MATERNAL PLACENTAL VASCULOPATHY AND INFECTION IN PATIENTS WITH PRETERM DELIVERY

Abstract

Background: Premature delivery remains the most important cause of neonatal mortality and there is considerable amount of information in the literature indicating a strong association between maternal placental vasculopathy and chorioamnionitis with preterm delivery.Objective: To outline the association between maternal placental vasculopathy and chorioamnionitis with preterm labor and premature rupture of membranes.Patients & Methods: We performed a case control study conducted on 54 patients who were delivered preterm 37 patients because of preterm labor and 17 because of premature rupture of membranes, and 54 patients who were delivered at term after uncomplicated pregnancy for the period from January 2004 to July 2005. We studied the clinical information’s obtained include demographic data, gestational age, obstetric history, route of delivery, infants birth weight and placental histopathological features. All the patients were seen at Gynecology & Obstetrics department at Al-Kadhimiya Teaching Hospital in Baghdad.Results: Maternal placental vascular lesions were present in 13 (35.1%) patients with preterm labor, and six (35.3%) patients, with premature rupture of membranes while only 6 (11.1) of control patients. Histopathological features suggestive of Infection of the placenta were found in 14 (37.8%) patients with preterm delivery and 6 (35.3%) patients with premature rupture of membranes and eight (14.8%) of control patients. Conclusion: It is possible to identify two subgroups of patients among those who are delivered preterm because of preterm labor or premature rupture of membrane, one with infection of the product of conception and another with maternal placental vasculopathy.