Resumen
La corioamnionitis se ha relacionados con desenlaces desfavorables en el período prenatal y neonatal (abortos, parto pretérmino, sepsis neonatal, entre otros), además de implicaciones a largo plazo en la infancia, tales como alteraciones en el coeficiente intelectual. Por esta razón es de vital importancia el diagnóstico histopatológico oportuno. En este artículo se revisará el abordaje histopatológico de la corioamnionitis, su estadificación e implicaciones clínicas.
Kim CJ, Romero R, Chaemsaithong P, Chaiyasit N, Yoon BH, Kim YM. Acute chorioamnionitis and funisitis: definition, pathologic features, and clinical significance. Am J Obstetr Gynecol. 2015;213(4):S29-S52. https://doi.org/10.1016/j.ajog.2015.08.040
Tita A. Intra-amniotic infection (clinical chorioamnionitis or triple I). UpToDate [internet]. 2019. Disponible en: https://www-uptodate-com.ezproxy.javeriana.edu.co/contents/intra-amniotic-infection-clinical-chorioamnionitis-or-triple-i?search=corioamnionitis&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1
Romero R, Chaemsaithong P, Docheva N, Korzeniewski S, Kusanovic J, Yoon B, et al. Clinical chorioamnionitis at term VI: Acute chorioamnionitis and funisitis according to the presence or absence of microorganisms and inflammation in the amniotic cavity. J Perinatal Med. 2016;44(1):33-51. https://doi.org/10.1515/jpm-2015-0119
Mendoza OE, Briceño Palomino F, Ramos Franco N, Rodríguez Guerra D, Rodríguez Niño N. Corioamnionitis. Repert Med Cir. 2013;22(4):248-56.
Redline RW. Inflammatory response in acute chorioamnionitis. Semin Fetal Neonatal Med. 2012;17(1):20-25. https://doi.org/10.1016/j.siny.2011.08.003
Mahe E, Hamid J, Terry J, Jansen JW, Bourgeois J, Arredondo-Marin J. Frozen section of placental membranes and umbilical cord: an aid to early postpartum diagnosis of intra-amniotic infection. Am J Clin Pathol. 2014;142(2):202-8. https://doi.org/10.1309/AJCPYN70DLUFFDVP
Mendoza O, Arias D, Rojas JL, Gómez J, Hernández K, Castro D, et al. Corioamnionitis en biopsia por congelación de placentas en pacientes con riesgo de infección y su relación con morbimortalidad del recién nacido. Repert Med Cir. 2014;23(2):134-8. https://doi.org/10.31260/RepertMedCir.v23.n2.2014.728
Menon R, Taylor RN, Fortunato SJ. Chorioamnionitis: a complex pathophysiologic syndrome. Placenta. 2010;31(2):113-20. https://doi.org/10.1016/j.placenta.2009.11.012
Rincón Ricote MI, Magdaleno Dans F, Sancha Naranjo M, Omeñaca Teres F, González González A. Corioamnionitis histológica y morbimortalidad neonatal: aproximación al síndrome de respuesta inflamatoria fetal. Rev Chil Obstetr Ginecol. 2010;75(3):172-8. https://doi.org/10.4067/S0717-75262010000300005
Strunk T, Doherty D, Jacques A, Simmer K, Richmond P, Kohan R, Charles A, Burgner D. Histologic chorioamnionitis is associated with reduced risk of late-onset sepsis in preterm infants. Pediatrics. 2012;129(1):e134-41. https://doi.org/10.1542/peds.2010-3493
Redline RW, Faye-Petersen O, Heller D, Qureshi F, Savell V, Vogler C. Amniotic infection syndrome: nosology and reproducibility of placental reaction patterns. Pediatr Dev Pathol. 2003;6(5):435-48. https://doi.org/10.1007/s10024-003-7070-y
Redline RW. Correlation of placental pathology with perinatal brain injury. Surg Pathol Clin. 2013;6(1):153-80. https://doi.org/10.1016/j.path.2012.11.005
Saunders-Hastings P, Crispo JAG, Sikora L, Krewski D. Effectiveness of personal protective measures in reducing pandemic influenza transmission: a systematic review and meta-analysis. Epidemics. 2017;20:1-20. https://doi.org/10.1016/j.epidem.2017.04.003
Olaya-Contreras M. Lo que las placentas dicen pero nadie quiere escuchar. Univ Méd. 2014;55(1):18-27. https://doi.org/10.11144/Javeriana.umed55-1.qpdp
Olaya-Contreras M, Vargas-Moreno W, Bernal-Villegas JE. Una aproximación desde la física a las consecuencias patológicas de la longitud excesiva del cordón umbilical. Rev Colomb Obstet Ginecol. 2015;66(1):53-60. https://doi.org/10.18597/rcog.8
