Febi Francis, Sajini Jacob

BACKGROUND The study was conducted to find the presence of placental inflammation in preterm deliveries and to assess its severity based on histopathological staging. METHODS This prospective observational study in preterm deliveries between 25 and 34 weeks of gestational age was conducted from May 2014 to December 2015 in a tertiary care hospital in South India. Placentas were collected during the delivery and histopathological examination was done to check acute placental inflammation. The inflammatory findings in the placental parenchyma and/or membranes were classified as maternal inflammatory response (MIR). The inflammatory findings in the umbilical cord sections were classified as foetal inflammatory response (FIR). As per the layers involved and severity of inflammation, the MIR and FIR were further divided into 3 stages and 2 grades. Based on presence/absence of placental inflammation, study cohort was grouped into two groups. The maternal and neonatal characteristics were compared between the two groups. RESULTS Among the 120-placentae studied, 39% (47/120) showed placental inflammation. The placental MIR was present in all forty seven placentas but foetal inflammatory response (FIR) was present only in 19% (23/120). Further staging and grading were done for all placentas with MIR or FIR. So, there were 47 cases in placental inflammation group and 73 cases in no placental inflammation group. The maternal and neonatal characteristics were compared between the two groups. The premature rupture of the membranes and the spontaneous onset of the labour were significantly higher in group with placental inflammation. CONCLUSIONS Acute placental inflammation was associated with preterm deliveries and significantly higher in preterms with premature rupture of membranes and spontaneous onset of labour.