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Antenatal diagnosis of chorioamnionitis: A review of the potential role of fetal and placental imaging

Research output: Contribution to journalReview articlepeer-review

Original languageEnglish
Pages (from-to)1049-1058
Number of pages10
JournalPrenatal Diagnosis
Volume42
Issue number8
DOIs
Accepted/In press2022
PublishedJul 2022

Bibliographical note

Funding Information: This work was supported by core funding from the Wellcome/EPSRC Centre for Medical Engineering [WT203148/Z/16/Z], by the NIH Human Placenta Project grant 1U01HD087202‐01 (Placenta Imaging Project (PIP)), by the Wellcome Trust, Sir Henry Wellcome Fellowship to JH [201374/Z/16/Z], by the UKRI, FLF to JH [MR/T018119/1] and by the National Institute for Health Research (NIHR) Biomedical Research Centre based at Guy's and St Thomas' NHS Foundation Trust and King's College London. LS is funded by Health Education England/National Institute for health Research (NIHR) (NIHR Advanced Fellowship 301664). The views expressed are those of the authors and not necessarily those of the NHS, the NIHR or the Department of Health. Publisher Copyright: © 2022 The Authors. Prenatal Diagnosis published by John Wiley & Sons Ltd.

King's Authors

Abstract

Chorioamnionitis is present in up to 70% of spontaneous preterm births. It is defined as an acute inflammation of the chorion, with or without involvement of the amnion, and is evidence of a maternal immunological response to infection. A fetal inflammatory response can coexist and is diagnosed on placental histopathology postnatally. Fetal inflammatory response syndrome (FIRS) is associated with poorer fetal and neonatal outcomes. The only antenatal diagnostic test is amniocentesis which carries risks of miscarriage or preterm birth. Imaging of the fetal immune system, in particular the thymus and the spleen, and the placenta may give valuable information antenatally regarding the diagnosis of fetal inflammatory response. While ultrasound is largely limited to structural information, MRI can complement this with functional information that may provide insight into the metabolic activities of the fetal immune system and placenta. This review discusses fetal and placental imaging in pregnancies complicated by chorioamnionitis and their potential future use in achieving non-invasive antenatal diagnosis.

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