Horn LC, Langner A, Stiehl P, Wittekind C, Faber R. Identification of the causes of intrauterine death during 310 consecutive autopsies. Eur J Obstet Gynecol Reproduct Biol. 2004;113(2):134-8. https://doi.org/10.1016/S0301-2115(03)00371-3
Familari M, Nääv Å, Erlandsson L, de Iongh RU, Isaxon C, Strandberg B, et al. Exposure of trophoblast cells to fine particulate matter air pollution leads to growth inhibition, inflammation and ER stress. PLoS One. 2019;14(7):e0218799. https://doi.org/10.1371/journal.pone.0218799
Menon R, Fortunato SJ, Yu J, Milne GL, Sanchez S, Drobek CO, et al. Cigarette smoke induces oxidative stress and apoptosis in normal term fetal membranes. Placenta. 2011;32(4):317-22. https://doi.org/10.1016/j.placenta.2011.01.015
Menon R, Richardson LS, Lappas M. Fetal membrane architecture, aging and inflammation in pregnancy and parturition. Placenta. 2019;79:40-5. https://doi.org/10.1016/j.placenta.2018.11.003
PrabhuDas M, Bonney E, Caron K, Dey S, Erlebacher A, Fazleabas A, et al. Immune mechanisms at the maternal-fetal interface: perspectives and challenges. Nat Immunol. 2015;16(4):328-34. https://doi.org/10.1038/ni.3131
Nancy P, Tagliani E, Tay CS, Asp P, Levy DE, Erlebacher A. Chemokine gene silencing in decidual stromal cells limits T cell access to the maternal-fetal interface. Science (1979). 2012;336(6086):1317-21. https://doi.org/10.1126/science.1220030
Heerema-McKenney A. Defense and infection of the human placenta. APMIS. 2018;126(7):570-88. https://doi.org/10.1111/apm.12847
Arenas-Hernández M, Gómez-López N, García-Flores V, et al. Choriodecidual leukocytes display a unique gene expression signature in spontaneous labor at term. Gen Immun. 2019;20(1):56-68. https://doi.org/10.1038/s41435-017-0010-z
Gómez-López N, StLouis D, Lehr MA, Sánchez-Rodríguez EN, Arenas-Hernández M. Immune cells in term and preterm labor. Cell Mol Immunol. 2014;11(6):571-81. https://doi.org/10.1038/cmi.2014.46
Mor G, Kwon JY. Trophoblast-microbiome interaction: a new paradigm on immune regulation. Am J Obstet Gynecol. 2015;213(4):S131-7. https://doi.org/10.1016/j.ajog.2015.06.039
King AE, Kelly RW, Sallenave JM, Bocking AD, Challis JRG. Innate immune defenses in the human uterus during pregnancy. Placenta. 2007;28(11-12):1099-1106. https://doi.org/10.1016/j.placenta.2007.06.002
Presicce P, Park CW, Senthamaraikannan P, Bhattacharyya S, Jackson C, Kong F, et al. IL-1 signaling mediates intrauterine inflammation and chorio-decidua neutrophil recruitment and activation. JCI Insight. 2018;3(6). https://doi.org/10.1172/jci.insight.98306
Cappelletti M, Presicce P, Kallapur SG. Immunobiology of acute chorioamnionitis. Front Immunol. 2020;11. https://doi.org/10.3389/fimmu.2020.00649
Romero R, Espinoza J, Kusanovic JP, Gotsch F, Hassan S, Erez O, et al. The preterm parturition syndrome. BJOG: An Int J Obstet Gynaecol. 2006;113(suppl. 3):17-42. https://doi.org/10.1111/j.1471-0528.2006.01120.x
Leviton A, Allred EN, Kuban KCK, et al. Microbiologic and histologic characteristics of the extremely preterm infant’s placenta predict white matter damage and later cerebral palsy: the ELGAN study. Pediat Res. 2010;67(1):95-101. https://doi.org/10.1203/PDR.0b013e3181bf5fab
Blanc WA. Pathology of the placenta and cord in ascending and in haematogenous infection. Ciba Found Symp. 1979;(77):17-38. https://doi.org/10.1002/9780470720608.ch3
DiGiulio DB, Callahan BJ, McMurdie PJ, et al. Temporal and spatial variation of the human microbiota during pregnancy. Proc Natl Acad Sci U S A. 2015;112(35):11060-5. https://doi.org/10.1073/pnas.1502875112
López-Osma FA, Ordóñez-Sánchez SA. Premature rupture of fetal membranes: from the physiopathology to the early markers of the disease. Rev Colomb Obstet Ginecol. 2006;(57):279-90.
