28.7% vs. 11.5%). Nulliparity and the duration of labor were independent variables associated with acute histologic chorioamnionitis. The presence of histologic chorioamnionitis did not affect neonatal outcome.
  
  
  CONCLUSIONS
  The present study showed a highest rate of histological chorionamniositis in women delivering after spontaneous onset of term labor, although the mode of delivery either vaginally or by emergency cesarean section was not influenced by the presence of this pathological condition.
authors.affiliation: Department of Pediatrics, Obstetrics and Reproductive Medicine, University of Siena, Italy.
authors.forename: Michela
authors.initials: M
authors.lastname: Torricelli
authors.forename: Chiara
authors.initials: C
authors.lastname: Voltolini
authors.forename: Nathalie
authors.initials: N
authors.lastname: Conti
authors.forename: Francesca Letizia
authors.initials: FL
authors.lastname: Vellucci
authors.forename: Cinzia
authors.initials: C
authors.lastname: Orlandini
authors.forename: Caterina
authors.initials: C
authors.lastname: Bocchi
authors.forename: Filiberto Maria
authors.initials: FM
authors.lastname: Severi
authors.forename: Paolo
authors.initials: P
authors.lastname: Toti
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Buonocore
authors.forename: Felice
authors.initials: F
authors.lastname: Petraglia
mesh_terms: D002821:Chorioamnionitis / Q000503:physiopathology*; D015331:Cohort Studies; D036861:Delivery, Obstetric / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007745:Labor Onset / Q000502:physiology*; D016015:Logistic Models; D011247:Pregnancy; D011256:Pregnancy Outcome