Altshuler defined grades of chorioamnionitis and related inflammation of the placenta.
Inflammatory:
(1) extraplacental inflammation (membranitis)
(2) chorioamnionitis
(3) umbilical cord funisitis (non-vessel)
(4) umbilical cord vasculitis
|
Membranitis (extraplacental inflammation) |
Grade |
|
neutrophils confined to decidua |
1 |
|
meutrophils in the chorion and the subamniotic connective tissue |
2 |
|
necrotizing inflammation in decidua, chorion and/or subamniotic connective tissue |
3 |
|
Chorioamnionitis |
Grade |
|
neutrophils confined to the placental chorionic plate |
1 |
|
neutrophils throughout the chorionic plate and the subamniotic connective tissue |
2 |
|
necrotizing chorioamnionitis |
3 |
|
multifocal chorionic abscesses |
3 |
|
Umbilical Cord Funisitis |
Grade |
|
focal inflammation |
1 |
|
diffuse inflammation |
2 |
|
necrotizing inflammation |
3 |
where:
• Necrotizing funisitis may be associated with calcifications and/or neovascular proliferation of capillaries in umbilical vessels and/or Wharton's jelly.
grade for umbilical cord vasculitis =
= (0.5 * (number of vessels showing inflammation)) + (0.5 * (number of vessels showing severe inflammation)
where:
• With 3 vessels, the maximum grade for umbilical cord vasculitis would be 3.
• If only 2 vessels are present, the score probably needs to be adjusted, with both showing severe inflammation being a Grade 3.
Specialty: Infectious Diseases, Obstetrics & Gynecology, Pedatrics
