Objective: This study was performed to determine the possible relationship
between histologic chorioamnionitis and genital tract cultures and their co
ntribution to preterm delivery. Methods: The study group consisted of 45 pr
eterm and 37 term pregnancies. Cervico-vaginal cultures were obtained from
all patients at admission and placentas were histopathologically evaluated
and graded for inflammation of the chorial plate, amniochorionic membrane,
umbilical cord and villi. Inflammation scores and presence of pathogenic ba
cteria were compared between the preterm and term patients. Results: Severe
chorionic plate inflammation was present in 35.5% of 45 preterm deliveries
as compared to 5.4% of 37 term deliveries. Amniochorionic-decidual inflamm
ation was not present in 14 of the term deliveries (38%), mild (Grade 1-2)
in 20 (54%) and severe (Grade 3-4) in 3 (8%) as compared to 14 (31%), 17 (3
8%), and 14 (31%) in the preterm group, respectively (P < 0.05). Pathogenic
bacteria were isolated from the lower genital tracts of all patients who h
ad severe chorionic plate (CP) and/or chorioamnionic (CA) inflammation whil
e this was true only in 37.5% of the patients with no or only mild chorioni
c plate inflammation (P < 0.001 for CP, P < 0.01 for CA). Conclusion: Our r
esults show that pathogenic bacterial colonisation of the cervicovaginal re
gion is closely associated with placental inflammation, preterm labor and c
ervico-vaginal cultures which may be useful in determining the pregnancies
at risk for preterm labor. (C) 2001 International Federation of Gynecology
and Obstetrics. All rights reserved.