title: Funisitis is more common in cervical insufficiency than in preterm labor and preterm premature rupture of membranes.
abstract: OBJECTIVE
  To compare the frequency of histologic chorioamnionitis and funisitis among women experiencing preterm labor, preterm premature rupture of membranes (PROM) and cervical insufficiency.
  
  
  METHODS
  This retrospective cohort study included singleton pregnant women who delivered at ≤36 weeks of gestation. The patients with preterm birth were subdivided into preterm labor (n=117), preterm PROM (n=153), and cervical insufficiency (n=20). All placentas were examined for pathology, according to the criteria of Salafia with minor modification. Frequencies of histologic chorioamnionitis and funisitis were evaluated according to the causes of preterm birth.
  
  
  RESULTS
  1) Histologic chorioamnionitis was diagnosed in 48.7% (57/117) of cases with preterm labor, 47.4% (73/153) with preterm PROM, and 75.0% (15/20) with cervical insufficiency. Funisitis was detected in 11.1% (13/117) of cases with preterm labor, 15.7% (24/153) with preterm PROM, and 40.0% (8/20) with cervical insufficiency. 2) Frequency of histologic chorioamnionitis was higher in cases with cervical insufficiency compared to preterm PROM. Frequency of funisitis was higher in cases with cervical insufficiency compared to both preterm labor and preterm PROM (P<0.05). The difference in frequency of funisitis remained significant after adjustment for gestational age at delivery and cervical dilatation at diagnosis. 3) Frequency of grade 2 funisitis was higher in cases with cervical insufficiency (35.0%, 7/20) compared to both preterm labor (6.8%, 8/117) and preterm PROM (9.8%, 15/153) (P=0.001). And the difference remained significant after adjustment for gestational age at delivery and cervical dilatation at diagnosis.
  
  
  CONCLUSIONS
  The highest frequency of funisitis was observed in cervical insufficiency among cases with spontaneous preterm birth.
authors.forename: Joohee
authors.initials: J
authors.lastname: Choi
authors.forename: Jeong Woo
authors.initials: JW
authors.lastname: Park
authors.forename: Byoung Jae
authors.initials: BJ
authors.lastname: Kim
authors.forename: Ye-Jin
authors.initials: YJ
authors.lastname: Choi
authors.forename: Jong Hee
authors.initials: JH
authors.lastname: Hwang
authors.forename: Seung Mi
authors.initials: SM
authors.lastname: Lee
mesh_terms: D000293:Adolescent; D000328:Adult; D002821:Chorioamnionitis / Q000453:epidemiology* / Q000209:etiology; D015331:Cohort Studies; D005260:Female; D005322:Premature Rupture of Fetal Membranes; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D008297:Male; D007752:Obstetric Labor, Premature; D010920:Placenta / Q000473:pathology; D011247:Pregnancy; D056910:Republic of Korea / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors; D002581:Uterine Cervical Incompetence; D055815:Young Adult