Chorioamnionitis During Pregnancy

One in 100 pregnant women are diagnosed with chorioamnionitis, which is a serious infection of the amniotic fluid, fetal membranes and placental tissues. Chorioamnionitis is regarded as a major cause of preterm premature rupture of membranes (PPROM) and premature labor.

• Chorioamnionitis is an inflammation of the two membranes that surround the fetus: the chorion and the amnion and the maternal membranes (placental tissues)
• It is more common in mothers who give birth prematurely.
• The consequences are serious: a blood infection in the mother and a serious infection in the newborn.
• Organisms responsible for this infection include E.coli commonly found in the vagina.
• Group B strep is another possible cause.
• When the membranes rupture for an extended period of time before the onset of labor, vaginal organisms can travel upwards into the uterus and stir up an infection.

Symptoms

• In some instances chorioamnionitis manifests no symptoms, more so in the beginning.
• The first sign is an accelerated heart rate in the mother
• A fever of over 104˚F develops soon after, displaying an increased white blood count (typical in cases of infection)
• Fetus develops a rapid heartbeat signaling danger and score low on a biophysical profile (BPP)
• Foul smelling amniotic fluid if the amniotic sac ruptures
• If the sac is intact an unpleasant smelling vaginal discharge is possible
• A tender and possibly painful uterus is common

Treatment

• A wide range of microorganisms are responsible for chorioamnionitis so it becomes difficult to pinpoint the exact cause. Lab tests are necessary in suspected cases. Either the mother or the amniotic sample will be tested for infection.
• Treatment also depends on the health condition of both mother and fetus
• Throughout testing and treatment fetal monitoring is important
• Antibiotics will be started which will continue even after delivery.
  
• Prompt delivery (especially if pregnancy is near term or if the membranes have ruptured) is recommended to prevent complications and/or if either baby or mother is in danger
• If the fetus is immature, large doses of antibiotics will be administered with careful monitoring and delivery will be postponed until the fetus is mature enough
• A newborn is treated with antibiotics and sometimes scores low on the APGAR test. There are usually no long term problems.