title: Accuracy of signs of clinical chorioamnionitis in the term parturient.
abstract: OBJECTIVE
  Uniform histopathologic guidelines were applied to diagnose chorioamnionitis and estimate the accuracy of clinical signs in term parturients.
  
  
  METHODS
  A retrospective cohort study utilized slides from term parturient placentas with Amniotic Fluid Infection Nosology Committee guidelines as the gold standard. Sensitivity, specificity and accuracy for fever, maternal tachycardia and fetal tachycardia were calculated.
  
  
  RESULTS
  Of 641 placentas, 367 (57.3%) had histologic chorioamnionitis and 274 (42.7%) were negative. Fever had a sensitivity of 42%, specificity of 86.5% and accuracy of 61%. Fever, maternal tachycardia and fetal tachycardia had a sensitivity of 18.3%, specificity of 98.2% and accuracy of 52.4%.
  
  
  CONCLUSIONS
  Histologic chorioamnionitis, frequently asymptomatic, is a common finding in placentas examined from term parturients. Clinical signs are not accurate in the diagnosis. Adoption of uniform pathologic guidelines will facilitate research into the clinical significance of these lesions in the future.
authors.affiliation: Department of Obstetrics and Gynecology, University of Rochester School of Medicine and Dentistry, Rochester, NY, USA. wcurtin@hmc.psu.edu
authors.forename: W M
authors.initials: WM
authors.lastname: Curtin
authors.forename: P J
authors.initials: PJ
authors.lastname: Katzman
authors.forename: H
authors.initials: H
authors.lastname: Florescue
authors.forename: L A
authors.initials: LA
authors.lastname: Metlay
mesh_terms: D000328:Adult; D002821:Chorioamnionitis / Q000145:classification / Q000175:diagnosis* / Q000473:pathology*; D015331:Cohort Studies; D003937:Diagnosis, Differential; D005260:Female; D005335:Fever of Unknown Origin / Q000209:etiology; D019983:Guideline Adherence; D006785:Hospitals, University; D006801:Humans; D007231:Infant, Newborn; D009518:New York; D010920:Placenta / Q000473:pathology; D011237:Predictive Value of Tests; D011247:Pregnancy; D011263:Pregnancy Trimester, Third; D012189:Retrospective Studies; D013610:Tachycardia / Q000209:etiology