Chorioamnionitis affects an estimated 2-4% of term deliveries and 40-70% of preterm deliveries1.
Clinically, chorionamnionitis can present with the following maternal signs and symptoms:1,2
- abdominal pain / uterine tenderness
- raised white blood cell count (> 15 000 cells/mm3)
- purulent or foul vaginal discharge
Chorioamnionitis most frequently occurs due to an ascending bacterial infection from the lower genital tract (vagina and cervix) in the setting of prolonged rupture of membranes (PROM)1. Other less common causes include introduction of an infection through invasive procedures such as amniocentesis and chorionic villus sampling1,2.
Treatment and prognosis
Immediate initiation of intrapartum broad spectrum antibiotics greatly reduces adverse maternal and fetal outcomes from chorioamnionitis1.
Differentials that may be considered in the setting of maternal fever and/or abdominal pain include:2
- epidural associated fever (in women with epidurals)
- neonatal sepsis1
- increased risk of cerebral palsy3
- 1. Czikk MJ, McCarthy FP, Murphy KE. Chorioamnionitis: from pathogenesis to treatment. Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases. 17 (9): 1304-11. doi:10.1111/j.1469-0691.2011.03574.x - Pubmed
- 2. Tita AT, Andrews WW. Diagnosis and management of clinical chorioamnionitis. Clinics in perinatology. 37 (2): 339-54. doi:10.1016/j.clp.2010.02.003 - Pubmed
- 3. Azziz R. Obstetrics and gynecology, cases, questions, and answers. McGraw-Hill Professional. (2006) ISBN:0071458204. Read it at Google Books - Find it at Amazonhttps://radiopaedia.org/articles/chorioamnionitis/edit#
- 4. Gantert M, Been JV, Gavilanes AW et-al. Chorioamnionitis: a multiorgan disease of the fetus? J Perinatol. 2010;30 Suppl : S21-30. doi:10.1038/jp.2010.96 - Pubmed citation
- 5. Baergen RN, Benirschke K(. Manual of Pathology of the Human Placenta. Springer Verlag. (2010) ISBN:1441974938. Read it at Google Books - Find it at Amazon