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Poster session IV Academic issues, epidemiology, global maternal-fetal public health, infectious diseases, intrapartum fetal assessment, operative obstetrics| Volume 201, ISSUE 6, SUPPLEMENT , S234, December 01, 2009

644: Longer intrapartum fever to delivery intervals are associated with higher stage chorioamnionitis

      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.
      Tabled 1Interval from First Fever and Higher Stage Chorioamnionitis
      VariablGroup 1 (n=72)Group 2 (n=82)OR (95CI)P value
      ≥Stage 2 chorio39 (54%)60 (73%)2.3 (1.2,5).014
      Funisit-is21 (29%)43 (52%)2.7 (1.4-5).003
      T max (°C)38.4±.438.5±.5-.24
      Dur labor (hrs)18±1218±9.2-.9
      Dur ROM (hrs)12±921±22-<.001
      No. vag. exams7.1 ±2.97.3 ±2.6-.77
      Int monit.45 (62%)62 (76%)-.08
      Amp - Gent45 (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.