Longer intrapartum fever to delivery intervals are associated with higher stage chorioamnionitis
Abstract
Objective
To determine if the time interval from first intrapartum fever until delivery was associated with higher stage histologic chorioamnionitis.
Study Design
Cohort study of 641 term singleton parturients who had the placenta submitted for pathologic examination at Strong Memorial Hospital in 2005. Subjects with both fever in labor and histologic chorioamnionitis were identified and divided into two cohorts: Group 1- Time interval from first fever until delivery ≤ 50th percentile and Group 2- Time interval > 50th percentile. Comparison was made in each group of the proportion that were stage 2 and 3 chorioamnionitis vs. stage 1 using, χ2 test. Maternal demographic and selected intrapartum data were compared.
Results
191 cases of fever in labor were identified, 37 of which were unassociated with histologic chorioamnionitis, leaving 154 subjects. The interval from first fever to delivery was ≤ 2.8 hours in Group 1 and >2.8 in Group 2. The results are given in the Table.
Interval from First Fever and Higher Stage Chorioamnionitis VariablGroup 1 (n=72)Group 2 (n=82)OR (95CI)P value ≥Stage 2 chorio 39 (54%) 60 (73%) 2.3 (1.2,5) .014 Funisit-is 21 (29%) 43 (52%) 2.7 (1.4-5) .003 T max (°C) 38.4±.4 38.5±.5 - .24 Dur labor (hrs) 18±12 18±9.2 - .9 Dur ROM (hrs) 12±9 21±22 - <.001 No. vag. exams 7.1 ±2.9 7.3 ±2.6 - .77 Int monit. 45 (62%) 62 (76%) - .08 Amp - Gent 45 (63%) 74 (90%) 5.6 (2.4-13) <.001
Conclusion
The proportion of placentas with ≥stage 2 histologic chorioamnionitis and funisitis increased with the longer time interval from first intrapartum fever.