Corioamnionitis histológica y morbimortalidad neonatal: Aproximación al síndrome de respuesta inflamatoria fetal

Abstract

Background: The fetal inflammatory response syndrome (FIRS) is an entity related to intrauterine inflammation which is commonly associated with intraamniotic infection. The most serious consequence is the neurologic damage and the subsequent development of cerebral palsy. Aims: To evaluate the relationship between the fetal inflammatory response syndrome and the development of neonatal complications. Method: Descriptive and retrospective study realized in "La Paz" University Hospital of Madrid, looking for an approximation to the FIRS from histologic chorioamnionitis/funisitis. Group of study constituted by 35 single preterm gestations collected during the first semester of 2008 and in which the pathologic anatomy study of the placenta and annexes showed the presence of histological corioamnionitis and/or funisitis. Results: Suspicious clinic was found in 7 cases (20%) but in 28 cases (80%) risk factors associated to FIRS were present. Perinatal mortality found was 11.4% (4 cases). Only in 2 cases (5.7%) the cause was relationated with FIRS. Pathology associated was found in 28 newborn (80%), being 17 cases (48.6%) pathology associated with the fetal inflammatory response syndrome, enhancing neonatal sepsis (40%), periventricular leukomalacia (14.3%), and bronchopulmonar dysplasia (5.7%). Conclusion: It is verified that FIRS enteals a high neonatal risk. The knowledge of this entity opens some diagnostic and therapeutic controversies. Current management protocols of preterm labor and preterm premature rupture of membranes should be revised.