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Poster Session 2

Category: Clinical Obstetrics

Poster Session 2

(427) Correlating placental pathology to clinically diagnosed intra-amniotic infection in PPROM

Wednesday, February 11, 2026

3:30 PM - 5:00 PM

Submitting Author and Presenting Author(s)

Anne Stoklosa, MD, MPH (she/her/hers)

Resident
University of Rochester Medical Center
Rochester, New York, United States

Coauthor(s)

MG

May Golenberg, MD

University of Rochester Medical Center
University of Rochester Medical Center, New York, United States
AM

Amber McFerren, BS

University of Rochester Medical Center
University of Rochester Medical Center, New York, United States
SC

Sarah Crimmins, DO

University of Rochester Medical Center - - Roches
University of Rochester, New York, United States
Ponnila S. Marinescu, MD

Assistant Professor, Department of Obstetrics and Gynecology
University of Rochester Medical Center
University of Rochester Medical Center, New York, United States

Objective:
Preterm prelabor rupture of membranes (PPROM) is a risk factor for the development of intra-amniotic infection (IAI). Placental histology can provide insight into the intra-uterine environment that may precede the PPROM and IAI events. There is limited evidence to suggest whether rates of clinically diagnosed IAI (cIAI) are equivalent to rates of histopathologic IAI (hIAI). The objective of this study was to correlate the clinical diagnosis of IAI with placental pathology findings.

Study Design:
Retrospective cohort study of individuals with PPROM managed at an academic medical center from 2022-2024. Available placental pathology for cases of PPROM with cIAI were compared to cases of PPROM without cIAI. Histopathologic evidence of IAI was defined by the presence of maternal or fetal acute inflammatory responses (MAIR, FAIR). Chi-square test was used to compare categorical variables.

Results:
Of 241 total PPROM cases, 81.7% (n=197) of corresponding placentas were available for review. There was clinical and histopathologic congruence (by presence of MAIR) in 81.8% of cases, reflecting sensitivity. There were 18.2% of cases with cIAI without corresponding evidence of hIAI (p=0.004). FAIR was present in 69.7% of cases of cIAI and 30.3% of cases without cIAI (p=0.001). The negative predictive values (NPV) for MAIR and FAIR were 94.3% and 93.3%, respectively. FAIR was more specific than MAIR for corresponding cIAI (63.4% vs. 45.2%). The positive predictive values for both MAIR and FAIR were low (18.2% and 22.1%).

Conclusion:
We demonstrate a high correlation between clinical and histopathologic IAI. Yet, in the absence of histologic evidence of IAI, the likelihood of a corresponding clinical diagnosis is low. This study uniquely calls attention to the interface between the clinical and in-utero manifestations of IAI. Future research is needed to understand how placental histopathology could inform antepartum clinical management.