web analytics

Description

Been et al reported clinical prediction rules for the diagnosis of chorioamnionitis in preterm neonates. These can help to identify a preterm neonate who may benefit from more aggressive management. The authors are from Maastricht University, Maxima Medical Centre Veldhoven, and Erasmus MC-Sophia Children's Hospital in The Netherlands.


Patient selection: preterm neonate

 

Parameters:

(1) preeclampsia

(2) small for gestational age (SGA)

(3) clinical chorioamnionitis

(4) gestational age in weeks

(5) preterm premature rupture of the membranes (PPROM)

(6) delivery

 

Parameter

Finding

Score 1

Score 2

preeclampsia

no

3

2

 

yes

0

0

SGA

no

3

1

 

yes

0

0

chorioamnionitis

no

0

0

 

yes

2

1

gestational age

<= 28 weeks

2

NA

 

> 28 weeks

0

NA

 

<= 27 weeks

NA

1

 

> 27 weeks

NA

0

PPROM

no

0

0

 

yes

1

1

delivery

vaginal

1

NA

 

Cesarean

0

NA

 

score 1 = histologic evidence of chorioamnionitis =

= SUM(points for all 6 parameters)

 

score 2 = histologic evidence of chorioamnionitis with fetal involvement =

= SUM(points for the first 5 parameters)

 

Interpretation:

minimum for scores: 0

maximum for score 1: 12

maximum for score 2: 6

Score 1 >= 7 indicates a positive result.

Score 2 >= 4 indicates a positive result.

 

Performance:

The area under the ROC curve for score 1 was 0.95 in the derivation group and 0.81 in the validation group.

The area under the ROC curve for score 2 was 0.92 in the derivation group and 0.83 in the validation group.


To read more or access our algorithms and calculators, please log in or register.