Steel JH, Malatos S, Kennea N, Edwards AD, Miles L, Duggan P, et al. Bacteria and inflammatory cells in fetal membranes do not always cause preterm labor. Pediatr Res. 2005;57(3):404-11. https://doi.org/10.1203/01.PDR.0000153869.96337.90
Goldenberg RL, Andrews WW, Hauth JC. Choriodecidual infection and preterm birth. Nutr Rev. 2002;60(suppl_5):S19-S25. https://doi.org/10.1301/00296640260130696
Gellin BG, Broome CV, Bibb WF, Weaver RE, Gaventa S, Mascola L. The epidemiology of listeriosis in the United States—1986. Am J Epidemiol. 1991;133(4):392-401. https://doi.org/10.1093/oxfordjournals.aje.a115893
Tabata T, Petitt M, Puerta-Guardo H, Michlmayr D, Wang C, Fang-Hoover J, et al. Zika virus targets different primary human placental cells, suggesting two routes for vertical transmission. Cell Host Microbe. 2016;20(2):155-66. https://doi.org/10.1016/j.chom.2016.07.002
Mysorekar IU, Diamond MS. Modeling zika virus infection in pregnancy. New Engl J Med. 2016;375(5):481-4. https://doi.org/10.1056/NEJMcibr1605445
Arora N, Sadovsky Y, Dermody TS, Coyne CB. Microbial vertical transmission during human pregnancy. Cell Host Microbe. 2017;21(5):561-7. https://doi.org/10.1016/j.chom.2017.04.007
Stegmann BJ, Carey JC. TORCH infections: toxoplasmosis, other (syphilis, varicella-zoster, parvovirus B19), rubella, cytomegalovirus (CMV), and herpes infections. Curr Womens Health Rep. 2002;2(4):253-8.
Sweeney EL, Dando SJ, Kallapur SG, Knox CL. The human Ureaplasma species as causative agents of chorioamnionitis. Clin Microbiol Rev. 2017;30(1):349-79. https://doi.org/10.1128/CMR.00091-16
Regan JA, Klebanoff MA, Nugent RP. The epidemiology of group B streptococcal colonization in pregnancy: Vaginal Infections and Prematurity Study Group. Obstet Gynecol. 1991;77(4):604-10.
