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Chorioamnionitis

Last revised by Dr Henry Knipe on 11 Mar 2022

Chorioamnionitis refers to infection of the chorion and amnion during pregnancy.

Chorioamnionitis affects an estimated 2-4% of term deliveries and 40-70% of preterm deliveries 1.

Clinically, chorioamnionitis can present with the following maternal signs and symptoms 1,2:

  • fever
  • abdominal pain / uterine tenderness
  • raised white blood cell count (> 15 000 cells/mm3)
  • purulent or foul vaginal discharge
  • tachycardia

Chorioamnionitis most frequently occurs due to 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 the introduction of infection through invasive procedures such as amniocentesis and chorionic villus sampling 1,2.

Immediate initiation of intrapartum broad-spectrum antibiotics greatly reduces adverse maternal and fetal outcomes from chorioamnionitis 1.

Differentials that may be considered in the setting of maternal fever and/or abdominal pain include 2:

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