Objective: The study deals with the question about the real incidence of the intrauterine infection (IUI) after PROM; the correlation between the clinical manifestation of IUI and histological findings as well as its relationships with the incidence of the neonatal infections.
Design: Prospective study.
Methods And Patients: One hundred eighty two pregnant women with premature delivery and their newborn infants were included. Clinical and laboratory signs concerning the presence of IUI were followed. A histological study of the fetal membranes, cord and placenta was done classifying the inflammatory changes according to there severity. The newborn infants were observed for signs of neonatal infection. Juxtaposition between the clinical manifestation of the IUI and the morphological signs of inflammation in the fetal membranes, cord and placenta was done.
Results: In 114 women histological signs of IUI were found but clinical signs of IUI were observed in only 51 cases (44.7%), i.e. in the other 63 cases the infection ran subclinically. An incidence of 11.5% (21 cases) of neonatal infection after PROM was registered and in 20 of them there were histological signs of intrauterine infection (in 14 cases with umbilical cord involvement--66.7%).
Conclusion: The cases with clinically manifested IUI do not reflect the real incidence of IUI--in about 34.5% of women with premature delivery infections run subclinically. There is a strong relationship between inflammatory changes in fetal membranes, cord and placenta and the neonatal infections. Among cases with severe inflammation (with fetal cord involvement) about one third of the newborn infants develop neonatal infections.
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