DiGiulio DB, Romero R, Kusanovic JP, et al. Prevalence and diversity of microbes in the amniotic fluid, the fetal inflammatory response, and pregnancy outcome in women with preterm pre-labor rupture of membranes. Am J Reprod Immunol. 2010;64(1):38-57. https://doi.org/10.1111/j.1600-0897.2010.00830.x
Romero R, Miranda J, Chaiworapongsa T, Korzeniewski SJ, Chaemsaithong P, Gotsch F, et al. prevalence and clinical significance of sterile intra-amniotic inflammation in patients with preterm labor and intact membranes. Am J Reprod Immunol. 2014;72(5):458-74. https://doi.org/10.1111/aji.12296
Sperling RS, Newton E, Gibbs RS. Intraamniotic infection in low-hirth-weight infants. J Infect Dis. 1988;157(1):113-7. https://doi.org/10.1093/infdis/157.1.113
Nikiforou M, Jacobs EMR, Kemp MW, Hornef MW, Payne MS, Saito M, et al. Intra-amniotic Candida albicans infection induces mucosal injury and inflammation in the ovine fetal intestine. Sci Rep. 2016;6(1):1-9. https://doi.org/10.1038/srep29806
Benirschke K, Raphael SI. Candida albicans infection of the amniotic sac. Am J Obstet Gynecol. 1958;75(1):200-02. https://doi.org/10.1016/0002-9378(58)90572-6
Romero R, Schaudinn C, Kusanovic JP, Gorur A, Gotsch F, Webster P, et al. Detection of a microbial biofilm in intraamniotic infection. Am J Obstet Gynecol. 2008;198(1):135.e1-135.e5. https://doi.org/10.1016/j.ajog.2007.11.026
Wu YW, Colford, Jr JM. Chorioamnionitis as a risk factor for cerebral palsy. JAMA. 2000;284(11):1417. https://doi.org/10.1001/jama.284.11.1417
Been JV, Lievense S, Zimmermann LJI, Kramer BW, Wolfs TGAM. Chorioamnionitis as a risk factor for necrotizing enterocolitis: a systematic review and meta-analysis. J Pediatr. 2013;162(2). https://doi.org/10.1016/j.jpeds.2012.07.012
Khong TY, Mooney EE, Ariel I, Balmus NC, Boyd TK, Brundler MA, et al. Sampling and definitions of placental lesions: Amsterdam placental workshop group consensus statement. Arch Pathol Lab Med. 2016 Jul;140(7):698-713. https://doi.org/10.5858/arpa.2015-0225-CC
Peng CC, Chang JH, Lin HY, Cheng PJ, Su BH. Intrauterine inflammation, infection, or both (triple I): a new concept for chorioamnionitis. Pediatr Neonatol. 2018;59(3):231-7. https://doi.org/10.1016/j.pedneo.2017.09.001
Higgins RD, Saade G, Polin RA, Grobman WA, Buhimschi IA, et al.; Chorioamnionitis Workshop Participants. Evaluation and management of women and newborns with a maternal diagnosis of chorioamnionitis: summary of a workshop. Obstet Gynecol. 2016 Mar;127(3):426-436. https://doi.org/10.1097/AOG.0000000000001246
Tita ATN, Andrews WW. Diagnosis and management of clinical chorioamnionitis. Clin Perinatol. 2010;37(2):339-54. https://doi.org/10.1016/j.clp.2010.02.003
Rouse DJ, Landon M, Leveno KJ, Leindecker S, Varner MW, Caritis SN, et al.; National Institute of Child Health And Human Development, Maternal-Fetal Medicine Units Network. The maternal-fetal medicine units cesarean registry: chorioamnionitis at term and its duration-relationship to outcomes. Am J Obstet Gynecol. 2004;191(1):211-6. https://doi.org/10.1016/j.ajog.2004.03.003
Hauth JC, Gilstrap LC 3rd, Hankins GD, Connor KD. Term maternal and neonatal complications of acute chorioamnionitis. Obstet Gynecol. 1985;66(1):59-62.
Gibbs RS, Duff P. Progress in pathogenesis and management of clinical intraamniotic infection. Am J Obstet Gynecol. 1991;164(5 part 1):1317-26. https://doi.org/10.1016/0002-9378(91)90707-X
Galinsky R, Polglase GR, Hooper SB, Black MJ, Moss TJ. The consequences of chorioamnionitis: preterm birth and effects on development. J Pregnancy. 2013;2013:412831. https://doi.org/10.1155/2013/412831
Romero-Maldonado S, Ortega-Cruz M, Galván-Contreras R. Riesgo de sepsis neonatal temprana en recién nacidos de madre con corioamnionitis: estudio de casos y controles. Perinatol Reprod Hum [internet]. 2013;27(4):217-21. http://www.scielo.org.mx/scielo.php?pid=S0187-53372013000400003&script=sci_arttext

Esta obra está bajo una licencia internacional Creative Commons Atribución 4.0.
Derechos de autor 2022 Mercedes Olaya Contreras, Beatriz Elena Caicedo Marmolejo