title: Frozen section of placental membranes and umbilical cord: an aid to early postpartum diagnosis of intra-amniotic infection.
abstract: OBJECTIVE
  We devised a rapid frozen section (FS) assessment technique of placental tissues and performed the first rigorous assessment of FS relative to conventional workup.
  
  
  METHODS
  We evaluated 49 placentas with clinical/gross suspicion of intra-amniotic infection by FS. Relative to formalin-fixed and paraffin-embedded tissues, we compared the grading, staging, and interobserver variability.
  
  
  RESULTS
  FS assessment demonstrated a sensitivity of 0.91 (95% CI, 0.77-0.97) and a specificity of 0.60 (95% CI, 0.36-0.80) for the presence of chorioamnionitis and a sensitivity of 0.89 (95% CI, 0.75-0.96) and a specificity of 0.69 (95% CI, 0.42-0.87) for the presence of funisitis. The χ2 goodness of fit for grade and stage in both placental membrane and umbilical cord sections was significant (P<.001). There was no significant difference in interobserver variability in comparison with permanent section results (P=0.06).
  
  
  CONCLUSIONS
  We conclude that FS is a reasonably sensitive screening technique, correlating well with conventional assessment, without significantly different interobserver variability.
authors.affiliation: From the Department of Pathology & Laboratory Medicine, University of Calgary, Calgary, Canada; and Etienne.mahe@medportal.ca.
authors.forename: Etienne
authors.initials: E
authors.lastname: Mahe
authors.affiliation: Department of Pathology & Laboratory Medicine, McMaster University, Hamilton, Canada.
authors.forename: Jemila
authors.initials: J
authors.lastname: Hamid
authors.affiliation: Department of Pathology & Laboratory Medicine, McMaster University, Hamilton, Canada.
authors.forename: Jefferson
authors.initials: J
authors.lastname: Terry
authors.affiliation: Department of Pathology & Laboratory Medicine, McMaster University, Hamilton, Canada.
authors.forename: Jan Willem
authors.initials: JW
authors.lastname: Jansen
authors.affiliation: Department of Pathology & Laboratory Medicine, McMaster University, Hamilton, Canada.
authors.forename: Jacquie
authors.initials: J
authors.lastname: Bourgeois
authors.affiliation: Department of Pathology & Laboratory Medicine, McMaster University, Hamilton, Canada.
authors.forename: Jorge
authors.initials: J
authors.lastname: Arredondo-Marin
mesh_terms: D000653:Amniotic Fluid / Q000378:metabolism / Q000382:microbiology*; D002821:Chorioamnionitis / Q000175:diagnosis* / Q000473:pathology; D005260:Female; D005312:Fetal Blood / Q000378:metabolism; D005629:Frozen Sections; D006801:Humans; D007239:Infections / Q000175:diagnosis* / Q000473:pathology; D010920:Placenta / Q000473:pathology*; D049590:Postpartum Period; D011247:Pregnancy; D014470:Umbilical Cord / Q000378:metabolism*
keywords: Chorioamnionitis; Frozen section; Funisitis; Intra-amniotic infection; Maternal and fetal inflammatory response; Placenta