Chorioamnionitis: An Update on Diagnostic Evaluation

Author:

Carter Sean W. D.1ORCID,Neubronner Samantha2,Su Lin Lin12,Dashraath Pradip2,Mattar Citra12,Illanes Sebastián E.134,Choolani Mahesh A.12,Kemp Matthew W.156

Affiliation:

1. Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117597, Singapore

2. Department of Obstetrics and Gynaecology, National University Hospital, Singapore 117597, Singapore

3. Center for Biomedical Research and Innovation, Reproductive Biology Program, Universidad de los Andes, Santiago 111711, Chile

4. IMPACT, Center of Interventional Medicine for Precision and Advanced Cellular Therapy, Santiago 8331150, Chile

5. Women and Infants Research Foundation, King Edward Memorial Hospital, Perth, WA 6008, Australia

6. Center for Perinatal and Neonatal Medicine, Tohoku University Hospital, Sendai 980-8574, Japan

Abstract

Chorioamnionitis remains a major cause of preterm birth and maternal and neonatal morbidity. We reviewed the current evidence for the diagnostic tests of chorioamnionitis and how this relates to clinical practice today. A comprehensive literature search and review was conducted on chorioamnionitis and intra-uterine inflammation. Data from randomized control trials and systematic reviews were prioritized. This review highlights that sterile inflammation plays an important role in chorioamnionitis and that the current tests for chorioamnionitis including clinical criteria, maternal plasma and vaginal biomarkers lack diagnostic accuracy. Concerningly, these tests often rely on detecting an inflammatory response after damage has occurred to the fetus. Care should be taken when interpreting current investigations for the diagnosis of chorioamnionitis and how they guide obstetric/neonatal management. There is an urgent need for further validation of current diagnostic tests and the development of novel, accurate, minimally invasive tests that detect subclinical intra-uterine inflammation.

Publisher

MDPI AG

Subject

General Biochemistry, Genetics and Molecular Biology,Medicine (miscellaneous)

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